Clinical lectures and essays on rickets : tuberculosis, abdominal tumours and other subjects / by Sir William Jenner, bart.

  • Sir William Jenner, 1st Baronet
Date:
1985
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Licence: Public Domain Mark

Credit: Clinical lectures and essays on rickets : tuberculosis, abdominal tumours and other subjects / by Sir William Jenner, bart. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    the very small space which it occupies in English books devoted to the diseases of children, and the contradictory statements on several most important points made by the best pathologists who have bestowed attention on the disease, that determined me to examine minutely the cases of rickets which came under my care in this Hospital. I shall in the remainder of this, and in my two succeed- ing lectures, detail to you what I know, from my own ob- servation of that which seems to me to be without question the most common, the most important, and in its effects the most fatal of the diseases which exclusively affect children. Rickets is a general, or diathetic disease, manifested after it has existed a longer or shorter time, by certain lesions of the structure of the bones,—and, I say, manifested after a time, because in some cases the general disoi'der unequivo- cally jjrecedes the local changes, and before these latter occur, we can predicate that they will occur. In some books, rickets is classed among diseases of the bones. This is a mistake; rickets is no more a disease of the bones, than is typhoid fever a disease of the intestines. Rickets leads to disease of the bones in the same way that typhoid fever leads to disease of Peyer's patches; but there is a general disease preceding and accompanying the disease of the bones in the one case, as there is preceding and accompanying the disease of the intestines in the other. The change in the bones is the anatomical character of rickets. The most constant and striking anatomical lesions in rickets are:— 1. Enlargement of the ends of the long bones,—of the parts where the bone and cartilage are in contact, i.e. where the cartilage is preparing for ossification, and where ossifica- tion is advancing in the cartilagre. 2. Softening of all the bones. 3. Thickening of the flat bones, e.ff. the bones of the skull —the scapula. 4. Deformities which follow from mechanical causes act- ing on the softened bones, e.g. the deformities of the thorax, pelvis, spine, long bones. 5. Arrest of growth, not only of the bones, but of all the
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