An experimental investigation on rickets : two lectures delivered at the Royal College of Surgeons of England / by Edward Mellanby.

  • Mellanby, Edward, Sir, 1884-1955.
Date:
1919?]
Catalogue details

Licence: In copyright

Credit: An experimental investigation on rickets : two lectures delivered at the Royal College of Surgeons of England / by Edward Mellanby. Source: Wellcome Collection.

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    body. The absence of, or deficiency in, one element means the ineffectiveness of another. For instance, the absence of carbohydrate involves a defective oxidation of fat, and probably an inefficient protein metabolism. Similarly, it is possible to imagine an abundance of accessory food factors in the diet which may, however, be ineffective because of some wrong balance in the energy-bearing materials. The same argument applies where the metabolism varies for reasons other than diet. These few words are all the more necessary because recent work on accessory food factors has appeared too self- contained and, if persisted in, may be responsible for a period of disbelief in their existence with subsequent lack of progress in the study of a subject which is obviously of prime importance both from the academic and practical points of view. The Dietetic Problem. There is some danger in applying laboratory results to a clinical condition, more especially when the results are new and for the most part uncontrolled by clinical observation. But some remarks are necessary in this connexion, for, if experimental research can point to the real cause of a disease, then not only is the curative treatment controlled, but, what is of much greater importance in the case of rickets, it ought to be possible to indicate why rickets is widespread and to direct knowledge along preventive lines. It appears, then, from this work that the foodstuffs of an infant ought to contain a maximum amount of anti-rachitic factor. Since, further, the dietetic problem is one of balance, foodstuffs which contain no anti-rachitic factor cannot be considered as neutral, but as positively rickets-producing, for the more of them that is eaten the greater is the necessity for foods containing the factor. Since there is a limit to what a child can eat, the inference is obvious. It is probaole that bread is the worst offender, and to allow bread to form too large a part of an infant’s dietary seems to me to be courting disaster. The same statement may apply to other cereals, but this has not been worked out to any extent. Another point of importance is the type and amount of fat eaten by children. Since the above remark as to the limited amount of food a child can eat applies with even greater force to fat, it is necessary to give children the best fat from the point of view under consideration. They should there¬ fore not be given vegetable margarines or any other vegetable fat. The natural fat for a child is the fat of milk, and to give it a vegetable fat not only limits th°, amount of butter it can eat, even if procurable, but also weighs down the diet in the rachitic direction. If additional fat is given to that normally eaten, then cod-liver oil is the best.