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July 23, 1904


JAMA. 1904;XLIII(4):247-254. doi:10.1001/jama.1904.92500040002e

The fact that pathology at most implies a disturbance of balance which causes a conflict of physiologic processes is nowhere more evident than in osteomalacia. The current error which assumes that any process aiding disease must be innately nosologic interferes with diagnosis and treatment alike. The clinical and pathologic work done on osteomalacia has been vitiated by the view-point just mentioned. Osteomalacia occurs from so many nosologic states as to indicate that it arises from a process physiologic in character, but perverted to nosologic ends by anything which disturbs the balance struggle for existence between the structures.

Bones do not grow in the ordinary sense, since the bone cells can not multiply. Apparent growth of bone is caused by destruction of bone already formed and by production of new bone. The production of new bone is one, as Minot (Embryology) points out, first to degeneration of the ossifying cartilage. Cartilage

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