![]() Shipley, showed the anti-rachitic substance to be a novel vitamin, which was then named vitamin āDā using the next free letter of the alphabet ( 5). ![]() A chemical basis for the therapeutic effectiveness of cod liver oil was first proposed in 1919 by Edward Mellanby ( 4), and subsequently biochemist Elmer McCollum, working with Johns Hopkins pediatrician John Howland, and later with doctors Edwards A. Early studies revealed that rickets was caused by combined nutritional deficiency and a sunless environment, and could be successfully treated with cod liver oil ( 3). Historically, rickets has been considered a manifestation of poor socioeconomic status and a diet that failed to provide adequate amounts of vitamin D and/or calcium ( 1, 2). ![]() The recognition that genetic defects in vitamin D activation or responsiveness could cause rickets evolved from detailed clinical and biochemical studies that identified the critical role that vitamin D played in ensuring normal bone and mineral metabolism. ![]()
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