Hyperemia of all the structures of the bone, periosteum, osseous tissue, cartilage and marrow, is the first step in the development of the rachitic lesion.充血的所有结构的骨，骨膜，骨组织，软骨和骨髓，是第一步，在发展的rachitic病变。 As a result, we have proliferation of cartilage cells, retarded and irregular development of bone, softening of matrix, undue vascularity of the cancellous tissues, and weakness and deformity of the bones in various parts of the body.因此，我们有扩散的软骨细胞，迟钝和不规则的发展，骨软化，基质，过大血管的骨组织中，积弱和畸形的骨头在各个身体部分。
The weight of the bones is lessened.重量骨头减少。 The vascularity of the bones is increased.血管的骨头是增加了。 In some cases the blue discoloration due to the increased vascularity may be seen even through the thick scalp.在有些情况下，蓝变色是由于要增加血管可以看出，甚至透过厚厚的头皮。 Outside of the bones they may find blurring of striation of muscles, excessive fat in connective tissue between the muscle fibre and rare cases of fatty degeneration of the muscle fibres themselves.外面的骨头，他们会发现，模糊的沟纹的肌肉，过量脂肪结缔组织之间的肌肉纤维和难得的案件脂肪变性的肌肉纤维本身。 The liver is occasionally enlarged the spleen more rarely so.肝脏是偶尔扩大会议脾脏更为罕见。
Rickets is the deficiency of vitamin D in the food ingested (this containing an excess of cereals but insufficiently of milk, butter and eggs) or want of adequate sunlight necessary for the absorption retention of an adequate quantity of calcium and phosphorus for bone formation.佝偻病是缺乏维生素D在食物中摄取（这含有过多的谷物，但不够的牛奶，黄油和鸡蛋） ，或者想有足够的阳光必要为吸收保留足够数量的钙与磷为骨形成。 A high carbohydrate diet may cause rapid muscular growth but without an adequate vitamin D, calcium and phosphorus the skeleton may not keep pace with it and this may cause deficient bone formation.高碳水化合物饮食可能造成肌肉快速增长，但如果没有足够的维生素D ，钙，磷骨骼未必跟得上它，这可能导致缺陷的骨形成。
Rickets is a condition of disorganized ossification: the ends of the long bones show excessive proliferation of the cartilage cells but these are arranged irregularly and not in regular columns.佝偻病是一个条件杂乱无章骨化：两端的长骨显示过度增殖的软骨细胞，但这些都安排了不定期，不正规栏目。 This causes a broad bluish area with thickening of the epiphyses.这造成了广泛青区增厚的骨骺。 The vascularity of the area is increased and inspite of good preparations, whatever bone is formed is soft and calcification is defective.血管的面积增加，尽管作了充分准备，无论是骨形成的是软的钙化是有缺陷的。 The periosteum is thickened and the marrow congested.骨膜是增厚及骨髓出现挤塞的情况。
On account of the over growth of osteoid tissues, certain areas show “bossing”.对帐户的过度增长，骨组织中，某些领域秀” bossing ” 。 Such areas are distal ends of the radius at the wrist, junction of the ribs with the cartilages on the sternum and the frontal and the parietal bones.这些地区是否具有远端两端的半径在手腕，路口的肋骨与软骨对胸骨和额叶和顶叶骨头。 The imperfectly calcified, soft bones bend when any weight is imposed on them causing deformities.这个不完美的钙化，软骨弯曲时，任何重量，是强加给他们造成畸形。
What are the causes of the rickets?是什么原因，佝偻病？
Heredity is a frequent predisposing cause.遗传是一个频繁的诱因。
Poor nutrition, poor housing facilities, want of cleanliness, want of sun light are both predisposing and exciting causes.营养差，恶劣的住房设施，要清洁，要阳光，都是诱发和令人振奋的原因。
Age plays a great part.年龄起着很大一部分。 Rickets is a disease of young children, starting at the age of sixth month or after, less commonly of adolescents, characterized by deficient bone formation.佝偻病是一种疾病的小孩，开始在年满6个月或之后，较少的青少年，其特点是有缺陷骨形成。 There is abundant formation of osteoid tissue but inadequate calcification.有丰富的形成，骨样组织，但不足钙化。
