The treatment consists in correcting the errors in diet.  The infant should have a wet nurse or a plentiful supply of cow’s milk in its natural state.  Anti-scorbutics in the form of orange, lemon, or grape juice, and of potatoes bruised down in milk, may be given.

#Osteomalacia.#—­The term osteomalacia includes a group of conditions, closely allied to rickets, in which the bones of adults become soft and yielding, so that they are unduly liable to bend or break.

One form occurs in pregnant and puerperal women, affecting most commonly the pelvis and lumbar vertebrae, but sometimes the entire skeleton.  The lime salts are absorbed, the bones lose their rigidity and bend under the weight of the body and other mechanical influences, with the result that gross deformities are produced, particularly in the pelvis, the lumbar spine, and the hip-joints.

Neuropathic forms occur in certain chronic diseases of the brain and cord; in some cases the bones lose their lime salts and bend, in others they become brittle.

Osteomalacia associated with New Growths in the Skeleton.—­When secondary cancer is widely distributed throughout the skeleton, it is associated with softening of the bones, as a result of which they readily bend or break, and after death are easily cut with a knife.  In the disease known as multiple myeloma, the interior of the ribs, sternum, and bodies of the vertebrae is occupied by a reddish gelatinous pulp, the structure of which resembles sarcoma; the bones are reduced to a mere shell, and may break on the slightest pressure; the urine contains albumose, a substance resembling albumen but coagulating at a comparatively low temperature (140 F.), and the coagulum is re-dissolved on boiling, and it is readily precipitated by hydrochloric acid (Bence-Jones).

#Ostitis Deformans—­Paget’s Disease of Bone.#—­This rare disease was first described by Sir James Paget in 1877.  In the early stages, the marrow is transformed into a vascular connective tissue; its bone-eating functions are exaggerated, and the framework of the bone becomes rarefied, so that it bends under pressure as in osteomalacia.  In course of time, however, new bone is formed in great abundance; it is at first devoid of lime salts, but later becomes calcified, so that the bones regain their rigidity.  This formation of new bone is much in excess of the normal, the bones become large and bulky, their surfaces rough and uneven, their texture sclerosed in parts, and the medullary canal is frequently obliterated.  These changes are well brought out in X-ray photographs.  The curving of the long bones, which is such a striking feature of the disease, may be associated with actual lengthening, and the changes are sometimes remarkably symmetrical (Fig. 135).  The bones forming the cranium may be enormously thickened, the sutures are obliterated, the distinction into tables and diploe is lost, and, while the general texture is finely porous, there may be areas as dense as ivory (Fig. 134).