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Group II (Rickets) .—In addition to one or more of the signs shown
by Group I, all these children exhibited bony changes, the most frequent
being bossing of the head, beading of the ribs, and delayed dentition.
Lateral bowing of the legs, knock-knees of varying degree, and minor
deformities of the chest are still quite common, but the gross deformities
of limbs and chest are now rare. Attention to their feeding, general
hygienic measures, regular and adequate doses of cod liver oil, and
treatment in the light department gradually overcome the disease, and
except in the severe cases no stigmata remain; but in this group antirachitic
measures must be carried on over a prolonged period. As in
Group I, increase of muscle tone and the cessation of head-sweating are
the earliest signs of improvement. Beading of the ribs is the first bony
sign to disappear.
Group III (Catarrhal) .—These, cases were referred on account of
frequent infections of the upper respiratory passages and bronchitis.
Among them are included cases showing some evidence of rickets.
Improvement follows treatment in a fair proportion of these children,
but those showing disease of the tonsils and adenoids do not respond well.
Group IV (Debility following Illness).—This comparatively large
group again includes some rachitic children. After prolonged confinement
indoors, ultra-violet light does much to hasten the convalescence,
especially after whooping cough. In this and the rachitic groups we get
our best results.
Groups V, VI and VII call for no special comment.
Group P. (Prophylaxis).—The. majority in this group are bottle-fed
children, and treatment was given as a precaution against rickets.
Mothers.—Only 14 mothers came under treatment during the year.
This is disappointing, because ultra-violet light during pregnancy is a
tonic to the mother, and we hoped it would prove yet another useful antirachitic
measure. Unfortunately there are few mothers who can give the
necessary time for the treatments.
No attempt has been made to assess the value of light treatment in
individual cases; in fact, it is impossible to dissociate the effects of
treatment in the light department from those obtained by the various
efforts to improve the health of the children attending the welfare clinics.