Osteomalacia has been called the rickets of advanced life. It is, however, characterized by a decalcification of bone, while in rickets the bone fails to calcify during the period of growth.

At first the bones that are affected are painful. They become brittle and liable to break or to bend, and thus to produce deformities. The disease usually progresses steadily and does not permit of a favorable prognosis.

It attacks women much oftener than men, usually between the ages of twenty and fifty. Pregnancy is a condition that especially predisposes to this disease, sometimes manifesting itself before and sometimes after the child's birth. It is of comparatively frequent occurrence in certain localities, notably in Lombardy, the Black Forest, and in Flanders, while equally rare in other localities. A parasitic origin has been suggested for it, but not demonstrated. Bouchard teaches that an excess of lactic acid in the blood dissolves the lime-salts of bone. That calcium may be removed by lactic acid in the blood has been proved by experiment, but tha,t there is always an excess of this acid in the blood in cases of osteomalacia has not been demonstrated.

Although due in the first place to a fault of nutrition, this disease will not be helped so much by diet as one might expect. Of course, foods rich in phosphates and mineral salts are especially indicated for use. Such are eggs, meat, cereals, and milk. At the same time, however, care must be taken that too much lactic acid is not generated by abnormal fermentation in the stomach. Of meats, beef, mutton, venison, rabbit, and fowl are richest in salts.

Phosphates, especially calcium phosphate, should be given to counteract the decalcification produced by the disease. Of the various phosphatic preparations, the compound syrup of phosphates, calcium hypophosphite, and calcium glycerophosphate are among the best. Cod-liver oil is also recommended.

Salt baths and other hydrotherapeutic measures are often beneficial. Good hygienic surroundings are essential. A residence upon dry ground and the wearing of warm clothing should be insisted upon. Necessarily, violent movements must be avoided, as they are liable to break the brittle bones. Often surgical treatment must be resorted to in order to correct deformities.