. Diseases of children. ay be present. In rachitis the bones are not so painful as insyphilis, and there is no roughening, although they may be thickenedat the ends. Prognosis.—The prognosis is good if the child comes under obser-vation early, and treatment is carried out thoroughly. Treatment.—Syphilitic bone lesions in children respond strikinglyto mercury and the iodides. A child five years of age should be givenfrom 3^ to -2V of ^ grain of bichloride of mercury daily, with from 12 to20 grains of potassium iodide daily, the drugs being given in separatemixtures. If the bichloride of mercury
. Diseases of children. ay be present. In rachitis the bones are not so painful as insyphilis, and there is no roughening, although they may be thickenedat the ends. Prognosis.—The prognosis is good if the child comes under obser-vation early, and treatment is carried out thoroughly. Treatment.—Syphilitic bone lesions in children respond strikinglyto mercury and the iodides. A child five years of age should be givenfrom 3^ to -2V of ^ grain of bichloride of mercury daily, with from 12 to20 grains of potassium iodide daily, the drugs being given in separatemixtures. If the bichloride of mercury given by the stomach disagrees,from 20 to 30 grains of mercurial ointment may be well rubbed intothe skin daily. In order to prevent gastric disturbance, the adminis-tration of potassium iodide should be interrupted for a few daysevery month; later these drugs may be given alternately. The partshould be protected locally, and placed at rest. Suppuration callsfor surgical intervention with removal of the dead Fig. 52.—Tuberculous dactylitis of ring finger. DACTYLITIS. Dactylitis is a disease of the phalanges in children, causing a fusiformswelling, and may be syphilitic or, rarely, tuberculous. It may alsobe due to streptococcic infection or trauma. Pathology.—In both tuberculous and syphilitic forms the process,which is a rarefying osteomyelitis, begins in the centre of the bone, CRANIOTABES 521 resulting in an enlargement of the medullary canal, while at the sametime there is a proliferative periostitis, causing a fusiform and necrosis occur, and a finger or toe may be acute dactylitis, arising from streptococcic infection or trauma,presents the symptoms of acute osteomyelitis. Diagnosis.—Syphilitic dactylitis is more common than the tuber-culous form. It occurs most frequently during the first two years andusually involves several bones. The proximal phalanges are apt to beinvolved in syphilis, and there is not the tendency t
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