. The diseases of infancy and childhood. hat the eruption is receding. There is acertain amount of brownish discoloration, its intensity depending some-what upon the complexion of the person affected. Xo itching is com-plained of, but a slight burning or tingling sensation. The nails areunaffected. The tongue is oftentimes red; it may be coated, with clearedges, or it may be dry and glazed. The papillae are often somewhatenlarged. The tongue may be swollen. In addition to the glossitis theremay be also stomatitis and gingivitis. Burning in the mouth is an occa-sional complaint. The gastric sym
. The diseases of infancy and childhood. hat the eruption is receding. There is acertain amount of brownish discoloration, its intensity depending some-what upon the complexion of the person affected. Xo itching is com-plained of, but a slight burning or tingling sensation. The nails areunaffected. The tongue is oftentimes red; it may be coated, with clearedges, or it may be dry and glazed. The papillae are often somewhatenlarged. The tongue may be swollen. In addition to the glossitis theremay be also stomatitis and gingivitis. Burning in the mouth is an occa-sional complaint. The gastric symptoms are few. Vomiting is rare. Anorexia may bemarked but at times there is a craving for unusual food. Diarrhea is 1160 OTHER GENERAL DISEASES the rule. The stools are from two or three to as many as fifteen a may be watery, but at times mucus and even blood are constipation is rare, but the diarrhea often alternates withperiods of constipation. The mental symptoms are not so marked in children as in Fio. 201.—Pellagra. Boy, five years old; died of the disease five months later. Depression is often present. There is frequently a change in disposition,the children becoming dull, morose and peevish. An anxious, distressedfacial expression is characteristic of marked cases. The reflexes areusually exaggerated. Ankle clonus is frequently present and there maybe a decided tremor upon exertion. If the intestinal symptoms aremarked, there may be great loss of weight. The progress of the symptomsis not usually continuous, but there are marked remissions and exacerba-tions. The disease often disappears in the fall and winter to return PELLAGRA 1161 again the following spring and this may lie repeated many times. It isfor this reason difficult to say when the disease is really cured. Theprognosis in children is better than that in adults but death may occurfrom a continuance of the diarrhea, from the development of markedmalnutrition or from interc
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