Climate also has its influence, more prevalent in moist than in dry climates.气候也有其影响力，更盛行于潮湿的，比在干燥的气候。 Diathetic influences are second only to heredity. diathetic影响仅次于遗传。 In the tropic the skin is more exposed to sunlight and severe forms of rickets are not usually seen.在热带皮肤更暴露于阳光和严重的形式佝偻病通常没有见过。
Rickets may be associated with chronic renal insufficiency.佝偻症可能与慢性肾功能不全。 Probably the kidneys failing to excrete, phosphorus passes into the bowels where it retards the absorption of calcium.可能是肾脏无法排泄，磷通行证进入肠胃而阻碍吸收的钙。 Hypocalcaemia that follows causes hyperactivity of the parathyroid: this leads to deflection of calcium from the bones. hypocalcaemia认为如下原因多动的甲状旁腺：这导致偏转钙从骨骼。
Signs and symptoms of rickets症状和体征佝偻病
The family history may show syphilis, tuberculosis or some other diathesis.家族病史可能呈现梅毒，肺结核或其他一些素质。 The condition of the mother before and during gestation may be that of over work, prolonged lactation; improper diet, or want of exercise etc. The general surroundings have been poor.条件母亲之前和期间的酝酿，可能是过度的工作，长时间的哺乳;不正当的饮食，或是想锻炼等一般环境一直很差。
Symptoms are slow in onset; the deficiency must be of several months to cause manifestations.症状是缓慢发病;缺陷，必须于数个月内，以事业表现。 In the beginning these are restlessness, irritability and sweating of the head at night, more marked in the winter and spring. The symptoms first presented by the patient are generally referable to the digestive organs, viz, in the unnatural appetite, the abnormal stools, the enlarged abdomen, etc., followed by loss of weight.在开始时，这些都是躁动，易怒及出汗的头在夜间，更加明显，在冬季和春季。症状，首先由病人一般都借鉴到消化器官，即在非自然的胃口，不正常的凳子，扩大后腹部等，然后按损失的份量。
Then the patient becomes dull, listless, easily tired, inactive, emaciated or flabby.然后，病人变得枯燥无味，无精打采，容易疲倦，不活跃，瘦弱或软弱。 Next may be an unhealthy skin, giving us profuse offensive perspiration etc.明年可能是一个不健康的皮肤，使我们深切进攻汗等。
Digestive disturbances as flatulence and diarrhoea are common.消化障碍，因为胀气和腹泻是常见的。 Muscles are weak and flabby and the ligaments loose肌肉软弱，软弱和韧带松散
On account of softening of the bones and consequent bending of the spine and lowering of the diaphragm the abdomen is protruded and the liver and the spleen are palpable, and somewhat enlarged also.对帐户的软化，骨头和相应的弯曲的脊椎和降低膈肌腹部是伸出及肝脏和脾脏是显而易见的，并有所扩大，也。
The later symptoms, effects, the results of the disease usually make their first appearance in the thorax.后来症状，效果，结果该疾病通常使他们首次出现在胸部。 They are nodules easily palpated and readily seen in the ribs with the cartilages and are due to proliferation of cartilage cells.他们是结节容易palpated和随时出现在肋骨与软骨，是由于扩散的软骨细胞。 These are not only the first, but the most prominent results of the disease.这些做法，不仅是第一次，但最突出的结果，这种疾病。
Treatment治疗
The child should be breast fed up to the 9 th month when weaned and put on to the good cow’s milk or good brand powdered milk having an adequate amount of vitamin D. the foods of the nursing mother also must have adequate vitamins.应把儿童乳房厌倦了，以第9个月时断奶，并就向好的牛奶的婴儿或良好的品牌奶粉有适当数量的维生素D的食物的护理母亲，也必须有充足的维生素。 The food must contain a plenty of fresh milk from a cow fed on green grass, also butter, cream and yolk of egg but not any excess of carbohydrate.食品必须包含足够的鲜牛奶从奶牛饲喂青草，还牛油，奶油和蛋黄的鸡蛋，但并没有任何多余的碳水化合物。
Plenty of sunlight, fresh air and muscular exercise are essential.大量的阳光，清新的空气和肌肉运动是很必要的。