Rickets Health Dictionary

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Rickets: From 4 Different Sources

A disease caused by nutritional deficiency that causes bone deformities in childhood. Bones become deformed because inadequate amounts of calcium and phosphate are incorporated into them as they grow. The most common cause is vitamin D deficiency. It also occasionally develops as a complication of malabsorption and may also occur in rare forms of kidney and liver disease.

Rickets due to dietary deficiency is treated with supplements.

The deformities usually disappear as the child grows.

Rickets occurring as a complication of a disorder is treated according to the cause.

Health Source: BMA Medical Dictionary
Author: The British Medical Association
A disturbance of the calcium/phosphorus metabolism which occurs in the growing child as a result of vitamin D deficiency
Health Source: Medical Dictionary
Author: Health Dictionary
A disease of childhood characterised chie?y by a softened condition of the bones (see BONE), and by other evidence of poor nutrition.

Causes This disease is the result of de?ciency of vitamin D in the diet. Healthy bones cannot be built up without calcium (or lime) salts, and the body cannot use these salts in the absence of vitamin D. Want of sunlight and fresh air in the dwellings where children are reared is also of importance. Once a common condition in industrial areas, it had almost disappeared in Great Britain but has recurred in recent years, largely amongst children of Asian and African origin.

The periosteum – the membrane enveloping the bones – becomes in?amed, and the bone formed beneath it is defective in lime salts and very soft. Changes also occur at the growing part of the bone, the epiphyseal plate.

Symptoms The symptoms of rickets most usually appear towards the end of the ?rst year, and rarely after the age of ?ve. The children are often ‘snu?y’ and miserable.

Gradually, changes in the shape of the bones becomes visible, ?rst chie?y noticed at the ends of the long bones. The softened bones also tend to become distorted, the legs bending outwards and forwards so the child becomes bow-legged or knock-kneed. Changes occur in the ribs (‘rickets rosary’) and cranial bones, while teeth appear late and decay or fall out.

The disease usually ends in recovery with more or less of deformity and dwar?ng – the bones, although altered in shape, becoming ultimately ossi?ed.

Treatment The speci?c remedy is vitamin D in the form of calciferol (vitamin D2). A full diet is of course essential, with emphasis upon a su?cient supply of milk. Rickets is very rare in breast-fed children but it is a wise precaution to give breast-fed babies supplementary vitamin

D. After the child is weaned, the provision of suitable food is vital, supplemented with some source of vitamin D. Regular exposure to sunlight is desirable. Controversy exists as to whether vitamin D should be added in the manufacture of ?our, particularly of types used by the Asian community.

De?ciency of vitamin D in adults results in osteomalacia (see under BONE, DISORDERS OF). (See also APPENDIX 5: VITAMINS.)

Health Source: Medicinal Plants Glossary
Author: Health Dictionary
n. a disease of childhood in which the bones do not harden due to a deficiency of *vitamin D. Without vitamin D, not enough calcium salts are deposited in the bones to make them rigid: consequently, they become soft and malformed. This is particularly noticeable in the long bones, which become bowed, and in the front of the ribcage, where a characteristic rickety ‘rosary’ may become apparent. The deficiency of vitamin D may be dietary or due to lack of exposure to sunlight, which is important in the conversion of vitamin D to its active form. In the UK rickets is more common in Asian immigrant families.

Renal rickets is due to impaired kidney function causing bone-forming minerals to be excreted in the urine, which results in softening of the bones.

Health Source: Oxford | Concise Colour Medical Dictionary
Author: Jonathan Law, Elizabeth Martin

Hypocalcaemia

A SERUM concentration of calcium below the normal range (between 2.33 and 3.05 mmol of calcium per 100 ml of serum). This may cause TETANY, acutely; chronically it may give rise to RICKETS, OSTEOMALACIA or osteoporosis (see BONE, DISORDERS OF). It may be caused by hypoparathyroidism (see THYROID GLAND, DISEASES OF), vitamin D de?ciency (see APPENDIX 5: VITAMINS), malabsorption, renal failure or acute pancreatitis (see PANCREAS, DISORDERS OF).... hypocalcaemia

Osteomalacia

Osteomalacia is the adult form of RICKETS. It is due to inadequate mineralisation of osteoid tissue caused by a de?ciency of vitamin D. This de?ciency may arise because of inadequate intake, or it may be due to impaired absorption such as occurs in intestinal malabsorption. It may also be due to renal disease, as the kidney is responsible for the hydroxylation of cholecalciferol, which has virtually no metabolic action, to dihydroxy-cholecalciferol – the metabolically active form of the vitamin. (See APPENDIX 5: VITAMINS.)... osteomalacia

Bone, Disorders Of

Bone is not an inert sca?olding for the human body. It is a living, dynamic organ, being continuously remodelled in response to external mechanical and chemical in?uences and acting as a large reservoir for calcium and phosphate. It is as susceptible to disease as any other organ, but responds in a way rather di?erent from the rest of the body.

Bone fractures These occur when there is a break in the continuity of the bone. This happens either as a result of violence or because the bone is unhealthy and unable to withstand normal stresses.

SIMPLE FRACTURES Fractures where the skin remains intact or merely grazed. COMPOUND FRACTURES have at least one wound which is in communication with the fracture, meaning that bacteria can enter the fracture site and cause infection. A compound fracture is also more serious than a simple fracture because there is greater potential for blood loss. Compound fractures usually need hospital admission, antibiotics and careful reduction of the fracture. Debridement (cleaning and excising dead tissue) in a sterile theatre may also be necessary.

The type of fracture depends on the force which has caused it. Direct violence occurs when an object hits the bone, often causing a transverse break – which means the break runs horizontally across the bone. Indirect violence occurs when a twisting injury to the ankle, for example, breaks the calf-bone (the tibia) higher up. The break may be more oblique. A fall on the outstretched hand may cause a break at the wrist, in the humerus or at the collar-bone depending on the force of impact and age of the person. FATIGUE FRACTURES These occur after the bone has been under recurrent stress. A typical example is the march fracture of the second toe, from which army recruits suffer after long marches. PATHOLOGICAL FRACTURES These occur in bone which is already diseased – for example, by osteoporosis (see below) in post-menopausal women. Such fractures are typically crush fractures of the vertebrae, fractures of the neck of the femur, and COLLES’ FRACTURE (of the wrist). Pathological fractures also occur in bone which has secondary-tumour deposits. GREENSTICK FRACTURES These occur in young children whose bones are soft and bend, rather than break, in response to stress. The bone tends to buckle on the side opposite to the force. Greenstick fractures heal quickly but still need any deformity corrected and plaster of Paris to maintain the correction. COMPLICATED FRACTURES These involve damage to important soft tissue such as nerves, blood vessels or internal organs. In these cases the soft-tissue damage needs as much attention as the fracture site. COMMINUTED FRACTURES A fracture with more than two fragments. It usually means that the injury was more violent and that there is more risk of damage to vessels and nerves. These fractures are unstable and take longer to unite. Rehabilitation tends to be protracted. DEPRESSED FRACTURES Most commonly found in skull fractures. A fragment of bone is forced inwards so that it lies lower than the level of the bone surrounding it. It may damage the brain beneath it.

