is--and screams if it is touched; a
swelling is found over one of the bones, usually the femur, accompanied
by exquisite tenderness; the skin is tense and shiny, and there may be
some oedema. These symptoms are due to a sub-periosteal haemorrhage, and
associated with this there may be crepitus from separation of an
epiphysis, rarely from fracture of the shaft of the bone. X-ray
photographs show enlargement of the bone, the periosteum being raised
from the shaft and new bone formed in relation to it. Haemorrhages also
occur into the skin, presenting the appearance of bruises, into the
orbit and conjunctiva, and from the mucous membranes.

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).

#Osti