A system of practical medicine. By American authors. Vol. 2 : $b General diseases (continued) and diseases of the digestive system
Science
A system of practical medicine. By American authors. Vol. 2 : $b General diseases (continued) and diseases of the digestive system
Medicine -- Practice
etiology of rachitis, the periosteal and cartilaginous proliferations
would find no explanation. But why is it that this peculiar process
takes place at an early age only? and in the bone only? Kassowitz urges
the fact that the growth of the bone differs in this from the
development of all other tissues: that the latter grow uniformly
through their whole mass; that the circulation in them is more uniform
and carries material through and into every particle simultaneously,
while in the bones the only places in which the whole circulation can
contribute to their growth--the few blood-vessels distributed in the
interior not adding to their growth at all--are the periosteum and the
places of apposition between epiphysis and diaphysis. Every morbid
irritation, whether resulting from bad air, habitation, and food, or
from either chronic or acute ailment, acts on the whole mass of other
tissues and organs, but in the bones only on the growing ends or
surface.
[Footnote 2: _Anatom. Museum_, Berlin, 1796, vol. ii.]
[Footnote 3: _Arch. f. Path. Anat._, vol. v.]
The results of the pathologists and experimenters are confirmed by
chemical analyses. Fat has been generally found somewhat increased in
the rachitical bones, and water largely so; chondrin is diminished
according to Marchand and Lehmann, but was found unaltered in the later
analyses of A. Baginsky. The latter found, after having deprived the
bone of fat, the organic and inorganic material to be in a proportion
of 100 to 563 in the normal, and of 100 to 160 in the rachitical
osseous tissue; and in 100 parts of dry bone, Gorup-Besanez found in
the
Ossein. Phosphoric Acid. Lime. Manganese Oxide.
Healthy adult 34 26 34 0.3
Infant of six months 34.9 27 35 0.5
Rachitical femur 72 7 9 0.3
" tibia 60 12.9 17 0.3
Defective calcification of the forming bone is one of the principal
characteristics of rachitis. In it lime cannot either enter into the
composition of the osseous tissue or remain in it. Its elimination must
take place either through the kidneys or the intestinal tract. In the
feces Ad. Baginsky, and many before him, have found an abnormal
quantity. In regard to the urine, modern investigations do not agree
with former analyses. Thus, Baginsky concludes that there is no
increase of lime in the urine of rachitical as compared with that of
healthy children; Seemann found even a diminution of the percentage of
lime. Amongst modern writers only Rehn found an occasional increase of
lime in the urine of rachitis.
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