Nutritional rickets is caused by a vitamin D deficiency, and people figured out two ways to treat it before we even knew what vitamin D was.

Research:

  • “Oldest UK case of rickets in Neolithic Tiree skeleton.” 9/10/2015. https://www.bbc.com/news/uk-scotland-glasgow-west-34208976
  • Carpenter, Kenneth J. “Harriette Chick and the Problem of Rickets.” The Journal of Nutrition, Volume 138, Issue 5, 827 – 832
  • Chesney, Russell W. “New thoughts concerning the epidemic of rickets: was the role of alum overlooked?.” Pediatric Nephrology. (2012) 27:3–6. DOI 10.1007/s00467-011-2004-9.
  • Craig, Wallace and Morris Belkin. “The Prevention and Cure of Rickets.” The Scientific Monthly , May, 1925, Vol. 20, No. 5 (May, 1925). Via JSTOR. https://www.jstor.org/stable/7260
  • Davidson, Tish. "Rickets." The Gale Encyclopedia of Medicine, edited by Jacqueline L. Longe, 6th ed., vol. 7, Gale, 2020, pp. 4485-4487. Gale OneFile: Health and Medicine, link.gale.com/apps/doc/CX7986601644/GPS?u=mlin_n_melpub&sid=bookmark-GPS&xid=811f7e02. Accessed 7 Jan. 2026.
  • Friedman, Aaron. “A brief history of rickets.” Pediatric Nephrology (2020) 35:1835–1841. https://doi.org/10.1007/s00467-019-04366-9
  • Hawkes, Colin P, and Michael A Levine. “A painting of the Christ Child with bowed legs: Rickets in the Renaissance.” American journal of medical genetics. Part C, Seminars in medical genetics vol. 187,2 (2021): 216-218. doi:10.1002/ajmg.c.31894
  • Ihde, Aaron J. “Studies on the History of Rickets. I: Recognition of Rickets as a Deficiency Disease.” Pharmacy in History, 1974, Vol. 16, No. 3 (1974). https://www.jstor.org/stable/41108858
  • Ihde, Aaron J. “Studies on the History of Rickets. II : The Roles of Cod Liver Oil and Light.” Pharmacy in History, 1975, Vol. 17, No. 1 (1975). https://www.jstor.org/stable/41108885
  • Newton, Gil. “Diagnosing Rickets in Early Modern England: Statistical Evidence and Social Response.” Social History of Medicine Vol. 35, No. 2 pp. 566–588. https://academic.oup.com/shm/article/35/2/566/6381535
  • O'Riordan, Jeffrey L H, and Olav L M Bijvoet. “Rickets before the discovery of vitamin D.” BoneKEy reports vol. 3 478. 8 Jan. 2014, doi:10.1038/bonekey.2013.212.
  • Palm, T. “Etiology of Rickets.” Br Med J 1888; 2 doi: https://doi.org/10.1136/bmj.2.1457.1247 (Published 01 December 1888)
  • Rajakumar, Kumaravel and Stephen B. Thomas. “Reemerging Nutritional Rickets: A Historical Perspective.” Arch Pediatr Adolesc Med. Published Online: April 2005 2005;159;(4):335-341. doi:10.1001/archpedi.159.4.335
  • Swinburne, Layinka M. “Rickets and the Fairfax family receipt books.” Journal of the Royal Society of Medicine. Vol. 99. August 2006.
  • Tait, H. P.. “Daniel Whistler and His Contribution to Pædiatrics.” Edinburgh Medical Journal vol. 53,6 (1946): 325–330.
  • Warren, Christian. “No Magic Bolus: What the History of Rickets and Vitamin D Can Teach Us About Setting Standards.” Journal of Adolescent Health. 66 (2020) 379e380. https://www.jahonline.org/article/S1054-139X(20)30038-0/pdf
  • Wheeler, Benjamin J et al. “A Brief History of Nutritional Rickets.” Frontiers in endocrinology vol. 10 795. 14 Nov. 2019, doi:10.3389/fendo.2019.00795
  • World Health Organization. “The Magnitude and Distribution of Nutritoinal Rickets: Disease Burden in Infants, Children, and Adolescents.” 2019. Via JSTOR. https://www.jstor.org/stable/resrep27899.7
  • Zhang, M., Shen, F., Petryk, A., Tang, J., Chen, X., & Sergi, C. (2016). “English Disease”: Historical Notes on Rickets, the Bone–Lung Link and Child Neglect Issues. Nutrients, 8(11), 722. https://doi.org/10.3390/nu8110722

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2026-01-26 40 min Transcript

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Transcript

00:00:01
Speaker 1: Welcome to Stuff You Missed in History Class, a production of iHeartRadio.

