The first people to talk about bone diseases in children were Soranus of Ephesus (98–138) and Galen of Pergamon (130–200). In those years, resting under the sun was recommended to protect against bone diseases. During the Renaissance, rickets was very common, especially in northern European countries. It has been reported that in almost every painting made by painters in those years, the main signs of rickets, such as a square head, deformities in the chest and legs, a sagging abdomen, widening of the wrists, rachitic rosaries and Harrison's groove, were noted.
Rickets in England. It was so common that in those years, the disease was seen in rich children who were not allowed out of their homes, and this disease was called the "English Disease". Although Daniel Whistler made a clear description of rickets in his doctoral thesis in 1648, the first book containing comprehensive information on rickets is Glisson's book "de Rachitides". Francis Glisson (1597–1677) described at the beginning of this book, which was published in Latin in London in 1650, that rickets was a separate disease, with almost current clinical findings, unlike anything known until then, and that the name rickets comes from the Greek word meaning twisting, bending in the extremities (twisted). He stated that it comes from "Rhachitis" meaning "Rhachitis". The disease, called Rickets in English today, is called rachitis in German and rachitisme in French.
During the industrial revolution, with the onset of air pollution in cities, rickets was more common in children of poor families living in densely placed houses that did not see the sun, but their nutrition was not at all. It has been reported that this disease is not encountered in children living in poor rural areas. In England, rickets was diagnosed in 80% of primary school students in 1915, 87% in kindergartens in 1928, and 79% in 3-6 year old children in 1944.
In the early 1800s, rickets was only caused by inadequate dietary intake. It was thought that he was connected. In 1822, Snadecki, a Polish doctor, suggested that parents with financial means take their children with rickets out of town and leave them there in the open air for a long time. Thus, Snadecki emphasized for the first time the effectiveness of sunlight (UV) in the prevention and treatment of rickets. In 1890, Palm made these observations. and initiated systemic sunbathing practices to prevent rickets. Huldschinsky demonstrated the place and importance of UV light in the treatment of rickets based on evidence by applying UV light using a quartz lamp 3 times a week for 1 hour in 1919.
In 1918, Mellanby used fish oil for rickets. showed that it could be prevented. Mc Collum proved that the substance in fish oil that prevents and treats rickets is vitamin D. Later, Steenbock and Black showed that various plants (yeast) converted from ergosterol to vitamin D2 through UV irradiation, thus giving the nutrients anti-rachitic properties. Later, the structure of vitamin D was clarified and herbal vitamin D, synthesized cheaply from yeast, was added to milk in a standard dose of 400 IU (250cc milk) to strengthen it. There was a significant decrease in the increasing frequency of nutritional rickets, especially in the USA after the 1920s. It was later shown that the antirachitic activity of this vitamin D was lower than that of vitamin D synthesized from the skin. Thus, vitamin D of plant origin began to be called vit D2 and vitamin D of animal origin began to be called vit.D3.
Secondly, between the 1960s and 1980s, a significant increase was detected in the number of cases diagnosed with nutritional rickets. The cases diagnosed with rickets in this period mostly consisted of babies whose skin color was dark, who preferred to wear veils for religious or cultural reasons, or whose mothers were vegetarians. These children were mostly babies living north of the 35th parallel, in countries with significant air pollution, and fed only with breast milk. The nutritional rickets epidemic during this period could be controlled with oral vitamin D3 administration.
From the 1990s to the present, a significant increase in nutritional rickets was detected for the third time. During this period, exclusively breastfed babies of African Americans and Hispanics in the USA constituted the leading risk group. In addition, life at home, maternal vitamin D deficiency, fear of vitamin D intoxication, protection from sunlight due to fear of skin cancer or melanoma, vitamin D fortified � Inability to consume nutrients is among the risk factors held responsible for the increase in the diagnosis of rickets in this period.
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