314 THE VITAMINES 



liver oil therapy, but by changing the diet of the mother. He believed 

 that this disease was associated with a disturbance in the metabo- 

 lism of the mother. One case of osteogenesis imperfecta has been 

 described by Bookman (1040). In this instance, calcium lactate and 

 cod liver oil were used with good results, but it is not quite clear 

 which of the two was responsible for the curative effect. This child 

 progressed even better on breast-milk. Another such case was re- 

 ported by McClanahan and Willard (1041); the child was born with 

 multiple fractures. Another case was improved with cod liver oil, 

 according to Schabad (1042). 



A logical transitional stage is the rickets in breast-fed children. 

 Brade-Birks (1043) reported such a case, and in this respect, Hess 

 and Unger (1044) controlled the diet of negro women in New York 

 in a district where the children suffered markedly from rickets. 

 The diet was recognized as being very inadequate from the 

 dietetic viewpoint. 



The deficient nutrition in Europe during the war, especially in 

 the central European countries, brought with it a great increase in 

 the number of cases of rickets, according to Japha (1045). The 

 mortality in rachitic age, due to the pulmonary complications, was 

 greatly increased according to Engel (1046). Weiss (1047) reported 

 that 90 per cent of the children born in Vienna after 1917 suffered 

 from rickets, not excepting the children of well-to-do parents. The 

 disease appeared mostly among children from 1 to 4 years of age. 

 Adams and Hamilton (1048) came to the same conclusion as regards 

 Germany. Rickets in older children was described by Schlee (1049), 

 Stetter (1050) and Sauer (1050a) in Germany, and by Sutton (1051) 

 in Australia; the literature on the subject was reviewed by Frangen- 

 heim (1051a). Schlatter's disease, which consists in a separation of 

 the epiphyses of the long bones and other similar fractures, was 

 described in a 13-year old boy by W. Miiller (1052) and in a similar 

 case by Paus (1052a); these cases were regarded as late rickets. 



The effect of rickets on later life has apparently been under- 

 estimated. Apart from the possibility of permanent bone deformity, 

 as reported by Park and Rowland (1052b) and by Brusa (1052c), 

 the disease, according to Engel (1053), exerts an influence on the 

 growth of the children, perhaps on the mental development. Accord- 

 ing to Karger (1054), these children are less active and mentally 

 underdeveloped. In this connection, Leri and Beck (1055) inves- 



