Usually the first symptoms to appear are tenderness of the legs. This will be observed from the fact that the child cries when his legs are moved. Eventually this tenderness localizes about the knees and ankles and it is accompanied with swelling of these parts. The gums then become swollen and show a marked tendency to bleed. This swelling may produce pain sufficient to interfere with the child taking food. The child loses weight, becomes very fretful, and has a slight fever. There is a characteristic posture in which the hips are rotated outward, while there is a semi-flexion of the thighs and legs. The child will usually lie very quietly because any movement produces pain, especially in the legs. There is marked sub-periosteal hemorrhages which may be so great that the limbs will become twice their normal size. In severe cases epiphyseal separation is not uncommon. Scurvy is very often associated with rickets. However, it is affirmed that they are two separate conditions and not just different forms of the same condition. Major Adjustment This incoördination requires a combination major which will be found at C.P. or S.P. and K.P. RICKETS Rickets is also called rachitis and known by some as Barlow’s dis-ease. It is listed as a dis-ease of nutrition, although the most important anatomical changes which take place are those affecting the bones. This dis-ease is found among people of all classes. There is no race that is immune, yet some nationalities seem to suffer more frequently and severely than others. Negroes and Italians seem to be especially susceptible when placed in northern climates and congested quarters in northern cities. In general practice rickets is considered a rather uncommon incoördination, although in congested cities it will be found quite prevalent. Symptoms The first symptoms to appear are nocturnal restlessness and profuse sweating about the head during sleep. The restlessness is usually quite marked; the patient rolls and tosses a great deal, and almost constantly moves the head back and forth on the pillow. Because of the profuse sweating the child becomes very susceptible to colds, bronchitis and bronchial pneumonia. A case of rickets is rather easily recognized by the large head, the pigeon breast, beaded ribs, the deformities of the extremities, the swelling of the epiphyses of the wrists and ankles, and the prominent abdomen. Deformities of the Head Deformity of the head appears very early in the dis-ease and is due to the thickening of the cranial bones, producing the typical square head of rickets. This square head is known as caput quadratum. Numerous soft spots are formed in the cranial bones which when pressed upon give one the impression that he is feeling parchment. This is known as cranial tabies. The fontanels and sutures are very late in closing, sometimes as late as the third or fourth year. The large rachitic head must not be mistaken for hydrocephalus. Deformities of the Thorax