Evidence of Rickets Prior to 1650

Abstract

When Whistler published his slim Leyden graduate thesis on rickets in 1645, which was followed by Glisson's adequate volume in 1650, the origin of what was then called "an entirely new disease" was attributed to conditions having little relation to diet and sunshine. But, by the end of the eighteenth century, authorities were able to conclude that climate and especially dampness had much to do with the origin of rickets, and that improper food also had some part in its etiology.From the time of the first description of this malady, the theory that rickets was an inheritable ailment has persisted with singular tenacity. The influence of maternal heredity still claims attention, even though modern experimental science seems to have proved that the disease is a disturbance of calcium and phosphorus metabolism caused by lack of a mysterious substance in the diet and a lack of sufficient sunshine on the surface of the body. The theory that it is a purely inheritable condition has not been substantiated by the animal experiments conducted by Hess and Weinstock.1 The hypothesis of Schmorl,-that rickets is a manifestation of a deficient mineral deposit at birth, which is shown in some infants to a greater degree than in others and which is most marked in those prematurely born, served to revive the persistent and recurring idea that maternal influence in the production of rickets is not negligible even though the disease may not be strictly inheritable. The fact that rickets was found in nursing infants of Central Europe to a marked degree after the late war, and especially in regions in which food shortage and dietetic imbalance had prevailed among the civilian population, served to focus attention on the implication of a maternal rôle in the production of this disease. Suggestive recent work of Mitchell, Greenbaum et al,3 would indicate that, while nearly all children ultimately develop incipient rickets, infants born of mothers who were fed on a low and insufficient caloric ration develop a type of the disease which is unusually resistant to the ordinary methods of treatment.

“English Disease”: Historical Notes on Rickets, the Bone–Lung Link and Child Neglect Issues

“…Indeed, a number of diseases, including rickets, were brilliantly known in ancient China. Iconography of the industrial cities of Germany and Holland, at least 200 years before Whistler’s description, definitely support the thesis that rickets existed to some extent at all times and periods of the world’s history [46,53,54]. …”

A painting of the Christ Child with bowed legs: Rickets in the Renaissance

“…More than a millennium later, iconography documents the presence of rickets in Europe among children living in the industrial cities of Germany and Holland (Foote, 1927;Friedländer, 1924;Heidrich, 1909). Then in 1582, we find that Jerome Reussner, in a disputation at Basle, "rediscovers" rickets as a medical condition, and describes it as a common disease that afflicts children of Holland and Switzerland.…”

“…It should not be too surprising that astute Renaissance artists might depict signs of nutritional rickets in their most elegant artwork, given the high prevalence of rickets among the rich and powerful of the time. Indeed, another remarkable pre-Whistler depiction of a rachitic infant may be found in Caravaggio's 1609 painting, Amore dormiente (Foote, 1927;Frenk, 1993;Frenk & Faure-Fontenla, 1995), although we note that some have diagnosed this deformed cupid with juvenile idiopathic arthritis (Espinel, 1994). The wealthy patrons of these talented artists were among the very few who had the financial resources to employ wet nurses to feed their infants, a luxury that paradoxically placed these privileged infants at greatest risk of vitamin D deficiency, the basis for nutritional rickets.…”

“…Here the renown Greek physician Soranus of Ephesus provides an accurate characterization of a deforming disorder of bone, which may have been rickets, and attributes this disease to improper childcare. More than a millennium later, iconography documents the presence of rickets in Europe among children living in the industrial cities of Germany and Holland (Foote, 1927; Friedländer, 1924; Heidrich, 1909). Then in 1582, we find that Jerome Reussner, in a disputation at Basle, “rediscovers” rickets as a medical condition, and describes it as a common disease that afflicts children of Holland and Switzerland.…”

Vitamin D in Human Health

“…Pectus carinatum), legs and arms. Rickets could also reflected in inadequate mineraliza tion of enamel and dentin (14). The first descriptions of clinical manifestations of rickets appeared in ancient times.…”