28 OSSEOUS TISSUE. 



from a single observation by Marchand. The assumption that 

 carbonate of lime is removed from the bones, is controverted not 

 merely by the result of analyses, but also by the indifferent beha- 

 viour of decidedly rachitic bones towards blue litmus. The ash of 

 these bones occasionally yields more carbonate of lime than we 

 calculate from the direct determination of the carbonic acid in 

 the fresh bones (after being merely deprived of their fat) ; a portion 

 of the lime must therefore have been combined with some organic 

 acid, which, however, need not necessarily be lactic acid, since a 

 fatty acid or some other substance may have been combined with 

 this base. The frequent occurrence of free uric acid, lactic acid, 

 and oxalate of lime, in the urine of rachitic children, cannot be re- 

 garded as affording evidence of the existence of a so-called lactic 

 acid diathesis or dyscrasia ; we shall indeed have occasion to 

 ;how that the osteomalacia of adults presents more grounds for 

 the establishment of such an hypothesis. Whether the basic 

 phosphate of lime found in the bones of rachitic patients is con- 

 verted into the -J basic salt is a question which must be decided by 

 more exact and direct investigations than any hitherto made. 



The Craniotabes (of Elsasser) is probably nothing but a form 

 of rachitis which affects the occipital and parietal bones during 

 the period of suckling, and we should, therefore, make no special 

 reference to it, were it not for the purpose of drawing attention to 

 the admirable investigations made by Schlossberger* on this sub- 

 ject, which may, indeed, serve as a model for all similar inquiries. 

 He ascertained that the 63^ of mineral substances, which he 

 found to occur in the normal occipital bones of healthy children 

 during the first year of their age, diminished to 51^ in the simply 

 attenuated parts of the bone, and to 40 or even to 23% in the 

 thickened and spongy softened parts ; he found that the carbonate 

 of lime was present either in a normal quantity, or only slightly 

 diminished, and that the cartilage was so far sound that it yielded 

 ordinary glutin on boiling, whilst the fat, when compared with that 

 in the rachitic bones of children of more advanced age, was not 

 at all or very slightly increased. 



The osteomalacia of adults, which undoubtedly depends upon 

 osteoporosis accompanied with diminution of volume and a depo- 

 sition of fluid fat in the dilated and newly formed cavities, would 

 appear to be more referable than rachitis to the excessive formation 

 of acid in the organism ; but a thorough investigation of the nature 

 of this remarkable disease and its products (such as that by 

 * Arch. f. phys. Heilk. Bd. 8, S. 69-87. 