00:00:12
Speaker 2: Hello and welcome to the podcast. I'm Tracy V. Wilson and I'm Holly Fry. Once again, I'm returning to the realm of nutritional deficiency diseases. I just find them very interesting, especially because people have really figured out how to treat them, way before they figured out exactly what was causing them, which has not always been the case with other diseases. Like scurvy is caused by vitamin SED efficiency, and people had figured out that some foods, including citrus fruit, could prevent scurvy by the seventeenth century. So today we know that these foods are good sources of vitamin C. But people made the connection between the food and the scurvy well over a century before Casimir Funk even coined the word vitamin, and that also happened before any individual vitamin had been identified and named. We have an episode on scarvey, and then last year we also did an episode on pelagra, which is caused by niasin deficiency. People were similarly treating pelagra with brewers yeast decades before we knew what niasin was or that Brewer's yeast has a lot of it in there. The discovery and identification of specific vitamins grew in part from people trying to figure out what exactly people were missing with that missing substance making them sick. Nutritional rickets is caused by a vitamin D deficiency, and people figured out two ways to treat it before we even knew what vitamin D was. So it's a fun word to say, but we don't really know where the word rickets even comes from. English physician Daniel Whistler wrote a thesis on rickets in sixteen forty five aimed that it had been named for someone who had supposedly tried to cure it, or from the term to rocket, which he said was used in parts of England to mean to breathe with difficulty. While there were people whose surname was Rickett, there's really no evidence of any of them trying to cure this disease, and it's also not clear whether there is any merit to that rocket idea. Another possibility is that it comes from German or Swedish words meaning twisting or swaying. Yeah, I went down a big rabbit hole trying to figure out if in sixteen forty five, people in parts of England were using the word to rucket. This way did not find a good answer. In the seventeenth century, ricketts was also called rachitis, and that came from Latin and Greek words to describe disorders or inflammations of the spinal column. The symptoms of rickets can include spinal pain and unusual spinal curvatures. So it's possible that writing in the Latin use the word rachitis because of these symptoms, and then lay people shifted that pronunciation to rickets, But again that is all very speculative. Rickets affects growing animals, not only human beings. In the body, vitamin D is converted into a hormone that affects the way calcium is absorbed in the digestive system, and it has other effects on calcium in the body. To put it really really, basically, without enough vitamin D, the body cannot absorb the calcium needed for bones to mineralize properly. Rickets usually affects animals during infancy, childhood, and adolescence when their bones are growing and mineralizing, especially during growth spurts. A similar vitamin D deficiency in adults is called Osteomalaysia. Animals get vitamin D from two primary sources, their food and exposure to the sun. Foods that are naturally high and vitamin D include egg yolks and various types of fish like salmon, tuna, and sardines. Wild mushrooms can also be high in vitamin D, but commercially grown mushrooms that are raised in the dark typically aren't. They aren't getting that sun exposure themselves to have vitamin D.

00:04:16
Speaker 1: Today, some foods are also fortified with added vitamin D, although which foods, whether fortification is voluntary or mandatory for manufacturers, and weather foods are fortified at all, depends on where you live. In the United States, foods that are most likely to be fortified with vitamin D include dairy and non dairy milks, orange juice, and breakfast cereals, all of which are associated, of course, with children's diets. In terms of sun exposure, again very very basically, UVB radiation converts cholesterol in the skin to kulic house for all, which is the more formal name for vitamin D three.

00:04:59
Speaker 2: This requires direct exposure to the sun because UVB is blocked by things like glass and clothing. Can also be blocked or at least reduced by things like fog and air pollution. UVB radiation is also affected by the Earth's atmosphere and the angle at which sunlight reaches the surface.

