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July 21, 1923

Rickets: The Relative Importance of Environment and Diet as Factors of Causation: An Investigation in London.

JAMA. 1923;81(3):238. doi:10.1001/jama.1923.02650030062037

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This is a comprehensive and painstakingly controlled report. The author emphasizes the rôle which unbalanced diet plays, contending that excessive carbohydrate with deficient fat is the main causative factor. He points out how lack of means promotes the use of such an adverse fatcarbohydrate diet. Contrary to Paton of Glasgow, he does not find that bad housing, and overcrowding and deficient air space are responsible, and he supports his. contention by control cases. Other influences, such as heredity, are discussed and evaluated. This field of study is broad, embracing widely varying social conditions; the deductions, therefore, are not from any one group of patients, living, necessarily, under the same conditions. The method and thoroughness of investigation make the author's conclusions convincing.

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