Rickets before the discovery of vitamin D

Abstract

The story of rickets leading to the discovery of vitamin D is an extraordinary tale, spread over many centuries and involving some remarkable characters with much speculation and a few mysteries, before reaching an exciting climax. It would be wrong to credit a single person as discovering rickets or being the first to describe its features, for reasons that will be set out here. Yet the emergence of the term 'rickets' is as important as the discovery of vitamin D itself and the possible causes of its deficiency. It permitted identification of a hitherto ill-defined disease entity, typically occurring in infants and children. It also provided a way for deciding if features of diseases that had been described earlier in the history of medicine could be seen as the symptoms and signs of related conditions.

Figure 1

A copy of the Bill of Mortality for 1634. The middle part of this, listing the number of deaths for each of the 122 parishes of the City of London, has been omitted for clarity. The causes of death are listed alphabetically and rickets is included among those on the right side. Reproduced with permission of The Guildhall Library of The City of London, London, UK.

Figure 2

Copies of the title pages of the four publications that appeared in Latin, over a 33-year period. The first three were reproduced from originals in the British Library, London, UK. The fourth is reproduced form the original with permission of the library of The Royal College of Physicians, London, UK. (a) The thesis of Daniel Whistler, 1645, entitled ‘Inaugural Medical Disputation, on the Children's Diseases of the English, Which the Inhabitants Idiomatically Call The Rickets'. (b) Arnold Boot's book published in 1649 entitled ‘Medical Observations on Neglected Ailments', in which chapter 12, entitled ‘Tabes pectoris' described rickets and used that word in the text. (c) Francis Glisson's book, published in 1650 with Bate and Regemorter, entitled ‘A Treatise of the Rickets: Being a Disease Common to Children. Wherein (among many other things) is shewed 1 The Essence. 2 The Causes. 3 The Signs. 4 The Remedies of the Disease'. (d) John Mayow's tract, published in 1668, entitled ‘Concerning Rickets'.

Figure 3

The veranda of the Meidling Hospital in Vienna with infants ‘receiving outdoor treatment in sun and shade respectively' (MRC 1923: reproduced with permission).