960 Osteomalacia. 



hogs and goats, sometimes also in dogs; these may also occur 

 in pelvic bones. The head appears much larger, the roof of 

 the mouth bulging into the oral cavity which therefore .becomes 

 smaller, or it becomes impossible to close the mouth so that 

 the appearance of maxillary paralysis is produced (Figs. 164 

 and 170). In such cases there is blood stasis in the tongue, 

 mastication is difficult or even impossible. The bulging of the 

 bones causes the nasal passages to become narrow, respiration 

 becomes difficult and accompanied by a snififiing or snoring 

 sound ; even attacks of asphyxia may occur. The bulging bones 

 are elastic and easily depressed. 



Moussu found the alkalinity of the blood diminished, the urinary phosphates 

 increased five-fold; Haubner & Siedamgrotzky, as well as Marcone, likewise dem- 

 onstrated a considerable increase in the phosphorus content of the urine. 



The emaciation of the animals gradually increases. The 

 muscles become flabby and in some groups of muscles there 

 occur at times fibrillary twitchings. With the severe pain in 

 some bones there is associated a surprisingly high muscular 

 tension in the corresponding region (Siedamgrotzky, the au- 

 thors). The temperature is usually normal, but is raised to 

 40° C. during very severe pain, and also in case of extensive 

 decubitus-gangrene. The secretion of milk diminishes steadily 

 and finally ceases. On the dry skin an eczematous eruption 

 may develop. Finally the animals, which persistently lie pros- 

 trate, become totally exhausted and perish. 



Course. Osteomalacia always takes a very chronic course. 

 Although the first symptoms usually do not become manifest 

 and the disease is recognized therefore only in a fairly advanced 

 stage, several months usually elapse from the time of its recog- 

 nition to that of complete exhaustion. Only the very rare cases 

 with severe nervous disturbances usually lead to death in a 

 short time. At times the disease may be arrested or there 

 may be improvement, but in such cases relapses may occur. 

 For the latter gestation, parturition and lactation are predis- 

 posing factors and rapidly progressive aggravations usually 

 occur during such times. Sometimes the disease has been latent 

 for some time and becomes manifest only through such an 

 aggravation. With temporary improvements and relapses the 

 disease may thus extend over several years. 



Diagnosis. As long as there are no signs of bony soften- 

 ing, the disease cannot be recognized positively in sporadic 

 cases. Licking disease may occur in the course of other affec- 

 tions, especially in gastric catarrh, while pain in the limbs is 

 observed also in muscular and articular rheumatism. In the 

 presence of these symptoms the suspicion of osteomalacia is 

 always well founded if the fodder is poor in lime salts. The 

 possibility of its existence must also be considered when milch 



