h'lChlJT.S 



445 



may be has not yet been ascertained, ^charf e ^■' and Bucura ^" both 

 state that tliere are no cliaracteristic or constant structural altera- 

 tions in the ovaries in osteonuUacia. McCrudden "' found that the 

 improvement in calcium metabolism observed after castration may 

 be but temporary, and therefore believes that the primary cause of 

 the disease does not lie in the ovaries. He is of the opinion that re- 

 peated drains on the calcium of the bones, incited most often by 

 pregnancy, occasionally by tumors, sometimes by unknown causes, 

 result in an excessive reaction to the stinuili, so that eventually the 

 losses become too great to be made up ; that is, osteomalacia is an 

 exaggei-ation of a normal process resulting either from excessive 

 stimulation of that process, or a failure to recover when the stimulus 

 ceases. The beneficial effects of castration are probalily ascribable 

 chiefly or solely to the prevention of pregnancy. Osteitis deformans 

 seemed to be a localized osteomalacia. The relation of the adrenals to 

 osteomalacia advocated by Bossi,^* is of questionable significance, and 

 there is no definite evidence as to any relation of exophthalmic goiter ^^ 

 or the parathyroids,^" although hyperplasia of the parathyroids has 

 been described." 



RICKETS i-^ 



As with osteomalacia, chemical studies of the bones in rickets have 

 thrown little light upon the etiology or pathogenesis of this condition. 

 As the following table (taken from Vierordt*^) shows, there is a 

 marked deficiency in the proportion of inorganic salts in the bones in 

 rickets. The proportion of the different salts seems to be quite the 

 same as in normal bone. 



445. 



35 Cent. f. Gyn., 1900 (24), 1216. 



36Zeit. f. Heilk., 1907 (28), 209. 



37Amer. Jour, of Physiol., 1906 (17), 211. 



38Zent. f. Gyn., 1907 (31), 69 and 172. 



39Tolot and Sarvonat, Rev. d. Med., 1906 (26 



4"Erdheim, Cent. nied. Wiss., 1908 (46), 163. 



■41 Bauer. Frankfurter Zeit. Pathol., 1911 (7), 231. 



•12 Complete literature and full discussion bv Pfatmdler. -lalir. f. 

 1904 (60), 123: also see Albu and Xeuberg. ".Mineralstotl'weclisel," 

 pp. 119-124; symposium in the Verhandl. Deut. Path. Gesellseh., 

 Metabolism studies by Meyer, Jahrb. Kinderheilk., 1913 (77), 28. 



43 Xothnagel's System, vol. 7, part ii, p. 21. 



Kin 



Ber 



1909 



dcrheilk.. 

 n. 1906, 

 (13), 1. 