HAIR-LINE FRACTURES These occur when the bone is broken but the force has not been severe enough to cause visible displacement. These fractures may be easily missed. Symptoms and signs The fracture site is usually painful, swollen and deformed. There is asymmetry of contour between limbs. The limb is held uselessly. If the fracture is in the upper

limb, the arm is usually supported by the patient; if it is in the lower limb then the patient is not able to bear weight on it. The limb may appear short because of muscle spasm.

Examination may reveal crepitus – a bony grating – at the fracture site. The diagnosis is con?rmed by radiography.

Treatment Healing of fractures (union) begins with the bruise around the fracture being resorbed and new bone-producing cells and blood vessels migrating into the area. Within a couple of days they form a bridge of primitive bone across the fracture. This is called callus.

The callus is replaced by woven bone which gradually matures as the new bone remodels itself. Treatment of fractures is designed to ensure that this process occurs with minimal residual deformity to the bone involved.

Treatment is initially to relieve pain and may involve temporary splinting of the fracture site. Reducing the fracture means restoring the bones to their normal position; this is particularly important at the site of joints where any small displacement may limit movement considerably.

with plaster of Paris. If closed traction does not work, then open reduction of the fracture may

be needed. This may involve ?xing the fracture with internal-?xation methods, using metal plates, wires or screws to hold the fracture site in a rigid position with the two ends closely opposed. This allows early mobilisation after fractures and speeds return to normal use.

External ?xators are usually metal devices applied to the outside of the limb to support the fracture site. They are useful in compound fractures where internal ?xators are at risk of becoming infected.

Consolidation of a fracture means that repair is complete. The time taken for this depends on the age of the patient, the bone and the type of fracture. A wrist fracture may take six weeks, a femoral fracture three to six months in an adult.

Complications of fractures are fairly common. In non-union, the fracture does not unite

– usually because there has been too much mobility around the fracture site. Treatment may involve internal ?xation (see above). Malunion means that the bone has healed with a persistent deformity and the adjacent joint may then develop early osteoarthritis.

Myositis ossi?cans may occur at the elbow after a fracture. A big mass of calci?ed material develops around the fracture site which restricts elbow movements. Late surgical removal (after 6–12 months) is recommended.

Fractured neck of FEMUR typically affects elderly women after a trivial injury. The bone is usually osteoporotic. The leg appears short and is rotated outwards. Usually the patient is unable to put any weight on the affected leg and is in extreme pain. The fractures are classi?ed according to where they occur:

subcapital where the neck joins the head of the femur.

intertrochanteric through the trochanter.

subtrochanteric transversely through the upper end of the femur (rare). Most of these fractures of the neck of femur

need ?xing by metal plates or hip replacements, as immobility in this age group has a mortality of nearly 100 per cent. Fractures of the femur shaft are usually the result of severe trauma such as a road accident. Treatment may be conservative or operative.

In fractures of the SPINAL COLUMN, mere damage to the bone – as in the case of the so-called compression fracture, in which there is no damage to the spinal cord – is not necessarily serious. If, however, the spinal cord is damaged, as in the so-called fracture dislocation, the accident may be a very serious one, the usual result being paralysis of the parts of the body below the level of the injury. Therefore the higher up the spine is fractured, the more serious the consequences. The injured person should not be moved until skilled assistance is at hand; or, if he or she must be removed, this should be done on a rigid shutter or door, not on a canvas stretcher or rug, and there should be no lifting which necessitates bending of the back. In such an injury an operation designed to remove a displaced piece of bone and free the spinal cord from pressure is often necessary and successful in relieving the paralysis. DISLOCATIONS or SUBLUXATION of the spine are not uncommon in certain sports, particularly rugby. Anyone who has had such an injury in the cervical spine (i.e. in the neck) should be strongly advised not to return to any form of body-contact or vehicular sport.

Simple ?ssured fractures and depressed fractures of the skull often follow blows or falls on the head, and may not be serious, though there is always a risk of damage which is potentially serious to the brain at the same time.

Compound fractures may result in infection within the skull, and if the skull is extensively broken and depressed, surgery is usually required to check any intercranial bleeding or to relieve pressure on the brain.

The lower jaw is often fractured by a blow on the face. There is generally bleeding from the mouth, the gum being torn. Also there are pain and grating sensations on chewing, and unevenness in the line of the teeth. The treatment is simple, the line of teeth in the upper jaw forming a splint against which the lower jaw is bound, with the mouth closed.

Congenital diseases These are rare but may produce certain types of dwar?sm or a susceptibility to fractures (osteogenesis imperfecta).

Infection of bone (osteomyelitis) may occur after an open fracture, or in newborn babies with SEPTICAEMIA. Once established it is very di?cult to eradicate. The bacteria appear capable of lying dormant in the bone and are not easily destroyed with antibiotics so that prolonged treatment is required, as might be surgical drainage, exploration or removal of dead bone. The infection may become chronic or recur.

Osteomalacia (rickets) is the loss of mineralisation of the bone rather than simple loss of bone mass. It is caused by vitamin D de?ciency and is probably the most important bone disease in the developing world. In sunlight the skin can synthesise vitamin D (see APPENDIX 5: VITAMINS), but normally rickets is caused by a poor diet, or by a failure to absorb food normally (malabsorbtion). In rare cases vitamin D cannot be converted to its active state due to the congenital lack of the speci?c enzymes and the rickets will fail to respond to treatment with vitamin D. Malfunction of the parathyroid gland or of the kidneys can disturb the dynamic equilibrium of calcium and phosphate in the body and severely deplete the bone of its stores of both calcium and phosphate.

Osteoporosis A metabolic bone disease resulting from low bone mass (osteopenia) due to excessive bone resorption. Su?erers are prone to bone fractures from relatively minor trauma. With bone densitometry it is now possible to determine individuals’ risk of osteoporosis and monitor their response to treatment.

By the age of 90 one in two women and one in six men are likely to sustain an osteoporosis-related fracture. The incidence of fractures is increasing more than would be expected from the ageing of the population, which may re?ect changing patterns of exercise or diet.

Osteoporosis may be classi?ed as primary or secondary. Primary consists of type 1 osteoporosis, due to accelerated trabecular bone loss, probably as a result of OESTROGENS de?ciency. This typically leads to crush fractures of vertebral bodies and fractures of the distal forearm in women in their 60s and 70s. Type 2 osteoporosis, by contrast, results from the slower age-related cortical and travecular bone loss that occurs in both sexes. It typically leads to fractures of the proximal femur in elderly people.

Secondary osteoporosis accounts for about 20 per cent of cases in women and 40 per cent of cases in men. Subgroups include endocrine (thyrotoxicosis – see under THYROID GLAND, DISEASES OF, primary HYPERPARATHYROIDISM, CUSHING’S SYNDROME and HYPOGONADISM); gastrointestinal (malabsorption syndrome, e.g. COELIAC DISEASE, or liver disease, e.g. primary biliary CIRRHOSIS); rheumatological (RHEUMATOID ARTHRITIS or ANKYLOSING SPONDYLITIS); malignancy (multiple MYELOMA or metastatic CARCINOMA); and drugs (CORTICOSTEROIDS, HEPARIN). Additional risk factors for osteoporosis include smoking, high alcohol intake, physical inactivity, thin body-type and heredity.

