EFFECTS OF INANITION ON THE BODY AS A WHOLE 109 



of the softening of the skeleton, as will be discussed later. Seibold ('27) described 

 three typical stages in the development of the disorder. 



In more recent descriptions of human rickets, Engel ('20, '20a) found that in 

 German children of 2-5 years, rickets has become increasingly prevalent since 

 191 7. Growth is much retarded in severe cases. According to data cited from 

 Baginsky by Wohlauer ('n), body length is not much affected by rickets in the 

 first year, but retardation becomes progressively evident in the second and third 

 years. The body, though dwarfed, may be well proportioned and nearly normal 

 in form; but the musculature is scanty and there is marked deformity of the 

 limbs and thorax in severe cases, resulting in a prodigious number of crippled 

 dwarfs. Looser ('20) stated that late rickets (or osteomalacia) is characterized 

 by a general inhibition of body growth, with retardation in the development of 

 the sexual organs and secondary sex characters. Well marked deformities of 

 the trunk and limbs are characteristic, as described by Jenner ('95), Comby 

 ('01), Vincent ('04), Wohlauer ('n) and others. 



In experimental rickets of animals, the reported effects on the growth of the 

 body as a whole are somewhat contradictory. Thus in puppies E. Voit ('80), 

 Miwa and Stoltzner ('98) and Quest ('06) found continued growth without 

 emaciation in rickets caused by calcium-poor meat diet, and Lipschutz ('10) 

 noted that the general growth is not much retarded in rickets caused by phos- 

 phorus deficiency. This is confirmed by the more recent experiments of 

 Mellanby ('21), with deficiency in vitamin A, etc. On the other hand, Sherman 

 and Pappenheimer ('21) and McCollum, Simmonds, Kinney, Shipley and Park 

 ('22) found growth retarded or suppressed in young rats with experimental 

 rickets. Jackson and Carleton ('23) noted that in such rats the weight appears 

 normal for body length, but that loss in body weight may be masked by increase 

 in intestinal contents. Nevertheless, in animals, as in man, rapid growth appears 

 most favorable for the development of rickets (at least during the latent period). 

 General malnutrition (total inanition) appears distinctly unfavorable to the 

 development of rickets, so that starvation, like sunlight, may even serve as 

 a preventive or healing factor (Sweet '21; Jundell '22; McCollum, Simmonds, 

 Shipley and Park '22). 



Elliot, Crichton and Orr ('22) state that during rickets in pigs the growth 

 rate appears to be retarded less in the head than in the rest of the body, so the 

 head often appears unusually large in the later stages. 



Stoeltzner ('09) and Mellanby ('21) have pointed out that rickets presents an 

 apparent exception to the "law of the minimum," since the absence of an essen- 

 tial factor in the diet may result in distortion of skeletal growth, without sup- 

 pression of growth in the body as a whole. 



Vitamin Deficiencies. — As early as 1881, Lunin found that mice are unable 

 to live long on an apparently adequate synthetic diet of proteins, fats, carbohy- 

 drates, salts and water. Since the addition of milk gave good results, he con- 

 cluded that other (unidentified) substances indispensable for nutrition must 

 be present in the milk. Similar experiments with better results were made by 

 Rohmann ('03, '08, ' 16), probably because his artificial diets were not sufficiently 

 purified. Hopkins ('06, '12) experimented upon rats with artificial purified 



