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1928
36
to direct sunlight. Sunlight and Cod liver oil therefore cure
rickets because sunlight produces in the skin the substance which
Cod liver oil provides ready made.
It is now intelligible why rickets is a comparatively rare
disease both in natives living under tropical conditions and in the
inhabitants of the Arctic zone. The extra sunshine experienced
by the one set of people makes the smaller amount of calcifying
Vitamins in their diet do the work carried out by the larger
intake of the Eskimo. People living in a temperate zone under
modern industrial conditions of diet are often poorly supplied
by both these therapeutic agents, and an intelligent application
of the facts which have come to light may confidently be expected
to result in the prevention of one of the most serious dsieases
to which urban populations are liable.
In this country it is difficult to estimate the relative
importance of these two factors in the causation of rickets.
Possitaly, their relation to rickets varies in different parts of
England and Wales, but it is incumbent for Public Health
authorities to use every means to apply the results of these
researches for the prevention of rickets. Most Infant Welfare
Centres have for years been instrumental in the cheap distribution
of Cod liver oil, and the instruction given at these Centres
included the importance of proper clothing of infants and the
inculcation of the cult of the open air.
Very few people are aware of the many and varied efforts
of Health Visitors in this respect. We are particularly fortunate
in this district in the number and situation of open spaces and
public parks, but many mothers are unable to take out the
younger children, and frequently, the only chance of the babies
enjoying the open air and sunshine occurs when they are put
out in the back or front garden in a perambulator. Even
perambulators are not always available and many an one has
been secured through the kind offices of the Health Visitors
among their friends whose children have grown up and can spare
the perambulator.
We can therefore claim to have applied the results of these
researches in the prevention of rickets, but during many months
of the year the amount of sunshine in towns is negligible, and
certainly not sufficient to exert any curative influence.
In this country heliotherapy and actinotherapy are of
necessity combined because of the difficulty of obtaining winter
sunlight in towns. Antinotherapy is really a natural development
of heliotherapy. It was the impossibility of securing reliable
sources of natural sunlight at low altitudes and the discovery
that a thin film of clouds, smoke or atmospheric moisture completely
absorbed the beneficial effects of sunlight that led Finsen