THE vast majority of cases of rickets arise in connection with errors of feeding. . . . This is seen in those by no means uncommon cases where children born healthy and of healthy, well- to-do parents, brought up under perfect hygienic conditions so far as air, light, cleanliness, and warmth are concerned, yet become rickety when brought up on artificial food .
A child may be reduced by starvation to the last state of atrophy, and yet not be rickety; and, conversely, it may be over-fed, fat and gross, and yet extremely rickety. Children fed almost entirely upon farinaceous preparations– oatmeal, cornflour, bread, patent foods, with little or no milk, even if such diet produce no digestive disturbance– certainly become rickety.
The effect of diet was shown in the most striking manner by Sir John Bland Sutton in the case of rickety animals at the Zoological Gardens in London. For many years the lion whelps have been weaned early, and put upon a diet of raw flesh only; they have invariably become rickety to so extreme a degree that it has been found impossible to rear them.
The history of these lion cubs is very significant; with the exception of a single litter, suckled by the dam ten years before, the cubs brought up on horse-flesh in this way, invariably died — the cause of death being, as invariably, extreme rickets. More than twenty litters had been lost in this way .. By the advice of Sir John Bland Sutton, milk, pounded bones, and cod-liver oil were added to the raw meat, which was continued exactly as before; they were kept in the same dens with the same amount of warmth and light and air, and, with the single exception of the addition to the diet, no change of any kind was made in the regimen.
The change in nutrition which followed was immediate and remarkable; in three months all signs of rickets had disappeared, and the animals grew up strong and healthy — a unique event in the history of the Society. The experiment seems a crucial one, and decisive as to the part played by fat and bone salts, with some caseine and lactine, in the production and cure of rickets.
The powerful influence which privation of light and of the direct rays of the sun have upon the production of rickets is evidenced by the greater prevalence of the disease in the clouded skies of temperate climates, and especially by the presence of its severer forms in the added darkness of great cities.
The influence of sunlight in prevention is shown by the rarity of the disease in the sunny climates of the south. The effect of sunlight is probably as potent or more potent than that of fresh air. Light, and especially full sunlight, is as important to the cure as the prevention of rickets, and the removal of a child thus suffering to a bright and sunny climate is of great value in hastening its recovery.