33^ Vitamines and Deficiency Diseases [June-September 



IX. OSTEOMALACIA, SPASMOPHILIA, ECLAMPSIA 



Osteomalacia may be considered as a rickety condition in adults. 

 This disease affects only women in pregnancy and Puerperium. A 

 slight degree of this affection occurs so frequently that we see, in 

 von Noorden's book on the Pathology of Metabolism, an expression 

 of the view that there may be a " physiological " osteomalacia (109) 

 in pregnant women. I have already referred to an analogous affec- 

 tion in cattle, called " Stalhnangel." Antoine (iio) described typi- 

 cal osteomalacia in dogs. In this review I have occasionally pointed 

 out the frequency in the occurrence of deficiency of vitamines dur- 

 ing pregnancy and lactation. Let me remind the reader of the 

 occurrence of infantile scurvy and beriberi in breast-fed infants 

 where the Symptoms of the diseases may or may not be shown by 

 the mothers. In the latter cases the mothers possess just enough 

 Vitamine to keep them free from these diseases but there is not 

 enough vitamine in their milk to protect their infants. In the same 

 way the infantile form of pellagra can be explained and also the 

 occurrence of rickets in breast-fed babies. 



The occurrence of rickets in breast-fed infants is often con- 

 sidered an argument against the vitamine-deficiency theory of the 

 etiology of rickets. These cases occur chiefly among poor people, 

 and the food of the mothers should undergo careful inquiry. But 

 even among wealthy people a deficiency of vitamines is not impos- 

 sible in pregnancy and lactation, for the appetite in such cases is 

 very often not up to the demand considering the condition of the 

 organism. Study of the nutrition in pregnancy suggests, so far as 

 vitamines are concerned, that the quantity of these substances which 

 would suffice under ordinary physiological conditions is often in- 

 adequate in pregnancy and lactation. 



I went into this field with special interest in the mysterious eti- 

 ology of eclampsia. Every available theory of its origin was tested 

 but without the slightest success. This condition occurs in the late 

 stages of pregnancy and also in the puerperium. I wish to draw the 

 attention of the clinicians to the possibility of a deficiency of vitam- 

 ines in this condition and to suggest research in this direction. 

 We shall better understand this possibility if we compare eclampsia 

 with beriberi, especially the spastic, tetanic form. 