00:05:18
Speaker 1: Of the Earth. Areas of very high latitudes get a lot less UVB light than the tropics do, and since melanin protects the body from UV light, the amount of vitamin D that a person's own body can synthesize is affected by how much melanin they have in their skin. People with more melanin, meaning people who are darker skinned, need more sun exposure to be able to synthesize enough vitamin D than people with lighter skin.

00:05:46
Speaker 2: We don't really know whether ricketts was a widespread problem during early human history, but it might not have been. Early hunters and gatherers, and then later on early farmers would have been spending a lot of time outside in the sun. In the tropics, where in the long ago past more people had more melanin in their skin. The sun was also a lot more direct, so they would have been getting more UVB exposure. Of course, those things are interconnected, the UV light and the melanin. Conversely, in the far north, for example, people had less exposure to sunlight since even during the long days of the summer, the sun's rays just aren't as direct, and people also tended to wear more clothing because it was colder. But these indigenous peoples have also historically had a diet that is rich in vitamin D. People still living in the same places that their ancestors did, following the same traditions and lifeways, are probably getting a lot of their vitamin D these same ways today. At the same time, it is possible and maybe even likely, that people around the world did historically go through periods when they weren't getting enough vitamin D actually in the winter or during times of famine, but this might not have been an ongoing problem since most people would have been spending more time outside again in the spring. One big exception here, at least in theory, is babies. Because breast milk alone does not provide infants with enough vitamin D. It would take a lot of vitamin D supplementation for a person to produce breast milk that was really rich in vitamin D like way beyond what someone would get through ordinary food and sunlight. So throughout history, babies who were breastfed and then also swaddled or covered up or kept out of the sun could be susceptible to rickets. Today, various health organizations around the world recommend that breastfed babies be given a vitamin D supplement, especially if they are exclusively breastfed.

00:07:56
Speaker 1: We do have some evidence of rickets in the archaeological record. In twenty thirteen, archaeologists in Scotland announced the discovery of a five thousand year old skeleton that showed evidence of rickets. That is the oldest example discovered so far. Prior to this discovery, the oldest skeletons known to have signs of rickets were from the Roman Era, and there's some evidence to suggest that it may have been more widespread in the Roman Empire. For example, in twenty eighteen, researchers from Historic England and McMaster University in Canada surveyed Roman Era skeletons from cemeteries from what's now northern England down to southern Spain, and they found evidence of rickets in more than one in twenty. Children with babies most often affected.

00:08:43
Speaker 2: What may be the earliest written description of rickets also comes from the Roman Era. Serranus of Ephesus wrote a treatise on gynecology around the first or second century CE. It includes a section about the care of newborns. The section, he advises loosening a baby's swaddling clothes only after their body has become reasonably firm, so that it does not become distorted. Serranus also recommends not letting babies try to sit up too early or for too long, because that could cause them to become hunchbacked, and he says if a baby is allowed to try to walk too early, their legs can become distorted. Bow legs and spinal curvatures are two of the most recognizable symptoms of rickets, so this is often interpreted as a description of the condition. There is some debate about whether that's really what he's talking about, but Siranis is generally more accepted as the first description of rickets than some earlier but even more vague possibilities. Yes, sometimes it's a brief sentence that sort of seems like maybe someone's leg was growing in a strange way.

00:09:58
Speaker 1: Could that have been rickets? Maybe?

00:10:01
Speaker 2: Of course, rickets is definitely not caused by unswaddling a baby too early. It is not caused by letting babies try to stand up too soon after they're born. And we really don't have any way to know if what Serranus is describing in this passage is something that he also would have recognized in the children from that twenty eighteen study we mentioned, or if the children in that study were seen as having some kind of illness or condition relating to their bones while they were alive.

00:10:31
Speaker 1: Ricketts was not recognized as a disease with a name until the early modern period, and we're going to get into that after we pause for a sponsor break.

