320 THE VITAMINES 



The addition of carbohydrates appears, according to the prevailing 

 data, to influence the calcium metabolism favorably, although the 

 results were not constant. Reports on this subject were made by 

 Dibbelt (1099), Massaneck (1100), Tada (I.e. 1092) and Rothberg 

 (I.e. 1093). Rowland and Marriott (1101) have investigated the 

 action of sugar and cereal addition and found it favorable; but the 

 effect of large excess of carbohydrates was not investigated. 



THERAPY AND THERAPEUTIC EFFECT ON THE METABOLISM. 



The therapy of rickets with phospho-cod liver oil was introduced 

 by Kassowitz, and is still used almost in the original form. Turning 

 to the findings on the calcium metabolism, the clinical reports on the 

 therapeutic value of cod liver oil are not particularly uniform, and it 

 may be concluded that perhaps not all cod liver oils possess the same 

 therapeutic value. As to this, we have, first of all, the prolific 

 work of Schabad (1102) and his co-workers, in which the favorable 

 effect of cod liver oil is demonstrated; the value of cod liver oil 

 emulsions was also tested. In a later investigation, Schabad (1103) 

 studied the effect of the Czerny-Keller diet on rickets and found that 

 it was evidently not adequate, since the addition of cod liver oil still 

 acted favorably, whereas in a pure milk diet, the oil was unnecessary. 

 Birk (1104) likewise reported on the results of phospho-cod liver oil 

 therapy. 



It is only questionable whether in the above combination, the 

 phosphorus addition is necessary. Frank and Schloss (1105) believe 

 that between the two preparations cod liver oil and phospho-cod 

 liver oil no far-reaching differences exist; however, Schloss (1106) 

 recommended a simultaneous addition of a calcium preparation. 

 Grosser (1107) investigated the retention of organic calcium salts. 

 Pereida y Elardi (1108) did not believe in the favorable effect of the 

 calcium addition, since a physiologically sufficient amount of calcium 

 is supposed to be present in the diet. Kurt Meyer (1109) studied 

 the effect of cod liver oil therapy on the calcium balance, and obtained 

 good results. Tobler (1110) cured four cases of late rickets with 

 phospho-cod liver oil, and similar results were obtained by Ricklin 

 (1111). Phemister(1112)was of the opinion that phosphorus, as such, 

 possesses no significance in the therapy of rickets, but does stimulate 

 the formation of osteoid tissue. Phemister, Miller and Bonar 

 (1112a) believe now that phosphorus, per se, has a curative action. 



