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Starved for Light

The Long Shadow of Rickets and Vitamin D Deficiency

A wide-ranging history of rickets tracks the disease’s emergence, evolution, and eventual treatment—and exposes the backstory behind contemporary worries about vitamin D deficiency.
 
Rickets, a childhood disorder that causes soft and misshapen bones, transformed from an ancient but infrequent threat to a common scourge during the Industrial Revolution. Factories, mills, and urban growth transformed the landscape. Malnutrition and insufficient exposure to sunlight led to severe cases of rickets across Europe and the United States, affecting children in a variety of settings: dim British cities and American slave labor camps, moneyed households and impoverished ones. By the late 1800s, it was one of the most common pediatric diseases, seemingly an intractable consequence of modern life.
 
Starved for Light offers the first comprehensive history of this disorder. Tracing the efforts to understand, prevent, and treat rickets—first with the traditional remedy of cod liver oil, then with the application of a breakthrough corrective, industrially produced vitamin D supplements—Christian Warren places the disease at the center of a riveting medical history, one alert to the ways society shapes our views on illness. Warren shows how physicians and public health advocates in the United States turned their attention to rickets among urban immigrants, both African Americans and southern Europeans; some concluded that the disease was linked to race, while others blamed poverty, sunless buildings and cities, or cultural preferences in diet and clothing. Spotlighting rickets’ role in a series of medical developments, Warren leads readers through the encroachment on midwifery by male obstetricians, the development of pediatric orthopedic devices and surgeries, early twentieth-century research into vitamin D, appalling clinical experiments on young children testing its potential, and the eventual commercialization of all manner of vitamin D supplements. As vitamin D consumption rose in the mid-twentieth century, rickets—previously a major concern for doctors, parents, and public health institutions—faded in its severity and frequency, and as a topic of discussion. But despite the availability of drugstore supplements and fortified milk, small numbers of cases still appear today, and concerns and controversies about vitamin D deficiency in general continue to grow.
 
Sweeping and engaging, Starved for Light illuminates the social conditions underpinning our cures and our choices, helping us to see history’s echoes in contemporary prescriptions.

288 pages | 19 halftones | 6 x 9 | © 2024

History: American History, Environmental History

History of Science

Medicine

Reviews

“This is a fascinating, well-researched, and lively account of the long history of rickets. This wide-ranging volume explores the emergence of modern medicine, theories of race and disease, public health, and ethics, literally lighting the way to a greater understanding of this medical condition. You won’t want to swallow cod liver oil after reading this book, but you might want to reach for a sunshine vitamin D beer—alas, no longer available.”

Janet Golden, author of Babies Made Us Modern: How Infants Brought America into the Twentieth Century

Starved for Light offers a fresh perspective on a complex and understudied aspect of the American past. Warren convincingly demonstrates how industrialization, urbanization, and commercialization contributed to sun and vitamin D deficiency, leading to a long history of disablement that still harms many marginalized populations to this day.” 

Beth Linker, author of Slouch: Posture Panic in Modern America

Starved for Light is a treasure trove of fascinating facts—from the origin of red-ochre paints on houses in Newfoundland fishing villages to the etymology of rickets—masterfully woven into a compelling narrative that shines a light on the history of rickets. Warren’s book shows that rickets is a socially constructed disease, driven not by skin color or race but by racism and a fixation of technological solutions. In the end, Warren argues, closer contact with the natural world—with sunlight—may be healthier than having a biomedical cure that keeps us living in the shadows.”

Bruce Lanphear, Simon Fraser University

“Readers may think that they know the history of rickets. In Warren’s telling, we learn so much more than a simple story of scientific discovery, as fascinating as that might be. Research ethics, the growth of obstetrics, the invention of devices and surgeries, and the public health choices that led to commercial products reducing but not eliminating rickets all feature in a book that’s truly fun to read. Like the best works in the history of medicine, Starved for Light reveals lessons in public policy in a way that will please and inform historians, clinicians, and public health experts.”

Jeffrey P. Brosco, Health Resources and Services Administration

Table of Contents

Introduction: Sun and Skin and Bones
1 “Coeval with Civilization”: Rickets from Ancient Egypt to the “Dark Satanic Mills”
2 Rickets and Race in the United States, 1492–1900
3 Diet or Light? The Science of Rickets I
4 Testing the Cure: The Science of Rickets II
5 Cod Liver Oil: From Folk Remedy to Proven “Specific”
6 Improving upon Perfection: Modern Vitamin D Fortification
7 A Long Shadow
8 No Magic Bolus: Rickets, Risk, and Race in the Age of Uncertainty
9 Epilogue: Hard Choices, Slow Violence

Acknowledgments
Notes
Index

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