00:10:49
Speaker 2: Rickets seems to have been a more widespread problem in parts of Europe in the sixteenth and seventeenth centuries, or at least that is when it seems to start showing up more in artwork and in written records. In fifteen oh nine, German painter Hans Borkmeyer the Elder painted a version of the Virgin and Child in which the infant Jesus appears to have bowed legs and other possible signs of rickets. In fifteen thirty two, German physician Hieronymous Roisner described a disease that occurred only in children whose symptoms included weakness, bowed legs, and chest malformations. Roisner said this disease was common in Holland and Switzerland.

00:11:33
Speaker 1: In fifteen fifty four, Theodosius of Bologna described a child who was very pale and had an unusual spinal curvature which could have been rickets. Other accounts in the late sixteenth century described children whose bones were bent and who seemed to have some kind of wasting disease. In sixteen fourteen, a visitor to a monastery in the Netherlands, which was at the time part of the Dutch Republic, described children being treated with water from a well dedicated to Saint Willibrard. These children were described as having Saint Willibard's infirmity or the ailment of Saint Willibrard. One of the symptoms was a.

00:12:15
Speaker 2: Series of knobs on the children's ribs, described as being like pinheads or rosary beads, or something of a similar size. Some of these children were also described as having the ailment of Saint Macketus, in which their legs appeared as though they were sitting cross legged. It was possible for a child to have both of these ailments at once. As we said earlier, bowed legs are one of the most recognizable signs of rickets. Another is called richitic rosary. These are knobs that develop where each rib connects to the costal cartilage on the front of a person's rib cage, and they're named for their resemblance to a string of rosary beads. So it seems likely that at least some of these children that Tracy was just shoying about had rickets. There were also other Willibrard wells and springs around the Netherlands, and their water was similarly used to try to treat children who had these conditions. The first known use of the word rickets and writing was a couple of decades after this visitor report. Unlike most of the first uses and writing we've talked about before, this was not in published material. It was a handwritten receipt book belonging to the Fairfax family of Yorkshire, England. People used to call recipes receipts, and the word receipt could also apply specifically to the ingredients and methods used to make medicinal preparations. This particular receipt book had belonged to Mary Chumley, who married the Reverend Henry Fairfax in sixteen twenty six. The book remained in the family, with people recording recipes for things like foods, medicines, and household preparations into the late eighteenth century. Some of the entries were attributed to well known physicians of the day, and others came from relatives or friends. An entry for February twenty fifth, sixteen thirty two includes five remedies for rickets in children, attributed to the reverend's cousin, Lady Fairfax of Steaton. There are also various recipes labeled for the rickets, and one marked for a child that is weak or lame in her joints. None of these remedies would have been effective in treating rickets. They included things like ointments made of herbs minced into butter, and drinks being made of things like herbs or dried fruit boiled in water or ale. But this suggests that by the first quarter of the seventeenth century, people in England knew about a disease that they were calling rickets, and that they were trying to figure out ways to treat it. The first use of the word rickets in published material was in the Annual Bill of Mortality of the City of London in sixteen thirty four. This was only the fifth year that the Annual Bill of Mortality included causes of death. This information was gathered by people called searchers, who were described as elderly matrons. Made a lot of sense for older women to be doing this job, since they were typically involved in laying out the dead and preparing people's bodies for burial. Good fit for them to also be the people determining cause of death. Since older women often cared for sick people. People also thought they might have some protection from whatever illness a person might have died of, and that experience could also theoretically help them identify and describe a person's cause of death. At the same time, these women typically didn't have access to a formal education. Most of them could not read or write, so they gave their reports to the clerk orly, and that means we don't have any details or notes about how they determined the causes of death.

00:16:00
Speaker 1: So at the time, these searchers were seen as knowledgeable and respected members of their community who were doing important work, but today their reports are not really seen as an accurate accounting of what people were dying of.

