Identifier: moderndiagnosis00shef (find matches)
Title: Modern diagnosis and treatment of diseases of childern; a treatise on the medical and surgical diseases of infancy anf childhood
Year: 1911 (1910s)
Authors: Sheffield, Herman Bernard, 1871- (from old catalog)
Subjects: Children Children
Publisher: Philadelphia, F. A. Davis company
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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beginning, but as the disease progresses theyshow a marked tendency to undergo caseation and suppuration.Fistuia> Furthermore, after evacuation of the pus which usually containstubercle bacilli they rarely cicatrize, but, on the contrary, continueas pus-discharging fistulae or indolent ulcers. The course of the disease depends greatly upon the vitalityof the patient and the mode of treatment. It is always chronic.Children removed from the obnoxious surroundings frequently SPONDYLITIS. 373 recover completely. In those not properly cared for the tuber-culous process is very prone to spread to the osseous system andto the internal organs. Spina ventosa, osteomyelitis and spondy-litis form frequent sequelae (for details of these affections thereader is referred to the chapter on Tuberculosis of the Bones,page 374). The internal organs, especially the liver, spleen andlungs, may be implicated singly or collectively, in which event theprognosis, of course, is extremely bad. Spinaventosa.
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Fig. 104.—Tuberculous Axillary Lymphadenitis. (Sheffield.) Characteristic as the symptom-complex of scrofulosis seemsto be, errors of diagnosis are nevertheless very apt to be made.The perplexity is often great in the differentiation betweenscrofula and inherited syphilis, both of which diseases have many syphilis-symptoms in common. In all such doubtful cases it is wise, onthe one hand, to employ the tuberculin reaction, and examine theaural and nasal secretions as well as the pus from scrofulous Tubercleabscesses for tubercle bacilli, and, on the other, to administer *™m in scroiulosis; mercury and look for the spirochete pallida. One should not f^™^^be too hasty in pronouncing a case as scrofulosis because of theso-called torpid habitus of the patient (pale, flabby, puffed face;thick nose, swollen and excoriated upper lip, redness and thick- 374 COMMUNICABLE DISEASES. ening of the lids), or the presence of adenoid-, or glandularswelling. These symptoms can and often do exist

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