Individuals at risk of osteopenia, or with an osteoporosis-related fracture, need investigation with spinal radiography and bone densitometry. A small fall in bone density results in a large increase in the risk of fracture, which has important implications for preventing and treating osteoporosis.

Treatment Antiresorptive drugs: hormone replacement therapy – also valuable in treating menopausal symptoms; treatment for at least ?ve years is necessary, and prolonged use may increase risk of breast cancer. Cyclical oral administration of disodium etidronate – one of the bisphosphonate group of drugs – with calcium carbonate is also used (poor absorption means the etidronate must be taken on an empty stomach). Calcitonin – currently available as a subcutaneous injection; a nasal preparation with better tolerance is being developed. Calcium (1,000 mg daily) seems useful in older patients, although probably ine?ective in perimenopausal women, and it is a safe preparation. Vitamin D and calcium – recent evidence suggests value for elderly patients. Anabolic steroids, though androgenic side-effects (masculinisation) make these unacceptable for most women.

With established osteoporosis, the aim of treatment is to relieve pain (with analgesics and physical measures, e.g. lumbar support) and reduce the risk of further fractures: improvement of bone mass, the prevention of falls, and general physiotherapy, encouraging a healthier lifestyle with more daily exercise.

Further information is available from the National Osteoporosis Society.

Paget’s disease (see also separate entry) is a common disease of bone in the elderly, caused by overactivity of the osteoclasts (cells concerned with removal of old bone, before new bone is laid down by osteoblasts). The bone affected thickens and bows and may become painful. Treatment with calcitonin and bisphosphonates may slow down the osteoclasts, and so hinder the course of the disease, but there is no cure.

If bone loses its blood supply (avascular necrosis) it eventually fractures or collapses. If the blood supply does not return, bone’s normal capacity for healing is severely impaired.

For the following diseases see separate articles: RICKETS; ACROMEGALY; OSTEOMALACIA; OSTEOGENESIS IMPERFECTA.

Tumours of bone These can be benign (non-cancerous) or malignant (cancerous). Primary bone tumours are rare, but secondaries from carcinoma of the breast, prostate and kidneys are relatively common. They may form cavities in a bone, weakening it until it breaks under normal load (a pathological fracture). The bone eroded away by the tumour may also cause problems by causing high levels of calcium in the plasma.

EWING’S TUMOUR is a malignant growth affecting long bones, particularly the tibia (calfbone). The presenting symptoms are a throbbing pain in the limb and a high temperature. Treatment is combined surgery, radiotherapy and chemotherapy.

MYELOMA is a generalised malignant disease of blood cells which produces tumours in bones which have red bone marrow, such as the skull and trunk bones. These tumours can cause pathological fractures.

OSTEOID OSTEOMA is a harmless small growth which can occur in any bone. Its pain is typically removed by aspirin.

OSTEOSARCOMA is a malignant tumour of bone with a peak incidence between the ages of ten and 20. It typically involves the knees, causing a warm tender swelling. Removal of the growth with bone conservation techniques can often replace amputation as the de?nitive treatment. Chemotherapy can improve long-term survival.... bone, disorders of

Fontanelle

Areas on the head on which bone has not yet formed. The chief of these is the anterior fontanelle, situated on the top of the head between the frontal and two parietal bones. In shape it is four-sided, about 25 mm (1 inch) square at the time of birth, gradually diminishing until it is completely covered by bone, which should happen by the age of 18 months. The pulsations of the brain can be readily felt through it. Delay in its closure is particularly found in cases of RICKETS, as well as in other states of defective development. The fontanelle bulges in raised intracranial pressure from HYDROCEPHALUS and MENINGITIS, and depressed in DEHYDRATION.... fontanelle

Vitamin D

The collective term for a group of substances that help to regulate the balance of phosphate and calcium in the body, aid calcium absorption in the intestine, and promote strong bones and teeth.

Good sources include oily fish, liver, and egg yolk; vitamin D is also added to margarines. In the body, vitamin D is synthesized by the action of ultraviolet light on a particular chemical in the skin.

Deficiency may occur in people with a poor diet, in premature infants, and in those deprived of sunlight. It can also result from malabsorption. Other causes include liver or kidney disorders and some genetic defects. Prolonged use of certain drugs, such as phenytoin, may also lead to deficiency. Deficiency in young children causes rickets; long-term deficiency in adults leads to osteomalacia.Excessive intake of vitamin D may lead to hypercalcaemia and abnormal calcium deposits in the soft tissues, kidneys, and blood vessel walls.

In children, it may cause growth retardation.... vitamin d

Tetany

A condition characterised by SPASM of muscle, usually caused by a fall in blood CALCIUM levels. This results in hyperexcitability of muscles which may go into spasm at the slightest stimulus. This is well demonstrated in two of the classical signs of the disease: Chvostek’s sign, in which the muscles of the face contract when the cheek is tapped over the facial nerve as it emerges on the cheek; and Erb’s sign, in which muscles go into spasm in response to an electrical stimulus which normally causes only a contraction of the muscle. Tetany occurs in newborn babies, especially if they are premature, and in infants; as a result of RICKETS, excessive vomiting, or certain forms of NEPHRITIS. It may also be due to lack of the active principle of the PARATHYROID glands. Overbreathing may also cause it. Treatment consists of the administration of calcium salts, and in severe cases this is done by giving calcium gluconate intravenously or intramuscularly. High doses of vitamin D are also required.... tetany

Rachitic

A term used to describe abnormalities associated with rickets or to refer to people or populations with rickets.... rachitic

Calcium

Mineral. Combines with protein to give structural solidarity to bones and flesh. Given with benefit for all bone problems, delayed union after injury, brittleness in the elderly, delayed dentition and weakness in rapidly growing children. Cataracts. Rickets in children; osteomalacia in adults.

Other deficiencies. Muscle cramps, spasms, tremors, nervousness, insomnia, joint pains.

Body effects. Healthy teeth and bones, blood clotting, nerve and muscle resilience.

Calcium helps reduce risk of fracture particularly in menopausal women who may increase intake to 1500mg daily. Calcium citrate malate is regarded as more effective than calcium carbonate. Calcium and Magnesium are essentials.

Sources. Dairy products, fish, sardines, salmon, watercress, hard drinking water, spinach. Dried skimmed milk may supply up to 60 per cent of the recommended daily amount.

Herbs. Chamomile, Clivers, Dandelion, Horsetail, Coltsfoot, Meadowsweet, Mistletoe, Plantain, Scarlet Pimpernel, Silverweed, Shepherd’s Purse, Toadflax. Taken as teas, powders, tablets or capsules.

