An American text-book of the diseases of childrenIncluding special chapters on essential surgical subjects; orthopaedics, diseases of the eye, ear, nose, and throat; diseases of the skin; and on the diet, hygiene, and general management of children . Jacobi also published the description of a case ofcongenital rachitic craniotabes. Enlargement of the costo-chondral articulations, knownas the rachitic rosary, has been observed, though rarely, ininfants only a few weeks old. Dr. Parry saw it as early asthe sixth week after birth, and Dr. Lee at the third or fourthweek. The significance of this e
An American text-book of the diseases of childrenIncluding special chapters on essential surgical subjects; orthopaedics, diseases of the eye, ear, nose, and throat; diseases of the skin; and on the diet, hygiene, and general management of children . Jacobi also published the description of a case ofcongenital rachitic craniotabes. Enlargement of the costo-chondral articulations, knownas the rachitic rosary, has been observed, though rarely, ininfants only a few weeks old. Dr. Parry saw it as early asthe sixth week after birth, and Dr. Lee at the third or fourthweek. The significance of this enlargement as a sign ofrachitis we have treated of elsewhere. We have stated thatCongenital Rachitis, with few exceptions rachitis begins before the close of thethird year. Though first detected and diagnosticated at alater date, it will ordinarily be ascertained, on inquiry, that its symptoms hadan earlier beginning. Still, according to certain observers, it may have a con-siderably later commencement. Glisson, Portal, and Tripier state that theyhave seen it commence in children who were well on toward the age of William Jenner says that he has seen children of seven and eight yearswho were only beginning to suffer from RACHITIS. 323 The following are the aggregate statistics of Bruennische, Von Eittershain, and Ritsche relating to the age at which rachitis occurs : No. of Cases. During the first half year 99 second half of first vear 259 year 342 . third year 134 fourth vear 31 fifth year 17 Between the fifth and ninth years 21 Aggregate 903 Etiology.—Inheritance.—Some patients with rachitis appear to haveinherited a predisposition to it. Feeble digestion and defective assimilationin the infant—which are, as we will see, important factors in producing therachitic state—are often traceable to disease or cachexia of one or both the parental causes may be mentioned poverty, hardships, and defect-ive nutrition of either parent; age of
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