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The Effect of the Acid-Base Content of the Diet Upon the Production and Cure of Rickets with Special Reference to Citrates

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Department of Pediatrics, Harvard Medical School, and The Infants' and The Children's Hospitals, Boston, Massachusetts

The diets used were made to contain eight different ratios of calcium to phosphorus. In each of these ratios there are zones where rickets were produced when the absolute amounts were low and no rickets when the amounts were increased.

1. a. The addition of NH₄Cl-(NH₄)₂CO₃ mixtures to non-rachitogenic diets, in each of the eight zones, renders them rachitogenic. Further, the same additions to the rachitogenic diets in each of the eight zones, intensifies the severity of the rickets produced.

b. The NH₄Cl is the more important moiety, though the (NH₄)₂CO₃ enhances the effect.

2. a. The addition of citric acid-sodium citrate mixtures to rachitogenic diets in each of the eight zones alters them so that they no longer produce rickets.

b. Both the acid reaction and the alkali ash factors are necessary to accomplish this result.

c. In the prevention of rickets, the citrates and tartrates alone, among the organic acids tested, were effective; therefore their action cannot depend entirely upon their acid-base effects.