330 THE VITAMINES 



1919 (1141). The frequency of the cases was remarked upon by 

 Partsch (1142) and by Sauer (1143). The disease did not occur only 

 in the adolescent period (12 to 20 years), according to Hamel (1144) 

 and Heyer (1145), but also in men, according to Kopchen (1146) 

 and in old age, among men and women, according to Curschmann 

 (1147). 



Symptoms 



Chelmonski (1147a) describes two forms of alimentary bone 

 disease which prevailed in Poland in 1917-1918; one form was 

 accompanied by pain in the joints and brittleness of the bones; 

 the other, more like the classical osteomalacia, but in the absence 

 of pregnancy, with severe changes in the pelvis and progressive 

 paralysis of the lower extremities. As in rickets, the bone changes 

 are most prominent; without this, the diagnosis is not easy and the 

 disease is often confused with rheumatism. In women, according to 

 Croftan (1148), fractures appear chiefly in the pelvic region. The 

 condition was described by Looser (1149) in young people of both 

 sexes (17 to 20 years of age). The symptoms consist in an enlarge- 

 ment of the thyroid, fatigue on walking, pains in the knees and 

 ankles. Pain in the bones is one of the earliest symptoms. Alwens 

 (1150) observed 26 cases among women between 19 and 72 years of 

 age, 65 per cent of which occurred during and after the climacteric. 

 The weight of the patients in most cases was about 100 pounds; 

 15 cases showed curvature of the spinal column, and in 10 cases, 

 spontaneous fractures were noted. Bohme (1151) emphasized, in 

 particular, the complete analogy between rickets and osteomalacia. 

 Imhof (1152) believed that osteomalacia is frequently accompanied 

 by psychoses (dementia praecox). Gould (1153) believed in a 

 complete analogy between osteomalacia and Recklinghausen's 

 disease and noted that besides an affection of the peripheral nerves 

 in the latter, still other factors play a role ; in his opinion, the observed 

 bone lesions point to this. Cases of Recklinghausen's disease were 

 described also by Weiss (1153a) and Comby (1153b). 



Anatomy 



Pathological findings were described by Hanau (1154) and by Wild 

 (1155). The latter observed changes in the bones, similar to those 

 in rickets, namely uncalcified osteoid tissue. 



