THE BONES AND JOINTS. 743 



It does not fall within the scope of this work to describe the various 

 deformities which may occur as a result of this disease. The familiar 

 pigeon breast ; the rows of knobs along the sides of the chest from bend- 

 ing and dilatation of the ribs at the point of junction of cartilage and 

 bone; the knock-knees, bow-legs, spinal curvatures, etc., may all be 

 the result of rachitic weakening of the bones. 



After a time the rachitic process may stop and the bones take on a 

 more normal character. The porous bone tissue becomes compact and 

 even unnaturally dense; the swellings at the epiphyses disappear; many 

 of the deformed bones may become of a normal shape. In severe cases, 



FIG. 492. CRAXIOTABES. 



This skull of a child is large, its bones are thin, with holes due to faulty development and covered only by 

 a thin, flbrous membrane. 



however, the deformities continue through life ; especially there is a ces- 

 sation of the growth of the bones in their long axis, so that the persons 

 affected are dwarfed. 



The disease may have an acute or a chronic character. The acute 

 form begins usually during the first six months of life. The children are 

 apt to suffer from vomiting, diarrhosa, profuse sweating, chronic bron- 

 chitis and pneumonia, general anaemia, and wasting. They either die or 

 the rachitic process is gradually developed. The chronic form is seen in 

 older children, and often in those apparently healthy. The changes in 

 the bones may take place without constitutional symptoms, though there 

 are often catarrhal bronchitis, pneumonia, and anaemia. 



