Volume 1

The standard physician : a new and practical encyclopaedia of medicine and hygiene especially prepared for the household / edited by Sir James Crichton-Browne [and others].

Date:: 1908-1909

Credit: The standard physician : a new and practical encyclopaedia of medicine and hygiene especially prepared for the household / edited by Sir James Crichton-Browne [and others]. Source: Wellcome Collection.

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$Brain THE STANDARD ITIVSICIAN entirely removed. Chronic hij')-ioint disease and chronic lmm])back are diseases of this kind. They are types of localised bone tubercnlosis. BONE, SOFTENING OF. -A condition which occurs almost only in adults, and which is due to a loss of the lime-salts ot the bone, the disease, which is comparatively rare, affects women ]:)rincipally. It appears that it is more frecpient in southern Germany and in the Rhine Valley than in the northern parts of Germany. It is very common in certain localities in Switzerland, northern Italy, and Austria, but comparatively rare in Great Britain. The cause and nature of the softening are not thoroughly understood as yet. Among the causes which give rise to the appearance of the disease are, principally, rapidly succeeding pregnancies and long-continued nursing with insufficient nutrition. It is claimed, further, that damp and dark dwellings or bed-rooms, improjier food (too many jiotatoes ; sour, black rye- bread, etc.), and occupations which subject the patient to cold and ilam|)ness, play a ])art in the occurrence of the affection. I'he first symptom of the disease is pain in the bones invoh'ed, mostly in the pelvis. The pains radiate towards the sjiinal column and thighs, and are at first often taken to be rheumatic. .Soon, however, an uncertain, dragging, or ])eculiarly waddling gait becomes noticeable. Sitting causes ])ain, and the bones bend. Tlie spinal column, no longer alile to carry the weight of the body, curves backward, and, as a result, the patients grow shorter. When the disease has reached a more advanced stage walking becomes impossible, and the patients must remain in bed. Although the course of the disease is a slow one, it is not always unfavour- able. Cessations and even cures have been observed. It is true, however, that the danger of a recurrence and progress of the disease is connected with every new ]iregnancy. Treatment is not cpiite as hopeless as it apjiears. If unfavourable conditions of life are ])resent, they should be al)olished. Dark and damp dwellings should be exchanged for bright and airy ones, d'he diet should })referably consist of foods which are rich in phos])horus and lime, such as eggs, meat, certain vegetables (beans, peas), and cheese. Potatoes must be avoided, and food which contains sugar should be taken only in moderation, but fruit is admissible. WArm baths in the form of sheet ])acks, with or without additions (salts, brine, herbs), and sun- baths usually act very beneficiall3\ A comfortable resting-place should be ])rovided, with suitable bolsters, water-bags, etc. In addition to cod-liver oil, iron and phosjdiorus are useful medicines in this disease. Recurrence of ju'egnancies should be avoided if ]X)ssible. If the disease ])rogresses in spite of careful treatment, there remains as a last resort Castration, which has given good results. A ]:)articular tvpe of bone-softening is seen in children who suffer from Rickets. BONESET.—See ErPATORirM.$