Herbal combination to increase intake. Comfrey 3, Horsetail 6, Kelp 1, Lobelia 1, Marshmallow root 2, Oats 4, Parsley root 1. Tea: 1 heaped teaspoon to each cup boiling water; infuse 15 minutes; 1 cup morning and evening.

Calcium tablet supplements should first be pulverised before ingestion and taken in honey, bread bolus, or other suitable vehicle. Vitamin D assists absorption – 400-800 international units daily. ... calcium

Antirachitic

Preventing or curing rickets... antirachitic

Bow Leg

Also known as genu varum: a deformity of the legs which comprises outward curvature between knee and ankle. It may be normal in infancy, and occurs in osteoarthritis, RICKETS and other metabolic bone diseases. In early childhood it may correct with growth, but in other cases surgical correction by osteotomy or ephiphyseal stapling is possible.... bow leg

Chest, Deformities Of

The healthy chest is gently rounded all over, its contour being more rounded in women by the breast tissue. In cross-section it is oval-shaped with a longer dimension from side to side than from back to front.

Barrel chest is found in long-standing ASTHMA or chronic BRONCHITIS and EMPHYSEMA, when the lungs are chronically enlarged. The anterio-posterior dimension of the chest is increased and the ribs are near horizontal. In this position they can produce little further expansion of the chest, and breathing often relies on accessory muscles in the neck lifting up the whole thoracic cage on inspiration.

Pigeon chest is one in which the cross-section of the chest becomes triangular with the sternum forming a sort of keel in front. It may be related to breathing problems in early life.

Rickety chest is uncommon now and is caused by RICKETS in early life. There is a hollow down each side caused by the pull of muscles on the softer ribs in childhood. The line of knobs produced on each side where the ribs join their costal cartilages is known as the rickety rosary.

Pectus excavatum, or funnel chest, is quite a common abnormality where the central tendon of the diaphragm seems to be too short so that the lower part of the sternum is displaced inwards and the lower ribs are prominent. When severe, it may displace the heart further to the left side.

Local abnormalities in the shape of the chest occur when there is a deformity in the spine such as scoliosis which alters the angles of the ribs. The chest wall may be locally ?attened when the underlying lung is reduced in size locally over a prolonged period. (See SPINE AND SPINAL CORD, DISEASES AND INJURIES OF.) This may be seen over a scarred area of lung such as that observed in pulmonary TUBERCULOSIS.... chest, deformities of

Cod-liver Oil

Cod-liver oil is derived from the fresh liver of the cod (Gadus callarius). It is a rich source of vitamin D, used in the prevention and treatment of RICKETS, and of vitamin A. Human milk contains more than enough vitamin D for the breast-fed baby, provided the mother has a balanced diet with adequate exposure to sunlight, or is taking vitamin supplements during pregnancy and lactation if considered necessary. All baby foods in the UK contain added vitamins, and therefore supplementation is unnecessary until weaning begins, and the baby starts taking cow’s milk, which contains less vitamin D than human milk. (See APPENDIX 5: VITAMINS.)... cod-liver oil

Cryptolepis Buchanani

Roem. & Schult.

Family: Asclepiadaceae; Periplo- caceae.

Habitat: Throughout India.

English: Indian Sarsaparilla (black var.).

Ayurvedic: Krishna Saarivaa, Jambupatraa Saarivaa, Karantaa, Shyamalataa, Shyaama, Gopi, Gopavadhu, Kaalghatika.

Siddha/Tamil: Maattan-kodi, Paal-Kodi, Kattupala.

Folk: Karantaa, Anantamuula (Varanasi).

Action: Blood-purifier, alterative. Used for rickets in children. In combination with Euphorbia microphylla, the herb is used as a galactagogue. A decoction of the stem is used as a supporting drug in paralysis; of the root bark in rheumatism.

The major constituent of the root extract is germanicol docosanoate. The roots contains cryptanoside C. The leaves gave cryptanoside A and B and a cardenolide, cryptosin.

Dosage: Root—5-10 g (API Vol. IV.); infusion—50-100 ml. (CCRAS.)... cryptolepis buchanani

Deformities

Malformations or distortions of part of the body. They may be present at birth, or they may be the result of injuries, or disease, or simply produced by bad posture, like the curved spine occasionally found in children. (See BURNS AND

SCALDS; CHEST, DEFORMITIES OF; TALIPES; FLAT-FOOT; JOINTS, DISEASES OF; KNOCK-KNEE; LEPROSY; PALATE, MALFORMATIONS OF; PARALYSIS; RICKETS; SCAR; SKULL; SPINE AND SPINAL CORD, DISEASES AND INJURIES OF.)... deformities

Ergocalciferol

A combination of CALCIFEROL and vitamin D2 (see APPENDIX 5: VITAMINS) given to prevent or cure RICKETS, a de?ciency disorder caused by the lack of calcium and vitamin D in the diet.... ergocalciferol

Ergosterol

A sterol found in yeasts and fungi and in plant and animal fat. Under the action of sunlight or ultraviolet rays it produces vitamin D2. The substance produced in this way is known as calciferol, and is used for the prevention and cure of RICKETS and OSTEOMALACIA. A similar change in the ergosterol of the skin is produced when the body is freely exposed to sunlight. Calciferol is probably not so active as, and di?ers chemically from, the vitamin D occurring in ?sh-liver oils. (See APPENDIX 5: VITAMINS.)... ergosterol

Dent’s Disease

a rare X-linked (see sex-linked) recessive inherited condition usually presenting in childhood or early adult life with polyuria, microscopic haematuria, renal stone disease, or rickets. The majority of patients have a mutation of the gene encoding chloride channel 5 (CLCN5); others have a defect of the OCRL1 gene, normally associated with Lowe’s syndrome, but do not present with the cataracts, learning disability, and tubular acidosis associated with this condition. In still others the genetic defect has yet to be defined but is not associated with either CLCN5 or OCRL1. Patients with Dent’s disease have evidence of proximal tubular dysfunction. [C. E. Dent (1911–76), British physician]... dent’s disease

Parsley

Petroselinum sativum

FAMILY: Apiaceae (Umbelliferae)

SYNONYMS: P. hortense, Apium petroselinum, Carum petroselinum, common parsley, garden parsley.

GENERAL DESCRIPTION: A biennial or shortlived perennial herb up to 70 cms high with crinkly bright green foliage, small greenish-yellow flowers and producing small brown seeds.

DISTRIBUTION: Native to the Mediterranean region, especially Greece. It is cultivated extensively, mainly in California, Germany, France, Belgium, Hungary and parts of Asia. The principal oil-producing countries are France, Germany, Holland and Hungary.

OTHER SPECIES: There are over thirty-seven different varieties of parsley, such as the curly leaved type (P. crispum), which is used in herbal medicine.

HERBAL/FOLK TRADITION: It is used extensively as a culinary herb, both fresh and dried. It is a very nutritious plant, high in vitamins A and C; also used to freshen the breath. The herb and seed are used medicinally, principally for kidney and bladder problems, but it has also been employed for menstrual difficulties, digestive complaints and for arthritis, rheumatism, rickets and sciatica. It is said to stimulate hair growth, and help eliminate head lice.

