Review: Phosphorus in Fish Nutrition

the causes of rickets, ". . . it most frequently occurs among persons living in low, dark, damp, filthy cellars, and
ill-ventilated and over-crowded dwellings, such as may be found in many parts of this metropolis, where they are
not only ill-fed and ill-clothed, but are also denied the enjoyment of a due supply of the great physical agents of
life,--- namely, light, heat, pure air, and water." Evanson & Maunsell (1847) wrote similarly alike; but they added,
". . . any thing, in fact, which prevents a healthy nutrition, may produce rickets." They did not mention specific
nutrients or foods.
Rickets: 1. Non-nutritional line
Coote (1869) wrote, "(In rickets) the tissues destined to form the hard bony skeleton remain soft in consequence of
insuffici ent impregnation or deposit of phosphate of lime, . . ." He suggested the following treatments for rickets,
"Of all measures the most important is the removal of the child to some country district where the air is pure and the
soil dry: in most cases the sea-side is preferable. The patient, lightly yet warmly clad, should pass nearly the entire
day out of doors, and for the moment books of instruction should be disregarded." Palm (1890), an English
physician who practiced in Japan for several years, noticed that rickets were abs ent in all classes of the native
population in Japan as compared with its lamentable frequency among the poor children of the large centres of
population in England and Scotland. He suggested that sunlight should be regarded as a therapeutic agent.
Findlay (1908) of the University of Glasgow produced rickets in a group of puppies fed on a milk and porridge diet.
When another group was allowed to run in the open, they did not develop rickets. He, therefore, thought that
exercise was the explanation of the difference. Raczynski (1912) performed a definite experiment by exposing
two rachitic puppies to either sunlight or shade for six weeks, and showed that the sunlight-exposed animal had a
1.5-fold higher bone mineral content. Huldschinsky (1919) reported that children could be cured of rickets by
exposing their skins to UV radiation, which was subsequently confirmed by Hess, Unger & Pappenheimer (1921)
in New York City and by Shipley, Park, Powers, McCollum & Simmonds (1921) in Baltimore. It should be
noted that Mellanby (1919)-- but not Mellanby (1918)-- reported that suet could be one of the most potent
antirachitic substances along with cod-liver oil and butter. Kramer & Howland (1922) studied normal and
ricketic rats, and noted that when the inorganic P of the serum was low it could be increased by (1) a few days of
starvation, (2) by addition of inorganic P to the diet, (3) by addition of cod liver oil and (4) by exposure of the
animals to UV radiations. Hess & Weinstock (1922) excised a small portion of skin, irradiated it with UV light,
and then fed it to groups of rachitic rats. The irradiated skin could provide an absolute protection against rickets,
whereas the unirradiated skin provided no protection. Goldblatt & Soames (1923) identified that when a
precursor of vitamin D in the skin (7-dehydrocholesterol) was irradiat ed with sunlight or ultraviolet light, a
substance equivalent to the fat-soluble vitamin was produced. Hess (1924) discovered that irradiating a
rickets-producing diet with UV light conferred on the diet anti-ricketic properties. Steenbock & Black (1924) also
showed that vegetable oils, devoid of fat-soluble vitamins, acquired the calcifying properties of vitamin D when
exposed to UV radiation.
Rickets: 2. Nutritional line
The history of cod-liver oil use as a medicine has been discussed in depth by Guy (1923) and Hess (1929).
Cod-liver oil appeared to be a folk medicine of Manchest er where the weather was frequently rainy and sunlight
seldom fell on the ground. In 1789, Percival of Manchester stated that cod-liver oil had been dispensed so largely
in the hospital here. He spoke about a letter of Dr. Darbey written in 1782 reporting the great effect of cod-liver oil
for the remedy of chronic rheumatism. Bennett (1848) said that Dr. Bardsley had written in a medical report of the
Manchester Infirmary in 1807 about the efficacy of cod liver oil for osteomalaci a. Schenck (1826) published a
paper on the remarkable value of cod-liver oil for curing rickets of children. However, until the latter half of the
19th century, major articles on rickets did not state anything about the use of cod-liver oil. Jenner (1860) wrote,
"Cod-liver oil is considered by some French writers of repute a speci fic in rickets. . . . But although my experience
of cod-liver oil does not confirm the statements of Bouchut, it enables me to say that it is a very valuable remedy."
He said, "rickets causes, primarily or secondarily, more deaths than any other disease of childhood." He added,
however, "There is no specific for the cure of rickets." He thought cancer and rickets were both nutritional diseases.
He also wrote, "It is not probable that there is any lack of lime in the blood, seeing that one secretion from the blood,
viz. the urine, was found, in Marchands's experiments, to contain six times its normal quantity of lime-salts." Also,
"The health of the mother, however, has a decided influence on the development of rickets in the child.", and ". . .
the child must be frequently taken out of door. . . it should be removed into the country. Dry, bracing sea air is the
© 2000, 2005. Shozo H. Sugiura. All rights reserved.
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