. The diseases of infancy and childhood : designed for the use of students and practitioners of medicine. es may enlarge and cause pain or tuber-culous infection of the peritoneum (tabes meseraica). In some casesthey may be palpated through the abdominal wall. 400 THE SPECIFIC INFECTIOUS DISEASES Bones and Joints.—The extremities of the long bones are mostfrequently the seat of disease; the diaphysis rarely so. The phalangesof the fingers, the toes, the radius, the ulna and fibula are affectedin the order of naming. The joint cavities may at first contain exu-date without perforation of the ca
. The diseases of infancy and childhood : designed for the use of students and practitioners of medicine. es may enlarge and cause pain or tuber-culous infection of the peritoneum (tabes meseraica). In some casesthey may be palpated through the abdominal wall. 400 THE SPECIFIC INFECTIOUS DISEASES Bones and Joints.—The extremities of the long bones are mostfrequently the seat of disease; the diaphysis rarely so. The phalangesof the fingers, the toes, the radius, the ulna and fibula are affectedin the order of naming. The joint cavities may at first contain exu-date without perforation of the cartilage; later pus is found in thecavity. All of the structures of the joint are in^ol^ed, and the joint maye\entually be destroyed. Suppuration of a chronic nature may, asstated elsewhere, tend to amyloid degeneration of the liver and spleen. There is, in addition, a progressive anemia. The temperature issometimes raised to ° or ° above the normal, at others it is nor-mal. Exhausting sweats occur; the disturbances of nutrition becomein some cases extreme. There may be intestinal Fig. 85.—Tuberculosis of the phalanx of the index finger in a scrofulous childthe subject of extensive lupus of the face and extremities (Spina ventosa). Course and Prognosis.—This condition is not necessarily fatal. Manycases make a good reco\ery under proper management. The diseasemay retrograde if localized to certain Ijonph nodes or bone foci. Diagnosis.—The diagnosis is made from the clinical history; eitherfrom the presence of the tubercle bacillus in the pus or lesions of thedisease, or in those forms in which it is not always possible to decidewhether the process is tuberculous or pyogenic bj the presence of thetuberculin reaction. Most striking is the cutaneous tuberculin reac-tion in cases in which there is a so-called tuberculotoxic effect on thetissues. Here we have latent tuberculous foci out of reach of observa-tion. The tuberculous toxins permeate th
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