The medical diseases of children . r bosses are separated fromeach other by a cruciform depression, so that the condition is some-times spoken of as the hot-cross-bun head {Fig. 13). Formerly,both head-bossing and craniotabes were regarded as evidence ofinherited syphilis rather than of rickets; but it seems certain that 5 66 CONSTITUTIONAL DISEASES both these conditions may occur from rickets alone, although in theworst cases the syphilitic taint is also present. Delayed dentition is a very constant sign of rickets. Frequently thefirst teeth do not appear until after the twelfth month. Their
The medical diseases of children . r bosses are separated fromeach other by a cruciform depression, so that the condition is some-times spoken of as the hot-cross-bun head {Fig. 13). Formerly,both head-bossing and craniotabes were regarded as evidence ofinherited syphilis rather than of rickets; but it seems certain that 5 66 CONSTITUTIONAL DISEASES both these conditions may occur from rickets alone, although in theworst cases the syphilitic taint is also present. Delayed dentition is a very constant sign of rickets. Frequently thefirst teeth do not appear until after the twelfth month. Their eruptionis likely to be associated with various nervous disorders in ricketychildren. When cut, the teeth tend to be frail and notched, and astheir enamel covering is poorly developed, they are prone to earlydecay. Dentition, should it have begun, may become suspendedwith the onset of the disease. The spine frequently shows the well-known curvature. It is usuallymore rounded than the angular deformity of tuberculous caries, and it. Fig. 13.—Rickets : Hot-cross-eun Head. is easily distinguished from this more serious disease by the absenceof rigidity, the spinal column becoming straight on extension, providedthe child is quiet and not resisting (Fig. 14). The long bones show many changes. The earliest is the enlargementof the lower radial epiphyses, those of the other bones being usuallyaffected later. As the result of crawling, walking, or even of beingcarried, the child may develop various curvatures usually more markedin the bones of the lower extremities than in those of the arms. Thecommonest deformity is a sharp lateral curve in the lower part of thetibia, with which may be associated a forward bending of the shaft of RICKETS 67 the bone (Ftg. 15). Such may develop before the child can walk,from the cross-legged position adopted in sitting. Genu valgum is
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectpediatrics, bookyear1