00:16:13
Speaker 2: All of that said, in sixteen thirty four, the annual Bill of Mortality of the City of London reported that fourteen people died of ricketts out of almost eleven thousand total deaths in the city. And while no English medical treatises have been unearthed that mention rickets before this point, it seems like it must have been something the medical community would have been aware of, otherwise how would it be reported as a cause of death in this official document. The first known clinical description of ricketts was written by Daniel Whistler in his MD thesis at the University of Leyten in the Netherlands, that is where a lot of people from Britain and Ireland went to study medicine. And this was written in Latin and its title translation to concerning the Disease of English Children, which in English it is called rickets. Whistler defended this thesis on October eighteenth, sixteen forty five, and he would eventually go on to be the President of the College of Physicians. In this work, Whistler described rickets as common in England. He listed a series of symptoms, including enlargements at the ends of the bones, weakness, deformities of the limbs, unusually flexible joints, delayed emergence of the teeth, decay in the teeth once they had emerged, and chest malformations. All of these very physically recognizable signs of rickets. He also listed some other symptoms that were not related to the skeletal system, like cough, fever, irregular pulse, and digestive distress. Some of these can occur in severe cases of rickets. He speculated that rickets was caused when blood clots form in the viscer, and he said that the disease was often fatal, especially in children who were affected with it from birth. Whistler also described rickets as something that was most frequent in England's wealthiest people, with the next most affected group being the poor. He thought that as.

00:18:18
Speaker 1: A group, people in the middle were the least affected by ricketts. He attributed the rate of ricketts among the wealthy to the use of wet nurses, and when it came to poor people, he blamed quote the intemperance of parents. Other works on ricketts soon followed. One was a book chapter by Arnold boot which was printed as part of a book on medicine that came out in sixteen forty nine. Boot was born in Holland and practiced medicine in Ireland. Then in sixteen fifty English physician Francis Glisson printed the longest and best known seventeenth century treatise on rickets. Its title translated to a Treatise of the rickets being a disease common to children. Glisson's work was so influential that some people started calling rickets glistens disease, and in some other parts of Europe it was known as English disease. All these works were written in Latin, which was the shared language of the European medical community, but most of them used the English word rickets for the name of the disease. Most of the people writing about rickets in the mid seventeenth century thought it was a new disease that had only been seen for the previous couple of decades. It's possible that this was just.

00:19:36
Speaker 2: Connected to growing awareness and more doctors starting to look for this disease, but it's also possible that rickets was becoming a bigger issue. This was during the period of regional cooling known as the Little Ice Age, when parts of the world, including parts of Europe, were generally cooler and wetter and cloudier. This could have affected how much sunlike people. It also led to poor harvests and food shortages that could have led to other nutrient deficiencies that people might have mistaken for rickets, and it's also possible that in major cities air pollution was becoming a factor. London in particular, was described as being blanketed in a cloud of smog that could be seen from miles away. We will be talking about that more in a future episode. It is likely that people were experiencing rickets in other parts of the world as well, but most of the writing about it is from northern and western Europe, and at this point there was no effective treatment being used in Europe. The idea of four humors was still a very big part of medicine, so most of the proposed treatments were influenced by that. In general, they did not include any vitamin D.

00:20:52
Speaker 1: No. We will get to.

00:20:54
Speaker 2: The first effective treatments for rickets after a sponsor break. The first effective treatment for rickets was cod liver oil, which we know today is high in vitamin D. As that name suggests, this is an oil made from the liver of Atlantic cod. An Atlantic cod live in coastal waters in the Northern Atlantic Ocean. By the seventeen hundreds, people who lived in areas that were home to a lot of cod fishing had started using cod liver oil for a range of medicinal purposes, including as a treatment for arthritis, sciatica, tuberculosis, and scropula, which is a swelling of the lymph nodes in the neck that is typically caused by tuberculosis. The discovery of cod liver oil as a rickets treatment may have been an accident. A lot of children who had rickets also had other conditions, such as tuberculosis, and some were more generally manourished. So in the eighteenth century, doctors and hospitals were using cod liver oil to treat a range of ailments and as a source of fat and calories for malnourished children. And people started noticing improvements in children who were recognized as having rickets, and children who weren't diagnosed with rickets but were just seen as small and sick started growing more and faster than could be explained simply by getting more food to eat. By the early nineteenth century, another proposed treatment for rickets was sunlight. Polish physician yed Rej Sniodeki proposed sunlight as a cure for rickets as early as eighteen twenty two. He wrote a book whose title translates to on the Physical Education of Children, and it had a chapter on the English disease. In that chapter, he said that if parents were financially able, they should take their children to the country to keep them in the dry, open air. And he said it was particular important that they be in the sun because the sun's action on the body was one of the most efficient methods for the prevention and cure of rickets. I do not know how he came to that conclusion, but it was correct. It may have just been that general fresh air and the great outdoors is good for kids. There was a lot of fresh air and sunlight focused, so it just might have been that Snandeki cited densely populated English towns as places where rickets was common. He described such towns as having narrow streets and poorly lit dwellings, places where people would not get a lot of sun and starting in the eighteenth century in the UK and in other parts of the world, more and more people.

