Rickets

Rickets (Rachitis) is a disease of childhood, in which the bones do not assume their normal hardness, and are thus liable to yield unduly, with resulting deformity. In rickets there is usually thickening of the joint ends of long bones, and there is often also enlargement of the liver and spleen, and general malaise. The abnormalities resulting from the yielding condition of the bones are most obviously manifested in curvature of the bones of the legs, with resulting knock-knee, and in curvature of the spine with exaggeration of the normal curves, and often lateral rotation of the bodies of the vertebrae, again in the deformed condition of the thorax, which is known as "pigeon-breast," in the delayed closure of the fontanelles of the skull, and in the prominences of the frontal and parietal eminences which are such characteristic appearances in the rickety cranium. There is usually, moreover, enlargement of the anterior extremities of the ribs, producing the beaded condition which is readily detected on passing the hand over the lateral aspects of the chest. Rickets usually manifests itself during the second year of life, and is often associated with conditions of poverty. It appears to be undoubtedly aggravated, if it be not actually caused, by improper diet. The majority of cases of rickets occur in children brought up by hand, and in such cases cross-examination usually elicits the fact that the most unsuitable articles of diet have been supplied to the child.