If the above measures are properly attemled to improvement will quickly begin. Directly the bowels have been got into a healthy state cod-liver oil should be given. A quantity much less than that usually prescribed is, however, sufficient ; for children, infants especially, have comparatively small power of digesting fats. It is best to begin with ten drops of the light brown oil, and during its administration the stools must be carefully watched for any appearance of undigested oil. The quantity can be grad ually increased by a few drops at a time as long as none of the oil is seen to pass undigested from the bowels. Iron is also useful. Iron wine xx.-xl.), the ensiccated sulphate of iron (gr. ij.-iv.), or the tincture of the perchlonde v.-xv.)—all these are useful, and are to be preferred to any of the syrupy preparations. The latter are not fitted for rickety subjects, as the large quantity of sugar they contain encourages fermentation and acidity, and often, indeed, by the disturbance it sets up in the bowels,' makes each dose of the medicine decidedly prejudicial to the patient. If quinine be given, the tannate is the most suitable preparation. One or two. grains should be suspended in glycerine and given two or three times a day. If there is any tendency to acidity left after rearrangement of the diet, the ammonio-citrate of iron may be given in a draught with a few grains of bicarbonate of soda and one drop of the tincture of nun vomica. between meals.
The salts of lime were at one time recommended in the treatment of rickets, as it was supposed that the bone-softening was due to a deficiency of lime in the system. In practice, however, the use of these drugs has not been found of value ; indeed, the remedy, for any special benefit it.
produces, may as well not be given at all.
The copious perspirations from the head and neck are always a source of great anxiety to the mother. They can be controlled by applying bella donna liniment to the Darts where secretion is couious before the child is put to bed. He may also take one drop of liq. atropi every night. Directly the tenderness has subsided steady frictions with the hand alone, or with olive-oil, all over the body, especially along the spine, are of great service and do much to strengthen the muscles. The nurse should be di rected to rub the child steadily for a quarter of an hour immediately after his bath. In the morning the open hand or a flesh glove may be used ; in the evening it is advisable to employ warm olive-oil for the frictions. As the child improves and his strength begins to return, a cold or tepid saline douche, given as he sits in the warm water of his bath, will be of service.
Care must be taken to prevent the child's getting on his feet before his bones are sufficiently solid to bear his weight. As his strength in]; proves he seizes every opportunity of practising his newly acquired power of standing, and very marked deformities of the tibia may be produced by this means. In such cases support may be given to the limbs by the use of light, padded splints, and if the ligaments of the joints are much relaxed a firmly applied elastic bandage can be made use of.
The treatment of any deformities which may remain after the complete cessation of the disease falls rather under the department of the surgeon. For the treatment of the various complications of rickets the reader is referred to the special chapters treating on these subjects.