INTUMESCENTIjE. 



to suckle children, it has been supposed that such nurses have 

 frequently given occasion to the disease ; and when nurses have 

 both produced and have suckled children who became rickety, 

 there may be ground to suspect their having occasioned the dis- 

 ease in the children of other persons : but I have had few op- 

 portunities of ascertaining this matter. It has in some measure 

 appeared to me, that those nurses are most likely to produce 

 this disease, who give infants a large quantity of very watery 

 milk, and who continue to suckle them longer than the usual 

 time. Upon the whole, however, I am of opinion, that hired 

 nurses seldom occasion this disease, unless when a predisposition 

 to it has proceeded from the parents. 



MDCCXXIII. With regard to the other antecedents, which 

 have been usually enumerated by authors as the remote causes 

 of this disease, I judge the accounts given to be extremely falla- 

 cious ; and I am very much persuaded, that the circumstances 

 in the rearing of children, have less effect in producing rickets 

 than has been imagined. It is indeed not unlikely, that some 

 of these circumstances mentioned as remote causes, may favour, 

 while other circumstances may resist, the coming on of the dis- 

 ease ; but at the same time, I doubt if any of the former would 

 produce it where there was no predisposition in the child's orig- 

 inal constitution. This opinion of the remote causes I have 

 formed, from observing, that the disease comes on when none of 

 these had been applied; and more frequently, that many of them 

 had been applied without occasioning the disease. Thus, the 

 learned Zeviani alleges, that the disease is produced by an acid 

 from the milk with which a child is fed for the first nine months 

 of its life : but almost all children are fed with the same food, 

 and in which also an acid is always produced ; while at the same 

 time, not one in a thousand of the infants so fed becomes af- 

 fected with the rickets. If, therefore, in the infants who be- 

 come affected with this disease, a peculiarly noxious acid is pro- 

 duced, we must seek for some peculiar cause of its production, 

 either in the quality of the milk, or in the constitution of the 

 child ; neither of which, however, Mr. Zeviani has explained. I 

 cannot indeed believe that the ordinary acid of milk has any 

 share in producing this disease, because I have known many in- 