00:23:46
Speaker 1: Were living this way. In the wake of the Industrial Revolution, more people were moving from the country to towns and cities and were working indoors in factories, and this included children. The air pollution problems that it are already been observed back in the seventeenth century, we're also getting worse because many of those factories were powered by burning coal. Soon ricketts was being associated with the urban poor, particularly in the UK, but in other industrialized nations as well.

00:24:17
Speaker 2: It's possible that there may have also been some dietary changes involved in this as people moved to the cities, especially for example, they moved from the coast, where they were eating a lot of fish, to somewhere farther inland where they were not. One potential factor in London was also the use of alum to whiten poor quality flour. Physician John Snow, most famous today for tracing the source of a cholera outbreak in London, understood that rickets was a disease that affected the mineralization of bone. In eighteen fifty seven, he published a paper arguing that alam was binding to phosphorus in the intestines of people who ate a lot of cheap bread and that kept their bones for mineralizing. People did already know what phosphorus was. Hennig Brand had figured that out after boiling huge amounts of urine. Just enormous amounts of urine way back in sixteen sixty nine. We have scheduled that as an upcoming Saturday classic. I got a fifteen hundred gallons a year and advised the Piaga workshop you want to come see. In the nineteenth century, people also started noticing rickets in other animals, including animals that were living in the gardens of the London Zoological Society. For example, surgeon John Bland Sutton described rickets as extremely frequent in the monkeys living in the garden. In eighteen eighty three, he wrote a paper titled on the Diseases of Monkeys in the Society's Gardens, in which he said nearly half of the monkeys in the gardens die rickety that is his direct quote, and that healthy monkeys that arrived in the gardens were dead of rickets within four months. These monkeys lived in a fully glassed in enclosure that would have blocked the UV light. By the late eighteen nineties, two schools of thought had evolved around rickets, one that it could be cured with cod liver oil and the other that it could be cured with sunlight, and a lot of doctors really thought it was one or the other, not both, or they focused mainly on one and not on the other. For example, physician Theobald Adrian Palm wrote a letter to the British Medical Journal in eighteen eighty eight in response to a report on rickets that had made the quote want of light sound unimportant. Palm was objecting to that dismissiveness. He had worked in Japan for almost ten years and described rickets there as quote conspicuous by its absence. He attributed this to Japan's abundant sunshine. He speculated that a worldwide study would find that rickets is directly related to an absence of sunshine. He advocated the use of sun baths as treatment. He did, not, at least in this piece, seemed to make any connection with cod liver oil and the fact that the Japanese diet included a lot of fish. Meanwhile, advocates of cod liver oil and other fish oils were bolstered by the work of Casimir Funk in nineteen twelve he coined the term vital amines or vitamins to describe compounds necessary for life. He theorized that a lack of vital amines could cause what he called deficiency diseases, including scurvy, pelagra, and rickets. The first vitamin to be isolated and named was vitamin A a few years later, followed by vitamins B and C. They were named that because that's the order of the alphabet. The search for vitamins was partly rooted in a search for nutrients that could prevent these diseases. When it came to vitamin C, that disease was, of course scurvy, and the search was for a substance with anti scorbutic properties, meaning the ability to fight off scurvy. So with these developments, researchers were also looking for a compound with anti rickets properties when cod liver oil was found to be a good source of vitamin A. After vitamin A was isolated, people started wondering if that was the anti rocritic component, and this led to some confusion and some kind of overlapping research about why exactly cod liver oil was an effective treatment for rickets. As that vitamin research was going on there were also ongoing efforts to study the use of both UV light and cod liver oil to treat rickets. In nineteen eighteen and nineteen nineteen, a doctor Holdshinsky successfully demon treated the use of UV lamps to treat rickets in children. He also noted that using the UV lamp on one arm treated rickets in both arms, and he speculated that the UV light was causing the synthesis of some kind of compound that could then circulate all throughout the body. At around the same time, American doctors Alfred Hesse and Lester Unger were testing cod liver oil as a treatment and preventative for scurvy in black children in New York City. As we noted earlier, people with darker skin are at greater risk for rickets because of the amount of melanin in their skin compared to the strength of the sun at that latitude. Not as much direct sunlight in New York than in parts of Africa, for example, cod liver oil treatments either prevented the onset of rickets or led to its resolution. In ninety two percent of infants who were treated for six months, and in more than and half of the infants who were treated for four months. Sixteen infants in the control group were not given any cod liver oil, and nearly all of them had rickets by the end of six months.

