The treatment of renal rickets.

Miller (1911), Parsons (1911), Parkes Weber (1912), Naish (1912), and Barber (1913) reported cases in the next year, and since then a large number of cases have been described in England, Canada, the United States and recently in France, Germany and Norway. The important papers by Barber (1920, 1926, 1933) and Parsons (1927), and the reviews by Mitchell (1930), Hamperl and Wallis (1933) give an excellent account of existing knowledge. Although so many papers have been written describing cases, many of which have ended fatally, little has been said about treatment either of the rickets or the kidney lesion. There is a general opinion that neither vitamin D nor ultra-violet light is of any value, and Park (1933) says that 'large amounts of vitamin D may produce calcification in the rachitic intermediate zone, but is useless because the D merely depletes the skeleton at one point in order to affect bone salt deposition at another, and is dangerous because it may lead to injury elsewhere' (metastatic calcification). Gyorgy (1928), Duken (1928), Schick (1929) and Karelitz and Kolomayzeff (1932), on the other hand, have each reported a case in which the condition of the bones improved after the administration of vitamin D. Salvesen (1934) found that the clinical condition as regards pain and comfort in walking improved when calcium lactate was given, although it deteriorated when ultra-violet light alone was given. Parsons (1927) and Barber (1926) have each reported one case in which the rickets healed although no vitamin D or ultra-violet light was given.