The root is current in the British Herbal Pharmacopoeia as a specific for flatulent dyspepsia with intestinal colic.

ACTIONS: Antimicrobial, antirheumatic, antiseptic, astringent, carminative, diuretic, depurative, emmenagogue, febrifuge, hypotensive, laxative, stimulant (mild), stomachic, tonic (uterine).

EXTRACTION: Essential oil by steam distillation from 1. the seed, and 2. the herb. (An essential oil is occasionally extracted from the roots; an oleoresin is also produced by solvent extraction from the seeds.)

CHARACTERISTICS: 1. A yellow, amber or brownish liquid with a warm woody-spicy herbaceous odour. 2. A pale yellow or greenish liquid with a heavy, warm, spicy-sweet odour, reminiscent of the herb. It blends well with rose, neroli, cananga, tea tree, oakmoss, clary sage and spice oils.

PRINCIPAL CONSTITUENTS: 1. Mainly apiol, with myristicin, tetramethoxyally benzene, pinene and volatile fatty acids. 2. Mainly myristicin (up to 85 per cent), with phellandrene, myrcene, apiol, terpinolene, menthatriene, pinene and carotel, among others.

SAFETY DATA: Both oils are moderately toxic and irritant – myristicin has been shown to have toxic properties, and apiol has been shown to have irritant properties; otherwise non sensitizing. Use in moderation. Avoid during pregnancy.

AROMATHERAPY/HOME: USE

Circulation muscles and joints: Accumulation of toxins, arthritis, broken blood vessels, cellulitis, rheumatism, sciatica.

Digestive system: Colic, flatulence, indigestion, haemorrhoids.

Genito-urinary system: Amenorrhoea, dysmenorrhoea, to aid labour, cystitis, urinary infection.

OTHER USES: Used in some carminative and digestive remedies, such as ‘gripe waters’. The seed oil is used in soaps, detergents, colognes, cosmetics and perfumes, especially men’s fragrances. The herb and seed oil as well as the oleoresin are used extensively in many types of food flavourings, especially meats, pickles and sauces, as well as alcoholic and soft drinks.... parsley

Dwarfism

Dwar?sm, or short stature, refers to underdevelopment of the body. The condition, which has various causes, is not common. All children who by the age of ?ve years are at least what is technically known as ‘three standard deviations below the mean’ – well below average size for children of that age – should be referred for specialist advice. Among the causes are:

•genetic: familial; abnormalities of chromosomes, for example, TURNER’S SYNDROME; abnormal skeletal development; and failure of primary growth.

intrauterine growth retardation: maternal disorders; placental abnormalities; multiple fetuses.

constitutional delay in normal growth.

systemic conditions: nutritional de?ciencies; gastrointestinal absorption disorders; certain chronic diseases; psychosocial deprivation; endocrine malfunctions, including HYPOTHYROIDISM, CUSHING’S SYNDROME, RICKETS, dysfunction of the PITUITARY GLAND which produces growth hormone, the endocrine growth controller. Treatment of short stature is, where possible,

to remedy the cause: for example, children with hypothyroidism can be given THYROXINE. Children who are not growing properly should be referred for expert advice to determine the diagnosis and obtain appropriate curative or supportive treatments.... dwarfism

Gait

The way in which an individual walks. Gait may be affected by inherited disorders; by illness – especially neurological disorders; by injury; or by drug and alcohol abuse. Children, as a rule, begin to walk between the ages of 12 and 18 months, having learned to stand before the end of the ?rst year. If a normal-sized child shows no ability to make movements by this time, the possibility of mental retardation must be borne in mind, and if the power of walking is not gained by the time the child is a year and a half old, RICKETS, CEREBRAL PALSY, or a malformation of the hip-joint must be excluded.

In hemiplegia, or PARALYSIS down one side of the body following a STROKE, the person drags the paralysed leg.

Steppage gait occurs in certain cases of alcoholic NEURITIS, tertiary SYPHILIS (tabes) and other conditions where the muscles that raise the foot are weak so that the toes droop. The person bends the knee and lifts the foot high, so that the toes may clear obstacles on the ground. (See DROP-FOOT.)

In LOCOMOTOR ATAXIA or tabes dorsalis, the sensations derived from the lower limbs are blunted, and consequently the movements of the legs are uncertain and the heels planted upon the ground with unnecessary force. When the person tries to turn or stands with the eyes shut, he or she may fall over. When they walk, they feel for the ground with a stick or keep their eyes constantly ?xed upon it.

In spastic paralysis the limbs are moved with jerks. The foot ?rst of all clings to the ground and then leaves it with a spasmodic movement, being raised much higher than is necessary.

In PARKINSONISM the movements are tremulous, and as the person takes very short steps, he or she has the peculiarity of appearing constantly to fall forwards, or to be chasing themselves.

In CHOREA the walk is bizarre and jerky, the affected child often seeming to leave one leg a step behind, and then, with a screwing movement on the other heel, go on again.

Psychologically based idiosyncracies of gait are usually of a striking nature, quite di?erent from those occuring in any neurological conditions. They tend to draw attention to the patient, and are worse when he or she is observed.... gait

Garcinia Cambogia

Desr.

Synonym: G. gummi-gutta (Linn.) Robs.

Family: Guttiferae; Clusiaceae.

Habitat: Western Ghats and Nilgiris.

English: Gamboge tree.

Ayurvedic: Vrkshaamla (allied species), Kokam (var.).

Siddha/Tamil: Kodakkapuli.

Action: Fruit rind—used in rickets and enlargement of spleen, in skeletal fractures.

The plant contains iso-prenylated polyphenols—cambogin and cambo- ginol. The fruit contains about 30% acid (dry weight basis), which is essentially (-)-hydroxycitric acid (HCA). HCA is a potent inhibitor of ATP citrate lyase, the enzyme that produces acetyl CoA for both fatty acid and cholesterol synthesis.

Taking Garcinia fruit rind extract orally does not seem to help decrease weight, satiety, fat oxidation or energy expenditure in obese people. Some researchers are of the view that garcinia inhibits the supply of fatty acids without affecting adipose conversion. (Natural Medicines Comprehensive Database, 2007.)

Latex gave benzophenone derivatives, camboginol and cambogin.... garcinia cambogia

Bowleg

An outward curving of bones in the legs that results in wide separation of the knees when the feet are together. Bowlegs are common in very young children and are a normal part of development. In most cases, the curve straightens as the child grows. If the bowing is severe, is on one side only, or persists beyond the age of 6, a doctor should be consulted. Surgery may be needed. Rarely, leg deformity is a result of bone disease, particularly rickets (a vitamin D deficiency) in children.... bowleg

Coxa Vara

A deformity of the hip in which the angle between the neck and head of the femur (thigh-bone) and the shaft of the femur is reduced, resulting in shortening of the leg, pain and stiffness in the hip, and a limp. The most common cause is a fracture to the neck of the femur or, during adolescence, injury to the developing part of the head of the bone. Coxa vara can also occur if the bone tissue in the neck of the femur is soft, a condition that may be congenital or the result of a bone disorder such as rickets or Paget’s disease. Treatment may include surgery (see osteotomy).... coxa vara

Fanconi’s Syndrome

A rare kidney disorder that occurs most commonly in childhood. Various important chemicals, such as amino acids, phosphate, calcium, and potassium, are lost in the urine, leading to failure to thrive, stunting of growth, and bone disorders such as rickets. Possible causes of the syndrome include several rare inherited abnormalities of body chemistry and an adverse reaction to certain drugs.

