The diseases of infants and children . stol Journ., )7, XXV, l,»;5.* Loc. cit. 5 Pniftitionor, 1001, LXVI, r^.\.8 Lyon iiR-d., 1875, XX, 626 THE DISEASES OF CHILDREN physicians. Barlow and Warner^ in 1881 reported upon 37 cases inchildren. In the United States it certainly appears to be uncommon, andthe same would appear to be true for Germany (Berkowitz).- I haveencountered it in but few instances. It appears to be more frequentin children than in adults. The nodules v?.ry in size from that of a pin-head to that of a small nut, are not reddened or tender, and are foundof
The diseases of infants and children . stol Journ., )7, XXV, l,»;5.* Loc. cit. 5 Pniftitionor, 1001, LXVI, r^.\.8 Lyon iiR-d., 1875, XX, 626 THE DISEASES OF CHILDREN physicians. Barlow and Warner^ in 1881 reported upon 37 cases inchildren. In the United States it certainly appears to be uncommon, andthe same would appear to be true for Germany (Berkowitz).- I haveencountered it in but few instances. It appears to be more frequentin children than in adults. The nodules v?.ry in size from that of a pin-head to that of a small nut, are not reddened or tender, and are foundoftenest upon the back of the head, about the joints, especially the elbows,knees and ankles, along; the tendons and the vertebrae and upon the pinnaof the ear. They are distributed somewhat symmetrically, vary in numberfrom very few to 50 or more and generally develop after the articularinflammation appears, although I have seen them abundant before usually take some weeks to disappear, and may exceptionally lastmanv Fig. 223.—Subcutaneous Fibrous of 4j^ years. Chorea, chronic endocarditis, nodules about the wrists and ankles.(Berkowitz, Arch. f. Kinderhk., 1912, LIX, 6.) Cutaneous Manifestations.—Rheumatic subjects are prone to attacksof erythema of various forms, with which articular inflammation is oftenassociated. Purpura too, is sometimes combined with rheumatic arthri-tis, with or without erythema. It is far from certain, however, that themajority of cases of arthritis with purpura have any connection withrheumatism. (See Purpura, Vol. II, p. 477.) Tonsillitis.—As already stated, inflammation of the tonsils or pharynxmay be promptly followed by articular inflammation or, even withoutthis, by cardiac disease. There seems to be a special tendency to ton-sillitis in evidently rheumatic subjects. Muscular Rheumatism. Rheumatic Myalgia.—The question whetherthis condition is actually rheumatic has been much disputed. Thereappears to be no
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