Rickets, including osteomalacia and tetany / by Alfred F. Hess.

  • Hess, Alfred F., 1875-1933.
Date:
1930
Catalogue details

Licence: In copyright

Credit: Rickets, including osteomalacia and tetany / by Alfred F. Hess. Source: Wellcome Collection.

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    the diffusion and the' practical ap])lication ol’ our knowledge, more particularly in regard to diagnosis, still lag far behind. In gen¬ eral. physicians arc far from appreciating the wide distribution of rickets. To my mind, it is still true that many more eases arc overlooked than arc recognized. Such being the case, our hope of eradicating rickets must rest on routine prophylactic measures, on giving specific antirachitic therapy of one sort or another, without trusting to diagnosis. Whether this end will be accomplished by means of cod-liver oil, by irradiated milk or by irradiated ergosterol, will have to be determined by practical experience. The eradication of rickets may be viewed in a two-fold light either from the practical point of view, as the stamping out of clinical rickets, or from the ideal point of view of doing away with even the minor manifestations of the disorder, even such as are evident only by chemical analyses of the blood. It is difficult to look back ten years, or to transport ourselves again to the old era— the days when the importance of ultra-violet light was not appreciated or surmised. This may perhaps be accom¬ plished by picturing the conditions which came to pass in Germany, Austria and Poland toward the end of the World War, but, more especially, during the early post-war period. Throughout these countries, nutritional disorders of the bones—rickets, “hunger osteomalacia,” “war osteopathy”—developed to a degree and extent such as had never been experienced in the history of medicine. Marked deformities of the spine and of the extremities, multiple fractures and functional disabilities by the thousand, were observed throughout the land. It is sad to contemplate that this epidemic, with its attendant misery, came about while the means for its prevention and cure were close at hand. Had physicians in 1918- 1920 known of the specific value of sunlight and of artificial ultra¬ violet rays, the so-called “war osteomalacia” would never have been rampant. I lari the discovery of the power of these rays to activate food and ergosterol been made but a few years sooner, these specific agents could have been used with telling effect. What would have been easier than to have grown yeast in large quantities and to have irradiated it? An example such as this well illustrates the import¬ ance of the advances which have been made in this field during the past few years, and the implications which may be involved in regard to the health and welfare of the civilized world. The subject as a whole may be viewed in quite another light. The investigation of rickets is perhaps tin* outstanding example of the value of interweaving the basic sciences with clinical medicine and might well serve as a text to illustrate the contributions of other sciences to medicine. It is an axiom that many disorders have been elucidated only with the aid of chemistry and animal experimenta¬ tion, but the instances are few in which biology, inorganic and