The child may resume normal growth if an underlying chemical abnormality can be corrected. Alternatively, a kidney transplant may be possible.... fanconi’s syndrome

Genetic Disorders

These are caused when there are mutations or other abnormalities which disrupt the code of a gene or set of GENES. These are divided into autosomal (one of the 44 CHROMOSOMES which are not sex-linked), dominant, autosomal recessive, sex-linked and polygenic disorders.

Dominant genes A dominant characteristic is an e?ect which is produced whenever a gene or gene defect is present. If a disease is due to a dominant gene, those affected are heterozygous – that is, they only carry a fault in the gene on one of the pair of chromosomes concerned. A?ected people married to normal individuals transmit the gene directly to one-half of the children, although this is a random event just like tossing a coin. HUNTINGTON’S CHOREA is due to the inheritance of a dominant gene, as is neuro?bromatosis (see VON RECKLINGHAUSEN’S DISEASE) and familial adenomatous POLYPOSIS of the COLON. ACHONDROPLASIA is an example of a disorder in which there is a high frequency of a new dominant mutation, for the majority of affected people have normal parents and siblings. However, the chances of the children of a parent with the condition being affected are one in two, as with any other dominant characteristic. Other diseases inherited as dominant characteristics include spherocytosis, haemorrhagic telangiectasia and adult polycystic kidney disease.

Recessive genes If a disease is due to a recessive gene, those affected must have the faulty gene on both copies of the chromosome pair (i.e. be homozygous). The possession of a single recessive gene does not result in overt disease, and the bearer usually carries this potentially unfavourable gene without knowing it. If that person marries another carrier of the same recessive gene, there is a one-in-four chance that their children will receive the gene in a double dose, and so have the disease. If an individual sufferer from a recessive disease marries an apparently normal person who is a heterozygous carrier of the same gene, one-half of the children will be affected and the other half will be carriers of the disease. The commonest of such recessive conditions in Britain is CYSTIC FIBROSIS, which affects about one child in 2,000. Approximately 5 per cent of the population carry a faulty copy of the gene. Most of the inborn errors of metabolism, such as PHENYLKETONURIA, GALACTOSAEMIA and congenital adrenal hyperplasia (see ADRENOGENITAL SYNDROME), are due to recessive genes.

There are characteristics which may be incompletely recessive – that is, neither completely dominant nor completely recessive – and the heterozygotus person, who bears the gene in a single dose, may have a slight defect whilst the homozygotus, with a double dose of the gene, has a severe illness. The sickle-cell trait is a result of the sickle-cell gene in single dose, and sickle-cell ANAEMIA is the consequence of a double dose.

Sex-linked genes If a condition is sex-linked, affected males are homozygous for the mutated gene as they carry it on their single X chromosome. The X chromosome carries many genes, while the Y chromosome bears few genes, if any, other than those determining masculinity. The genes on the X chromosome of the male are thus not matched by corresponding genes on the Y chromosome, so that there is no chance of the Y chromosome neutralising any recessive trait on the X chromosome. A recessive gene can therefore produce disease, since it will not be suppressed by the normal gene of the homologous chromosome. The same recessive gene on the X chromosome of the female will be suppressed by the normal gene on the other X chromosome. Such sex-linked conditions include HAEMOPHILIA, CHRISTMAS DISEASE, DUCHENNE MUSCULAR

DYSTROPHY (see also MUSCLES, DISORDERS OF – Myopathy) and nephrogenic DIABETES INSIPIDUS.

If the mother of an affected child has another male relative affected, she is a heterozygote carrier; half her sons will have the disease and half her daughters will be carriers. The sister of a haemophiliac thus has a 50 per cent chance of being a carrier. An affected male cannot transmit the gene to his son because the X chromosome of the son must come from the mother; all his daughters, however, will be carriers as the X chromosome for the father must be transmitted to all his daughters. Hence sex-linked recessive characteristics cannot be passed from father to son. Sporadic cases may be the result of a new mutation, in which case the mother is not the carrier and is not likely to have further affected children. It is probable that one-third of haemophiliacs arise as a result of fresh mutations, and these patients will be the ?rst in the families to be affected. Sometimes the carrier of a sex-linked recessive gene can be identi?ed. The sex-linked variety of retinitis pigmentosa (see EYE, DISORDERS OF) can often be detected by ophthalmoscopic examination.

A few rare disorders are due to dominant genes carried on the X chromosome. An example of such a condition is familial hypophosphataemia with vitamin-D-resistant RICKETS.

Polygenic inheritance In many inherited conditions, the disease is due to the combined action of several genes; the genetic element is then called multi-factorial or polygenic. In this situation there would be an increased incidence of the disease in the families concerned, but it will not follow the Mendelian (see MENDELISM; GENETIC CODE) ratio. The greater the number of independent genes involved in determining a certain disease, the more complicated will be the pattern of inheritance. Furthermore, many inherited disorders are the result of a combination of genetic and environmental in?uences. DIABETES MELLITUS is the most familiar of such multi-factorial inheritance. The predisposition to develop diabetes is an inherited characteristic, although the gene is not always able to express itself: this is called incomplete penetrance. Whether or not the individual with a genetic predisposition towards the disease actually develops diabetes will also depend on environmental factors. Diabetes is more common in the relatives of diabetic patients, and even more so amongst identical twins. Non-genetic factors which are important in precipitating overt disease are obesity, excessive intake of carbohydrate foods, and pregnancy.

SCHIZOPHRENIA is another example of the combined effects of genetic and environmental in?uences in precipitating disease. The risk of schizophrenia in a child, one of whose parents has the disease, is one in ten, but this ?gure is modi?ed by the early environment of the child.... genetic disorders

Knock-knee

Inward curving of the legs so that the knees touch, causing the feet to be kept further apart. Knockknee is common in toddlers and may be part of normal development. In adults or children, it may be caused by a disease such as rickets that softens the bones; osteoarthritis or rheumatoid arthritis of the knee; or a leg fracture that has not healed correctly. In children, the condition usually disappears by age 10. Knock-knee that persists, or is caused by a disorder, may require osteotomy, in which the tibia (shin) is cut and realigned to straighten the leg. In adults, knee-joint replacement may be needed.... knock-knee

Metabolic Disorders

A collection of disorders in which some part of the body’s internal chemistry (see METABOLISM; CATABOLISM) is disrupted. Some of these disorders arise from inherited de?ciencies in which a speci?c ENZYME is absent or abnormal, or does not function properly. Other metabolic disorders occur because of malfunctions in the endocrine system (see ENDOCRINE GLANDS). There may be over- or underproduction of a hormone involved in the control of metabolic activities: a prime example is DIABETES MELLITUS – a disorder of sugar metabolism; others include CUSHING’S SYNDROME; hypothyroidism and hyperthyroidism (see THYROID GLAND, DISEASES OF); and insulinoma (an insulin-producing tumour of the pancreas). The bones can be affected by metabolic disorders such as osteoporosis, osteomalacia (rickets) and Paget’s disease (see under BONE, DISORDERS OF). PORPHYRIAS, HYPERLIPIDAEMIA, HYPERCALCAEMIA and gout are other examples of disordered metabolism.

