Review: Phosphorus in Fish Nutrition

est." He also recommended numerous other remedies, most of which were, however, questionable. The gravity
of rickets was evident in those days as Jenner also wrote, "Can we wonder that rickets is prevalent among the poor
of London? Can we fail to wonder that geography, history, and crochet-work form so large items in the instruction
imparted at our national schools, and the doctrines of life so small. Let the girls there educated be taught that
Constantinople is the capital of Turkey if it be any advantage for them to know it, but let them also learn how to
dress, nurse, feed, and lodge an infant, so that it may run a fair chance of not swelling the amount of that truly awful
column in the Registrar-General's returns--- Deaths under one year." Dick (1863) fed dogs with meat, bread and
broth, and experimentally produced rickets. This convinced him to say that rickets is induced by improper or
insuffici ent food, especi ally with bad milk. He wrote (in the footnote!), "About three months after the above was
written, the dogs completely recovered under the administration of cod-liver oil, with a bread-and-milk diet. Only
their fore-legs remain slightly bent." Brodhurst (1868) gave numerous recommendations for the treatment of
rickets, including cod-liver oil as well as warm clothing, a diet composed mainly of animal sources, dry and pure air,
tepid bathing, various preparations of iron, and lastly nitro-muriatic acid bath (which, he said, was a recourse and of
great value when used occasionally). However, the author was obviously uncertain about the value of cod-liver oil.
Coote (1869) recommended the diet that was light, nutritious, consisting chiefly of milk and farinaceous food, of
fruit and vegetables, and meat should be given sparingly. He objected repeatedly to the use of cod-liver oil since
the stomach seemed to reject it. He said that the same benefits could be obtained by regulation of the suitable
articles of diet. "When the bowels are out of order", he said, "the alimentary canal should be cleared by the use of
gentle pugatives, such as rhubarb and magnesia, or rhubarb and gray powder (i.e. mercury), or a dose of castor oil."
He also recommended the use of iron preparations, chalybeate waters, quinine, etc. Interestingly, only in the
previous year in the same journal, did Gee (1868) strongly recommend the use of cod-liver oil in the treatment of
rickets as he wrote, "And in cod liver oil we possess a pharmaceutical agent worthy of a place beside iron, Peruvian
bark, and mercury. We ought to lose no time over the symptoms of rickets; slight catarrh, diarrhoea, paleness, a
tendency to fits, these will all disappear under cod liver oil: give expectorants, purgatives, styptics, and the rickets
will increase under our eyes. . ." Gee also mentioned about the dentition in rickets, "The teeth tend to decay--
owing to deficient enamel, . . .", and he also presented the cases of delayed dentition among rachitic children.
Smith (1881) wrote, "The medicines which are of undoubted efficacy in rachitis are cod-liver oil and lime."
Bland-Sutton (1889) experimentally demonstrated that feeding crushed bone and cod liver oil cured rickets of the
lion cubs at the Zoological Gardens in London. Hopkins (1906) expressed his belief that scurvy and rickets are
disorders caused by diets deficient in unidentified trace nutrients, which he called "accessory food factors".
Schabad (1910) in Petrograd cured rickets of a four-year-old child by adding cod liver oil to a diet of bread and
milk. He found based on the balance that the absorption of Ca and P markedly increased by cod liver oil. Hess &
Unger (1917) in New York City also showed the therapeutic effect of cod liver oil by treating ricketic children.
Edward Mellanby (1918) of Great Britain also demonstrated that rickets is a nutritional disease. He reported that
certain diets caused rachitic changes in the bones of puppies and that the inclusion of certain substances in the diet
led to a normal bone development. The substances preventing rickets were meat, butter, cod-liver oil and among
others, and the substances not preventing rickets were casein, linseed oil, yeast, protein of meat, etc. In this short
report, he also mentioned, " . . . it seems clear that rickets is a deficiency disease of the type of scurvy and beri-beri.
Similarly the anti-rachitic accessory factor has charact ers related to the growth accessory factor, although it is not
identical with the latter, since rickets is rather an abnormality of growth and is most prominently shown in quickly
growing animals." Mellanby (1919) wrote, ". . . large and rapidly growing children most often suffer from rickets,
whereas marasmic children generally escape. It is, therefore, diffi cult at first sight to associate a disease of rapid
growth with a deficiency of fat-soluble A which is, according to accept ed teaching, necess ary for growth." May
Mellanby (1918) also wrote, "As a general rule, it is difficult to associate rapid growth with ill-health, and yet we
have seen in these experiments that the teeth of the more rapidly growing puppies are worse . . ." Unfortunately,
however, he became compromised in his position as Mellanby (1919) also wrote, "Whether the anti-rachitic factor
is fat-soluble A as previously understood is therefore undecided, but, on the whole, these substances appear to be
identical." Mellanby (1921) also wrote, "The action of fats in rickets is due to a vitamin or accessory food factor
which they contain, probably identical with the fat-soluble vitamin.", and “ the substance in fats stimulating the
calci fication of bones is probably the same as fat-soluble A, that is the factor which stimulates growth in rats.”
Later, Mellanby (1950) reflected on this, "One of my great intellectual diffi culties with this particular line of
investigation was that accessory food factors were called 'growth factors' and I observed early on that rickets was a
disease of growth--- no growth, no rickets. It was diffi cult to believe that a deficiency of something essential for
growth could be responsible for rickets." McCollum et al. (1922) demonstrated that the factor in cod liver oil,
which promotes growth and prevents xerophthalmia, differs from that prevents rickets by using oxidized cod liver
oil. The oxidized oil lost vitamin A activity (c.f. Hopkins 1920 reported this method); however, it still retained
© 2000, 2005. Shozo H. Sugiura. All rights reserved.
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