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
It is not impossible that phosphorus, in substance, not in any of its
compounds, may prove of great utility in the treatment of rachitis.
Minimal doses of phosphorus render the newly-formed tissue at the
points of apposition of the bones more compact in a very brief time.
The new formation of blood-vessels in the osteogenous tissue gets
retarded by it. Larger doses of phosphorus, however, increase
vascularization, and osseous tissue is either less rapidly formed or
even softened. When the doses are still larger, vascularization and
softening may rise to such a point as to separate the epiphysis from
the diaphysis. Thus the administration of the drug results in an
irritation which, according to the doses employed, may give rise either
to normal condensation or to inflammatory disintegration. This
experience, arrived at by Wegner in a great many experiments made on
animals, Kassowitz has confirmed. For its therapeutic effect he tried
phosphorus in 560 cases of rachitis. Employing doses of one-half
milligramme (one one-hundred-and-twentieth of a grain) several times
daily (less will suffice), he soon found the skull to become harder,
the fontanel smaller, the softening of the bones of the thorax and
extremities to disappear, and all the other symptoms of rachitis to
improve. This result was obtained though no particular change in the
feeding of the patients was resorted to. To what extent this experience
will be verified by others we shall soon learn. My own is already
sufficiently extensive to base upon it a strong recommendation of the
plan of treatment I have detailed. My therapeutical results in other
diseases of the bones also encourage me to believe that phosphorus will
accomplish much in the treatment of rachitis. Ever since Wegner's
publications--viz. these thirteen or fourteen years--I have utilized
phosphorus in cases of chronic and subacute inflammations of the bones,
mainly of the vertebral column and the ankle-joint and tarsus. After
having taught the method for many years in my clinic and otherwise, I
made a brief communication on the subject to the Medical Society of the
State of New York.[22] Since that time, again, I have followed the same
plan in many cases of the same description, and feel sure that the
prognosis in this serious class of bone diseases has become more
favorable and recovery speedier. Infants of a year or more were given a
dose of one-eightieth or one one-hundredth of a grain of phosphorus
daily. One grain, dissolved in an ounce of oil or cod-liver oil, is a
convenient mixture, four or six drops of which may be administered
daily in two or three doses.
[Footnote 22: _Trans._, 1880.]
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