American practice of surgery : a complete system of the science and art of surgery . l senses. The causeof the changes is absolutely unknown. In some instances there have beenprevious attacks of erysipelas or of suppuration of the lachrymal passages,ami yet no direct connection can be traced. One may sum up our presentknowledge on the subject, then, by simply confessing that absolutely nothingis known regarding its etiology. So far as its treatment is concerned we are also helpless. When such anextent of the cranium is involved as we see in most instances there is no possi-bility either of res
American practice of surgery : a complete system of the science and art of surgery . l senses. The causeof the changes is absolutely unknown. In some instances there have beenprevious attacks of erysipelas or of suppuration of the lachrymal passages,ami yet no direct connection can be traced. One may sum up our presentknowledge on the subject, then, by simply confessing that absolutely nothingis known regarding its etiology. So far as its treatment is concerned we are also helpless. When such anextent of the cranium is involved as we see in most instances there is no possi-bility either of resection or of any other operation which will permit of anybenefit to the patient. Rachitis: Rickets. In general, rickets constitutes a disease to be spoken of as among the con-stitutional and general nutritional, whose most pronounced expressions areseen in the bony skeleton. While essentially diathetic and often spoken of as astarvation disease, it is consequently most looked for among the children of thevery poor. It is a starvation matter, however, only in that the bones of the. Fiq. i >ssea:Volkmann. (von NON-INFLAMMATORY AFFECTIONS OF BONES. 347 growing foetus or infant are starved, since they do not secure a proper amountof nourishment, this having to do more with the financial means or social en-vironment of their parents than with physical conditions, and being solely aquestion of suitable nutritional supply for the needs of a growing foetus. Someof the most pronounced cases of rickets are seen among the children of the well-to-do, whose mothers, however, have either been deficient in the quality of themilk with which they have nursed their children, or of the blood which theyfurnished them previous to their birth, or else who have been so devoted tosocial affairs as to have neglected their primary maternal duties, and have leftthe question of nourishment either to artificial foods or to living substitutesfor themselves. Under the general term ricke
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