00:30:13
Speaker 1: Today, this study would not be viewed as ethical, since other studies had already established that cod liver oil could be used to treat rickets. What wasn't as well established was whether cod liver oil could prevent rickets, not just treat it, and this study was the first to show that it could. The Henry Street Settlement House, which was involved with this study, also became a rickets screening and treatment center for the community more broadly as it was going on. Also, we should take a moment to note that the prevalence of rickets among black people living in North America was used to justify racism, with racists arguing that it signaled some kind of inherent weakness in their bodies. This, again was just about melanin, and the vitamin D was isolated and named not long after this study. Multiple people contributed to its discovery, some of them through their previous work on vitamin A. In nineteen nineteen, Edward Mellanbee wrote about a fourth vitamin the absence of which could cause rickets, concluding that it was either vitamin A or another fat soluble vitamin that's found in a lot of the same foods as vitamin A. Elmer McCollum, who had helped discover vitamin A, differentiated the two and he was the one who coined the name vitamin D.

00:31:35
Speaker 2: In nineteen twenty two, bacteriologist Harriet Chick of the Lister Institute of Preventive Medicine in London led a team from the British Medical Research Council to Vienna to study ricketts there. They had been invited by Charles Perku, director of the University of Vienna's Kinder Clinic. This was an unusual research team for the time because most of its members, including Chick, were women. They divided the babies into two groups. Group one continued on the Kinder clinics regular diet, which included local cow's milk and sucrose, while Group two had full cream dried milk with some added sugar supplemented with cod liver oil. They assessed the babies for rickets using X rays. Half of the babies in Group one developed rickets, while none of the babies in group two did this study took place over the course of nineteen twenty one and nineteen twenty two, and the results were different based on the season. Babies in Group one, who had showed signs of rickets early in the year seemed to improve in the spring and summer, so the team did further research to narrow down whether this had something to do with the quality of the local milk changing seasonally, or if it was the fact that the babies were being placed outside on balconies as soon as the weather was warm enough. Eleven babies from Group one were kept strictly indoors for about three months and developed rickets, and they all rapidly improved after being brought outdoors when the weather allowed it. Babies also improved after being exposed to light from a mercury vapor lamp. The babies in group one who had developed rickets also rapidly improved once cod liver oil was added to their food. This study helped establish that rickets could be treated with both cod liver oil and sunlight. This was not the one or the other situation that a lot of researchers had been thinking that it was. By nineteen twenty five, this was generally accepted within the medical community, and then over the nineteen twenties and thirties, researchers figured out how to produce vitamin D, allowing it to be added to things like infant formula and other food that led to a sharp decline in rates of rickets in some parts of the world. Continues to be an ongoing issue, though in addition to the things that we've talked about, people who have other conditions that affect their absorption of nutrients can certainly develop rickets. This includes coeliac disease, inflammatory bowel disease, and cystic fibrosis.

00:34:16
Speaker 1: Among others.

00:34:18
Speaker 2: In more recent years, there have also been concerns that advice to wear sunblock to prevent skin cancer has led to a rise in rickets. This seems to be complicated in lab studies. Unquestionably, sunblock keeps the skin from being able to synthesize vitamin D, but in real world situations it is not nearly as clear. Most people just don't apply sunblock perfectly or often enough, or use enough of the product, so at least some sun exposure is still happening. It's possible that a bigger factor than wearing sunblock is just the fact that some people don't go outside much at all. Like if a child is being driven to school and then does not have recess at school and then comes back home and reads and plays video games and goes to bed, not a lot of opportunity there for direct sun exposure.

