962 Osteomalacia. 



then become evident, also that sometimes an increase in the 

 frequency of fractures is observed. The supply of hard drink- 

 ing water should also be considered, wherever the local condi- 

 tions permit it. 



Lime salts should always be added to the food. Among 

 them the same preparations come first into consideration as 

 are used in rickets (see p. 947), but they must be given in 

 sufficiently larger doses ; for instance, for large animals, accord- 

 ing to weight and employment, and to the probable lime con- 

 tent of the food, 30-80 to 100-200 gm. ; for smaller ruminants 

 and hogs, 10-20 gm. in three portions with each feeding. If 

 there is no deficiency in phosphoric acid, chalk is efficient and 

 may be partially (1/3-2/3) replaced by calcium chlorate, which 

 corresponds to about two parts of chalk, or hydrochloric acid 

 may be given with the drinking water at the same time. In 

 coexisting phosphoric acid deficiency "opened" bone meal is 

 indicated and is, in accordance with Klimmer & Schmidt, given 

 suitably in alternation with the chalk, thus that the animals 

 receive for 2 or 3 days a calcium preparation and during the 

 next 2 or 3 days a preparation of phosphoric acid, for instance 

 sodium phosphate (tablespoonful 3 times daily). The other 

 preparations of lime (see p. 948) are less suitable. The 

 systematic administration of HCl or of NaCl is also indicated 

 in such cases in which calcium carbonate is not given. From 

 phosphorus (0.01-0.05 per day in oil) Klimmer & Schmidt saw 

 no results. If symptoms of licking disease appear, apomor- 

 phine hydrochlorate (0.10-0.20 gm. subcutaneously) is indicated 

 according to Lemke, who claims that after three doses the licking 

 disease will be relieved for 3 to 4 months (Hafner saw no im- 

 provement follow this treatment) . In cachectic animals Klimmer 

 & Schmidt obtained transitory improvement in the general 

 condition by the administration of pilocarpine and caffeine. 



The suggestion of Eoloff not to milk the affected cows 

 empty and to exclude them from breeding during the duration . 

 of the disease, deserves consideration if the economical condi- 

 tions permit it. Klimmer & Schmidt believe it more appropriate 

 to diminish the nitrogenous food-stuffs in order to reduce milk 

 secretion, or to permit cows in advanced pregnancy to stand 

 dry for 6 to 8 weeks. Finally the extirpation of the ovaries 

 might be considered, especially if a proper regulation of the 

 diet is difficult, yery ill animals should be killed as soon as 

 possible. 



Prevention. Experience has shown that the disease can 

 be prevented by proper feeding, especially of the cows during 

 pregnancy and lactation, and by suitable cultivation of the soil. 

 Prophylactic measures merit particular consideration in regions 

 where osteomalacia is already enzootic; with appropriate fer- 

 tilization, especially after the use of fertilizers which contain 

 phosphorus, the disease usually becomes less prevalent in such 



