ntage. To avoid
those postures which predispose to deformities, the child should lie as
much as possible. In the well-to-do classes this is readily accomplished
by the aid of a nurse and the use of a perambulator. In hospital
out-patients the child is kept off its feet by the use of a light wooden
splint applied to the lateral aspect of each lower extremity, and
extending from the pelvis to 6 inches beyond the sole.

When deformities are already present, the treatment depends upon whether
or not there is any prospect of the bone straightening naturally. Under
five years of age this may, as a rule, be confidently expected; the
child should be kept off its feet, and the limbs bathed and massaged. In
children of five or six and upwards, the prospect of natural
straightening is a diminishing one, and it is more satisfactory to
correct the deformity by operation. In rickety curvature of the spine,
the child should lie on a firm mattress, or, to allow of its being taken
into the open air, upon a double Thomas' splint extending from the
occiput to the heels; the muscles acting on the trunk should be braced
up by massage and appropriate exercises.

#Late Rickets# or #Rachitis Adolescentium# is met with at any age from
nine to seventeen, and is generally believed to be due to a
recrudescence of rickets which had been present in childhood. The
disease is not attended with any disturbance of the general health; the
pathological changes are the same as in infantile rickets, but are for
the most part confined to the ossifying junctions, especially those
which are most active during adolescence, for example at the knee-joint.
The patient is easily tired, complains of pain in the bones, and, unless
care is taken, deformity is liable to ensue. There can be no doubt that
adolescent rickets plays an important part in the production of the
deformities which occur at or near puberty, especially knock-knee and
bow-knee.

#Scurvy-Rickets# or #Infantile Scurvy#.--This disease, described by
Barlow and Cheadle, is met with in infants under two years who have been
brought up upon sterilised or condensed milk and other proprietary
foods, and is most common in the well-to-do classes. The haemorrhages,
which are so characteristic of the disease, are usually preceded for
some weeks by a cachectic condition, with listlessness and debility and
disinclination for movement. Very commonly the child ceases to move one
of his lower limbs--pseudo-paralys