00:35:18
Speaker 1: Yeah, having a flashback to our episode where we talked about sunscreens, I'm not knocking reading and playing video games.

00:35:25
Speaker 2: Those are two of my favorite pastor. I am an advocate of sunscreened.

00:35:33
Speaker 1: All of these things are important, but you must get vitamin D. Do you have listener mail for us? I do have listener mail. This is from Charylyn, who wrote, Hi, both, I've been listening for over a decade. My now ex wife used to refer to you as the Ladies because you were and still are my food prep companions. Appreciate the years of company, as well as the reflective and sometimes self reflective way you addressed your work. I grew up half an hour south of Boston, so hearing bits of Tracy's life is like fragments from home. I now live in Wales, and my first bit of Welsh history from you years before I moved here. It was the Abravan disaster and living in the Welsh valleys as I do, understanding the mining history is an important culture point. I have been to the graves of the children who died in the Abravan disaster, which is absolutely heartbreaking. I almost took this last line out because I cried writing it, and I can picture Holly trying not to cry reading it. But the personal connection to history and this bridge this podcast has been is part of the point on two iguanadons in between Boston and Wales. In between Boston and Wales, I lived not far from Crystal Palace, which is an area of London in addition to a park, so I really enjoyed hearing about the creation of the park. My shorthand for the statues has always been what the Victorian's thought dinosaurs looked like, so it was interesting to hear the background to them. I too was sad to think of the people working on it seeing them already be incorrect because of new discoveries. But they are still fun to visit. I recommend them to anyone wanting something a little more offbeat in London. The larger park is also lovely, and the train station is now part of the Tube network. It was also interesting to hear that they demolished the Pinge mansion for the park, as Pinge is now an area down the road slash Hill for a pet tax I've attached my eight year old cat, Willow. Her pet sitter got this scratching pad for Christmas, and he was instantly appreciative. Thank you for all you do, especially as it gets harder to access resources. You are my podcast staple and the one I most often recommend to others.

00:37:53
Speaker 2: All the best, Charlyn.

00:37:55
Speaker 1: We have a.

00:37:56
Speaker 2: Picture of a black cat. Computer does not want to open it at full skies at the moment, but oh, there we go. As soon as I said that and tried to close the window, it appeared we have a black cat on Christmas tree shaped one of those cardboard like scratching pads.

00:38:18
Speaker 1: Super cute. I in my house have.

00:38:23
Speaker 2: A cardboard Halloween house that was bought at the pet store on impulse a couple of years ago and became one of Opal's favorite things. It is still in good enough shape to still be in the house. I'm always wondering how much longer though, until like the bottom is all the way shredded through. How I don't know even the right word for a person's first bit of Welsh history before moving to Wales being the Abervan Disaster one of the saddest episodes we have ever done.

00:38:58
Speaker 1: Listen well, while you were reading, I was hoping she was going to say it was the Mary Lloyd.

00:39:04
Speaker 2: It was going to be.

00:39:05
Speaker 1: Poor skeletons of the holidays, but no, Alas no.

00:39:09
Speaker 2: Yeah. Now, it's so sad that I kind of erased it from my memory for a while after we recorded it. And when someone asked about what are some of the saddest episodes you've ever done? I didn't mention it, and somebody else was like, what about the Abravant Well, I blocked it out of my head.

00:39:28
Speaker 1: Is that's what hard? Same? I had some that we had talked about that were really harrowing come up in recent research, and I was like, I forgot we did these. I think my brain did that on purpose.

00:39:38
Speaker 2: Yeah, can only hold so much. So thank you again, Chrilyn for this lovely email. I'm glad you enjoyed visiting the Crystal Palace Park. Perhaps one day I will make it and see them myself. If you would like to send us some notes, Our email addresses History Podcast at iHeartRadio dot com, and you can subscribe to the show on the iHeartRadio app or anywhere else you'd like to get your podcasts. Stuff you Missed in History Class is a production of iHeartRadio. For more podcasts from iHeartRadio, visit the iHeartRadio app, Apple Podcasts, or wherever you listen to your favorite shows.

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