The diet of rachitic children has to be watched carefully in order that overfeeding may be avoided. With artificial feeding it is advisable to add some fresh fruit and vegetables to the other food even from about the seventh month, and to give, in addition to the cow's milk, meat broth, yolk of egg, fresh scraped mutton, fresh vegetable puree, fresh fruit juice and the like. Naturally, all these articles are to be given only in small amounts, and only once a day. In order to increase the diet of thin rachitic children a small teaspoonful of malt extract may be given two or three times a day, either clear or stirred in the milk.
Salt baths for fat, pasty children act well, but with thin erythema tous ones they do more harm than good. They should be given two or three times a week for about 10 minutes at a time at about 3:3° C. (93° F.), and containing 1 to 4 pounds to 2 kilos) of sea salt to a bath.
Residence at the seashore is valuable as a climatic cure but for various reasons it is only exceptionally available. In cases in which there is no special tenderness it is advisable to employ regular bathing with alcoholic liquids, or gentle rubbing with aromatic liniments. After
the decline of the active stage, massage properly carried out for a month or so acts very favorably upon the general health, the ability to walk, and even upon the growth.
The Epstein rocking chair is especially recommended for children with beginning spinal deformity. With severe craniotabes it is well to have the head of the child lie upon a soft ring or upon a horse hair pillow with a depression in the centre.
Angular deformities of the long bones are best corrected in the active stage of the disease, but it is far more judicious to delay the or thopedic treatment of rachitic deformities of the limbs until the sixth or seventh year. Very frequently even severe deformities correct them selves spontaneously before this time if the child grows strong. In the case of rachitic dwarfs a long continued and careful treatment with small doses of thyroid extract is beneficial, in addition to the massage. The treatment of rachitic fractures of the femur by vertical extension is to be condemned, for rachitic bones which arc vertically suspended undergo an acute softening, the anatomical basis of which is an acute rachitic osteoporosis.