There are also more than 200 identi?ed disorders described as inborn errors of metabolism. Some cause few problems; others are serious threats to an individual’s life. Individual disorders are, fortunately, rare – probably one child in 10,000 or 100,000; overall these inborn errors affect around one child in 1,000. Examples include GALACTOSAEMIA, PHENYLKETONURIA, porphyrias, TAY SACHS DISEASE and varieties of mucopolysaccharidosis, HOMOCYSTINURIA and hereditary fructose (a type of sugar) intolerance.... metabolic disorders

Vitamin

A term applied to a group of substances which exist in minute quantities in natural foods, and which are necessary to normal nutrition, especially in connection with growth and development. Some – A, D, E and K – are fat-soluble and can be stored in the body. The remainder – C, B12 and other members of the B complex – are water-soluble and are quickly excreted. Most vitamins have now been synthesised. When they are absent from the food, defective growth takes place in young animals and children, and in adults various diseases arise; whilst short of the production of actual disease, persistent deprivation of one or other vitamin is apt to lead to a state of lowered general health. Certain de?ciencies in DIET have long been known to be the cause of SCURVY, BERIBERI, and RICKETS. A diet containing foods such as milk, eggs, butter, cheese, fat, ?sh, wholemeal bread, fresh vegetables and fruit should contain su?cient vitamins. Details of the various vitamins are given in APPENDIX 5: VITAMINS.... vitamin

Bladderwrack

Black tang. Fucus vesiculosis L. German: Algen. French: Algue marine. Italian: Alga marina. A sea-plant which transforms inert inorganic substances from the sea into organic minerals capable of nourishing the human body. One of the richest sources of minerals (micro-nutrients) chiefly iodine, sodium, manganese, sulphur, silicon, zinc and copper.

Keynote: thyroid gland.

Action: anti-hypothyroid, anti-obesic, anti-rheumatic, blood tonic, adaptogen, stimulates the circulation of lymph. Endocrine gland stimulant. Laxative. Antibiotic. Diuretic (mild).

Uses: Thyroid disease, thyroxin deficiency, simple goitre. Obesity of low-thyroid function, myxoedema (adaptogen). Faulty nutrition, listlessness, rickets, glandular ailments, general debility; to build up old broken-down constitutions. Cases requiring increased body heat – hypothermia. Allays onset of arteriosclerosis by maintaining elasticity of walls of blood vessels. Beneficial to male and female reproductive organs, liver, gall bladder and pancreas. Militates against onset of rheumatism and arthritis. Contains Vitamin K for prevention of strokes.

Combination. Burdock root, Clivers, Ground Ivy and Bladderwrack. (Heath and Heather)

Preparations: Thrice daily.

Teas: half teaspoon to each cup boiling water; infuse 15 minutes. Half-1 cup.

Liquid Extract: 1:1, 25 per cent ethanol, 5-10 drops.

Tincture, BHC Vol 1. 1:5, 25 per cent ethanol, Dose: 4-10ml.

Powder: important to those who do not eat fish or sea-foods. Added to soups, salads, cottage cheese; sprinkled on muesli or on a cooked meal.

Tablets/capsules. 300mg Kelp BHP (1983) with 12mg Kelp extract. 1 tablet or capsule thrice daily after meals. Not for children under five.

Diet: Combination rich in essential nutrients: Kelp powder, Alfalfa tea, Soya bean products, Dandelion (coffee). ... bladderwrack

Osteodystrophy

Any generalized bone defect due to metabolic disorders.

Types of osteodystrophy include rickets; osteomalacia; osteoporosis due to Cushing’s syndrome or excessive intake of corticosteroid drugs; and bone cysts and bone mass reduction associated with chronic kidney failure or hyperparathyroidism.

In adults, an osteodystrophy is usually reversible if the underlying cause is treated before bone deformity occurs.... osteodystrophy

Alfacalcidol

n. 1?-hydroxycholecalciferol: a derivative of vitamin D that is used to raise blood calcium levels for the prevention or treatment of rickets and *osteomalacia in patients with severe kidney disease.... alfacalcidol

Dwarfism

n. abnormally short stature from any cause. The most common type is achondroplastic dwarfism (see achondroplasia). Pituitary dwarfism results from a deficiency of *growth hormone due to a defect in the pituitary gland; people with this type of dwarfism are well proportioned. Primordial dwarfism is due to a genetic defect in the response to growth hormone. Dwarfism may also be associated with thyroid deficiency (see cretinism), in which both physical and mental development are arrested; chronic diseases such as rickets; renal failure; and intestinal malabsorption.... dwarfism

Bone Disorders

May be present at birth or due to infection (osteomyelitis, tuberculosis, etc), fractures from injury or accident, osteoporosis, Paget’s disease (deformity due to mineral deficiency), tumour or sarcoma, osteomalacia, rickets due to Vitamin D deficiency. Brittle-bone disease. Arthritis. See separate entries.

Comfrey decoction. 1 heaped teaspoon to cup water gently simmered 5 minutes; strain when cold; 1 cup – to which is added 20 drops Tincture Calendula (Marigold), thrice daily. Fenugreek seeds may be used as an alternative to Comfrey.

Alternative:– Mixture: equal parts liquid extracts: Comfrey, Marigold, St John’s Wort. One teaspoon in water or honey thrice daily.

Tablets/capsules. Fenugreek, St John’s Wort.

Topical. Comfrey, Fenugreek or Horsetail poultice.

Supplements. Vitamin A, C, E. Dolomite, Zinc.

Supportive. Exposure of site to sunlight.

Comfrey. The potential benefit of Comfrey root outweighs possible risk for bone disorders. ... bone disorders

Craniopharyngioma

A rare, non-hormone-secreting tumour of the pituitary gland. Symptoms of a craniopharyngioma may include headaches, vomiting, and defective vision. If a craniopharyngioma develops in childhood, growth may become stunted and sexual development may not occur. Craniopharyngiomas are usually removed surgically. Untreated, they may cause permanent brain damage. craniosynostosis The premature closure of one or more of the joints (sutures) between the curved, flattened bones of the skull in infants. If all the joints are involved, the growing infant’s brain may be compressed and there is a risk of brain damage from pressure inside the skull. If the abnormality is localized, the head may be deformed. Craniosynostosis may occur before birth and, in some cases, is associated with other birth defects. It may also occur in an otherwise healthy baby, or in a baby affected by a disorder such as rickets. If the brain is compressed, an operation may be performed to separate the fused skull bones.... craniopharyngioma

Deformity

Any malformation or distortion of part of the body.

