Rickets was at one time thought to be a disease of the bones; it is now known to be a general disease caused by malnutrition, and which is almost always preventable. The well-known changes which take place in the bones are but the signs and symptoms of a constitutional condition. Rickets in the child is the incontrovertible sign of ignorance, neglect, or incompetence in the mother or nurse. A mother should be as ashamed of her child having rickets as of its having vermin. Both mean neglect of maternal duties. The neglect may be, it is true, due to ignorance; but in these days of enlightenment and education, ignorance on matters of vital importance is inexcusable. But in these days also of patent foods for infants, ignorance shelters itself behind assumed knowledge, and patent foods plus ignorance are the fruitful source of much rickets.

A story will illustrate my meaning. Some time ago I was interested in a "bonnie baby," the only and posthumous child of a young widowed mother. The child was the joy of her heart, and its evident health and ceaseless activity and gaiety were sources of pride and pleasure to her. She suckled the baby herself. When it was about six months old I lost sight of it for eight months. When I saw the child again I was immediately struck by its altered appearance. It was pale and peaky, had lost its gaiety and activity, and had a look of premature age and weariness. "Your baby is starved," I said with brutal frankness to the mother; "what are you feeding it on?" "I suckled it until it was eleven months old," she replied, "and since then I have fed it on------," mentioning a patent food. "What is it made of?" I asked. "I don't know," was the answer. "Don't know!" I exclaimed, "don't know on what you are feeding your baby! You have only one thing to do - to bring up that baby - and you are steadily starving it into rickets by not taking the trouble to learn how to feed it properly." I presented the alarmed mother with various text-books, giving the required information how to feed infants, and I hope she has profited by them; otherwise her child will have rickets. This is an example of how the disease is produced by carelessness and ignorance on the part of well-meaning mothers.

Rickets is caused by the necessary elements of albumen and fat being absent from the food, and by feeding children on starchy foods and skimmed milk. It hardly ever occurs in suckled infants; but it is developed in babies brought up by hand, or during or after weaning. Insanitary conditions, such as bad air and unwholesome dwellings, may aid in the development of rickets, but they are not sufficient to produce it; while food deficient in albumen and fat will cause it, even when the hygienic conditions are of the very best.