The diseases of children : a short introduction to their study / by James Frederic Goodhart.

  • Sir James Goodhart, 1st Baronet
Date:
1888
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Licence: Public Domain Mark

Credit: The diseases of children : a short introduction to their study / by James Frederic Goodhart. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    syphilitic appears to us iu our present state of knoM'- ledge not jiroveu. The apportionment of the eflects. jn'oduced severally hy rickets and s}4')hilis in this and other cases cannot as yet be determined.” Very much the same must be said of late rickets and its relation to osteo-malacia. Some cases more resemble lickets,, others osteo-malacia; hut whether the real meaning of this be that the two diseases are the same, with now one ])art of the process now another in the ascendant; or whether we have several distinct diseases which iu anatomical change resemble each other, is uncertain in our present state of knowledge. Let the obscurity that surrounds the subject stimulate the reader to invc.stigate these very interesting diseases. I ought ' to add that Dr. Judson Bury, of IManchester, has re- corded a ca.se of a female infant of eight months,* which, in the absence of any rachitic changes, in the appearances in the medulla, in the thinning and easy fracture of the bones, is not unlikely to have been an example of tiue osteo-malacia. Dr. Thomas Barlow was kind enough to show me .specimens of the bones from this case, and the aj^pearances certainly closely resembled those of the osteo-malacia of adults, whilst those of rickets were absent. Prognosis.—This must be somewhat guarded. Fractures in these cases repair readily, .so that there- is no want of activity of a sort, although it is hardly of the kind that is required. Some of these cases have lived sufficiently long to pass out of notice, a few have died from bronchitic and other complications. Treatment.—They must be treated on the same- lines as the rachitic patient, and it will he unnecessary to say more. Inasmuch as the bones fracture spon- taneously with the least force, the greatest cai'e must be taken to avoid all undue movement and exertion. Foetal Rickets.—The occurrence of true rickets at birth, or congenital rickets, is very rare. Most f “ A Case of Osteo-Malaeia in a Child : ” British i)fedical Journal^ 1884, vol. i. p. 213.
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