The practice of pediatrics . re probably two reasons: the diminished thoracic cavitypresses down the diaphragm and crowds the abdominal viscera, andthe stomach and intestines are more or less distended as the result of acomplicating chronic indigestion and weakened muscular walls. Thereis regularly no change in the heart, except that due to anemia and mal-nutrition, nor in the temperature. The urine, however, may present an 328 DISEASES OF NUTRITION excess of phosphates and show traces of albumin. A bruit is often to lieheard over the anterior fontanel, but this is of no special
The practice of pediatrics . re probably two reasons: the diminished thoracic cavitypresses down the diaphragm and crowds the abdominal viscera, andthe stomach and intestines are more or less distended as the result of acomplicating chronic indigestion and weakened muscular walls. Thereis regularly no change in the heart, except that due to anemia and mal-nutrition, nor in the temperature. The urine, however, may present an 328 DISEASES OF NUTRITION excess of phosphates and show traces of albumin. A bruit is often to lieheard over the anterior fontanel, but this is of no special of the marked characteristics of rachitic children is their tendencyto catarrhal inflammations of the gastroenteric and respiratory tracts,and to reflex explosions of their nervous systems. So we frequentlysee gastritis, gastroenteritis, chronic indigestions of gastric or entericorigin; laryngitis, bronchitis, or bronchopneumonia; and laryngismusstridulus, tetany, or general convulsions developing in the rachitic. Flu. 09. Skiagram of Fig. 6S. showing the deformity to be due to distortions of the diapbyses of the bones,while the epiphyses are practically normal. (Whitman.) Furthermore, children with rickets are much less resistant to infectionby the various contagious diseases than normal, and if they do developthem their mortality rate is higher than usual. Rickets runs a course of one to two years, and most of the symptomsdisappear spontaneously. The bone changes, however, are more per-sistent. Diagnosis.—In the early stages of the disease and in mild cases it isonly necessary to have rickets in mind, so as not to overlook it. Thepresence of anemia, muscular weakness, constipation, delayed dentition, RACHITIS 329 orsweating of the head should always call ones attention to the possibilityof the beginning of rickets. With this idea in mind, a careful exami-nation of the bony framework will usually show enough to corroboratethe diagnosis. Well-marked cases should offer no d
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