Deformities may be congenital (present from birth), or they may be acquired as a result of injury, disorder, or disuse.

Most congenital deformities are relatively rare.

Among the more common are club-foot (talipes) and cleft lip and palate.

Injuries that can cause deformity include burns, torn muscles, and broken bones.

Disorders that may cause deformity include nerve problems, some deficiencies, such as rickets, and Paget’s disease of the bone.

Disuse of a part of the body can lead to deformity through stiffening and contracture of unused muscles or tendons.

Many deformities can be corrected by orthopaedic techniques, plastic surgery, or exercise.... deformity

Short Stature

A height significantly below the normal range for a person’s age. Short stature in children is often due to hereditary factors or slow bone growth. In most cases, growth eventually speeds up, resulting in normal adult height. Less commonly, it is due to a specific disorder such as bone disease (as in untreated rickets or achondroplasia) or certain hormonal disorders such as growth hormone deficiency and hypothyroidism. Emotional deprivation, chronic malnutrition and malabsorption can also limit growth. Certain chromosomal disorders cause short stature; stunting occurs in Down’s syndrome, and the pubertal growth spurt is absent in Turner’s syndrome. Other causes of restricted growth in children include prolonged use of corticosteroids and anticancer drugs. Severe untreated respiratory disease or congenital heart disease can also cause short stature.

An affected child’s growth rate is monitored by regular measurement of height.

X-rays and blood tests may help identify an underlying cause, which will then be treated.

Growth hormone is given for hormone deficiency, and also to treat short stature due to disorders such as Turner’s syndrome.

(See also growth, childhood.)... short stature

Fanconi Syndrome

a disorder of the proximal kidney tubules, which may be inherited or acquired and is most common in children. It is characterized by the urinary excretion of large amounts of amino acids, glucose, and phosphates (though blood levels of these substances are normal). Symptoms may include osteomalacia, rickets, muscle weakness, and *cystinosis. Treatment is directed to the cause. [G. Fanconi]... fanconi syndrome

Laryngismus

n. closure of the vocal folds by sudden contraction of the laryngeal muscles, followed by a noisy indrawing of breath. It occurs in young children and was in the past associated with low-calcium rickets. Now it occurs when the larynx has been irritated following administration of anaesthetic, when a foreign body has lodged in the larynx, or in *croup.... laryngismus

Comfrey

Knitbone. Symphytum officinale, L. French: Grande consoude. German: Reinweld. Italian: Consolide maggiore. Part used: root and leaves. Considerable therapeutic versatility.

Constituents: allantoin, pyrrolizidine alkaloids (fresh young leaves and roots), mucilage, phenolic acids, steroidal saponins (root).

Action: astringent-demulcent, haemostatic, vulnerary. Rapid healer of flesh and bones by its property to accelerate mitosis (cell-division). Useful wherever a mucilaginous tissue restorative is required (repairing broken bones and lacerated flesh), especially in combination with Slippery Elm powder which prevents excess fluidity.

Uses: Ulceration anywhere along the gastrointestinal tract; colitis, hiatus hernia.

Bleeding from stomach, throat, bowel, bladder and lungs (haemoptysis) in which it reduces blood clotting time. Once used extensively for tuberculosis (pulmonary and elsewhere). Irritating cough, ‘dry’ lung complaints; pleurisy. Increases expectoration. Should not be given for oedematous conditions of the lungs.

Bones – fractures: to promote formation of a callus; rickets, wasting disease. Skin – varicose ulcers and indolent irritating sores that refuse to heal. Promotes suppuration of boils and gangrene as in diabetes. Bruises. STD skin lesions, internally and externally. Blood sugar control: assists function of the pancreas. Urine: scalding. Rheumatoid arthritis: improvement reported. Malignancy: cases of complete regression of sarcoma and carcinoma recorded. Rodent ulcer, (as a paste).

Preparations: thrice daily.

Tea: dried herb, one heaped teaspoon to each cup; or, 1oz to 1 pint boiling water; infuse 15 minutes, half- 1 cup for no more than 8 weeks.

Tincture (leaf). 1 part to 5 parts alcohol: dose 2.5-5ml. Maximum weekly dosage – 100ml for no more than 8 weeks.

Tincture (root). 1 part to 5 parts alcohol. Maximum weekly dosage – 80ml, for 8 weeks.

(National Institute of Medical Herbalists)

Poultice. A mucilage is prepared from fresh root in a liquidiser or by use of a rolling pin. For sprains, bruises, severe cuts, cleaning-out old ulcers and wounds.

Compress. 3 tablespoons crushed root or powder in 1 pint (500ml) water. Bring to boil; simmer gently 10 minutes. Saturate linen or suitable material and apply. Renew 2-3 times daily as moisture dries off. Ointment. 1 part powder, or liquid extract, to 10 parts base (cooking fat, Vaseline, etc).

Oil (external use). Ingredients: powdered Comfrey root in peanut oil and natural chlorophyll. (Henry Doubleday Research Association)

Notes. Contains trace element germanium, often given for cancer and arthritis. (Dr Uta Sandra Goodman) Helps eliminate toxic minerals. Neutralises free radicals that are created by toxic substances entering the body. Restores the body’s pH balance disturbed by highly acid foods such as meat, dairy products, refined foods and alcohol.

Dr H.E. Kirschner, well-known American physician, reported being called to the bedside of a patient with a huge advanced cancer of the breast. The odour was over-powering and the condition hopeless, but he advised poultices of fresh crushed Comfrey leaves several times daily to the discharging mass. Much to the surprise of all, the vile odour disappeared. The huge sore scaled over and the swelling subsided. Within three weeks the once-malignant sore was covered with a healthy scale and the pain disappeared. Unfortunately, treatment came too late; metastases had appeared in the liver which could not be reached by the poultices.

Claims that Comfrey is a toxic plant are unsubstantiated by a mass of clinical evidence to the contrary. Attempts to equate the effects of its isolated compounds apart from the whole plant yield conflicting results. For thousands of years the plant has been used by ancient and modern civilisations for healing purposes. Risks must be balanced with benefits.

There is a growing body of opinion to support the belief that a herb which has, without ill-effects been used for centuries and capable of producing convincing results is to be recognised as safe and effective.

Experiments reveal that in sufficient doses Comfrey can cause liver disease in laboratory animals. Its risk to humans has been a matter of serious debate since the 1960s, and is still unresolved. Although the overall risk is very low, a restriction has been placed on the plant as a precautionary measure. Fresh Comfrey leaves should not be used as a vegetable which is believed to be a health risk. It is believed that no toxicity has been found in common Comfrey (Symphytum officinale L). No restriction has been placed on use of dried Comfrey leaves as a tea. The debate continues.

It would appear that use of the root of Symphytum officinale may be justified in the treatment of severe bone diseases for which it has achieved a measure of success in the past, such as rickets, Paget’s disease, fractured bones, tuberculosis, etc, its benefits outweighing risks. Few other medicinal plants replenish wasted bone cells with the speed of Comfrey. (external use only) ... comfrey


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