Identifier: amerbook00star (find matches)
Title: An American text-book of the diseases of children ..
Year: 1895 (1890s)
Authors: Starr, Louis, 1849-1925 Westcott, Thompson Seiser, 1862-
Subjects: Children
Publisher: Philadelphia, W.B. Saunders
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library

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begun to walk. It attacks by preference the femur, tibia,and bones of the forearm, occurring usually from the second to the fourth orfifth year. There is more or less enlargement of the affected bone. At anearly stage of the disease the bones are attacked symmetrically, but later cir-cumscribed nodes may be placed unilaterally. Dactylitis.—The phalanges and the metacarpal and metatarsal bones maybe enlarged to several times their natural size. After an interval of time theskin may become inflamed and break down from the formation of an abscess.The proximal phalanges are more apt to be attacked than the distal, and sev-eral bones of each hand may be affected. There is not much destruction of 132 AMERICAN TEXT-BOOK OF DISEASES OF CHILDREX. bone, even in severe cases, and, although the disease tends to run a slow course,it is always influenced favorably by treatment. Dactylitis is apt to occur in veryyoung subjects, when it takes the form of a gummatous infiltration. (Fig. 1). Fig. 1.
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Syphilitic Dactylitis. Craniotabes.—The local thinning of portions of the cranial bones wasformerly attributed exclusively to rickets, but is now known to ensue as wellin the malnutrition accompanying syphilis. As it is due to pressure of thethin skull between the brain and pillow, it is especially apt to involve theoccipital bone. Carpenter considers that both craniotabes and Parrots nodesare often syphilitic manifestations, although they are more frequently regardedas evidences of rickets: 74 per cent, of cases of craniotabes are syphilitic,according to this author. Symptoms.—The symptoms of hereditary syphilis vary widely accordingto the extent of the poison. When the virus is concentrated, as in cases whereboth parents are syphilitic, the foetus will be attacked by the disease in theuterus, and. as a result, we shall have abortion more or less early in the preg-nancy. As the disease abates in one or both parents the pregnancies willbe longer in duration, until finally apparent

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