748 



FRANCIS H. McCRUDDEN 



plete metabolism study of seven days made during the period of improve- 

 ment (March twenty-ninth to April fourth), showed a calcium retention 

 of 3.8 grams (intake 29.2 grams, outgo 25.4 grams). 



In another case studied by Neumann (6), clinical improvement 

 followed castration. During the active stage of the disease, the patient 

 showed a negative calcium balance (Table 17). After improvement be- 

 gan, a five-day study showed: intake of CaO 12.98 grams, outgo 7.20 

 grams; retention 5.78 grams. 



His(d) and IJotz have studied the calcium balance in cases 

 of osteomalacia during the active period, during a period of improvement 

 following phosphorus administration, and afterwards following relapse, 

 with the same results (Table 25). 



TABLE 25 



COMPARISON OF CALCIUM BALANCE IN THREE STAGES OF OSTEOMALACIA: A, DURING THE 

 ACTIVE STAGE; B, DURING IMPROVEMENT; AND C, DURING A RELAPSE 



Less complete metabolism data are available for the other bone diseases, 

 but the data are in harmony with our view regarding the nature of the 

 process in osteomalacia. Thus Bookman (a.) found a negative calcium 

 balance with a positive balance for phosphorus, sulphur, and nitrogen in a 

 case of osteopsathyrosis. And the same author (6) found the retention 

 of calcium decidedly below the normal in the case of a child with osteo- 

 genesis imperfecta. 



Metabolism experiments in rickets, during the active period of the 

 disease, show either a negative calcium balance or only a very slight 

 positive balance, one that is far below normal. Just before the onset of 

 clinical improvement, the calcium balance becomes positive; the amount 

 retained increases until, during convalescence, the retention may become 

 two or three times the normal. Later, after recovery, the retention falls 

 to normal again (Schabad(&)). 



