A system of surgery . ons of thebones.—Theeffect of thesyphilitic poi-son upon thenutrition of the comparatively soft developing bones of youngchildren leads to changes in the secondary stage— during thefirst two years—which have no parallel in the acquired disease ofadult life. Craniotabes.—By this term is understood a thinning of the flatbones of the cranial vault, particularly the parietals and occipital,which occurs in somewhat circular patches, which may necrosis ever occurs, but the place of the bone may be whollytaken by fibrous tissue, and the affection is obviously a d
A system of surgery . ons of thebones.—Theeffect of thesyphilitic poi-son upon thenutrition of the comparatively soft developing bones of youngchildren leads to changes in the secondary stage— during thefirst two years—which have no parallel in the acquired disease ofadult life. Craniotabes.—By this term is understood a thinning of the flatbones of the cranial vault, particularly the parietals and occipital,which occurs in somewhat circular patches, which may necrosis ever occurs, but the place of the bone may be whollytaken by fibrous tissue, and the affection is obviously a defect ofnutrition of the bone, aided by pressure of the childs head as it liesin bed or on the nurses arm, since craniotabes is almost confined tothe posterior regions of the skull-vault. It may be detected by thesurgeon pressing his finger over this part whilst holding the headsteady, a characteristic sensation of denting will be felt as the softpatch is depressed, which is compared to that of a thin tin Fig. -Severe Eruption on the Face of an Infant with CongenitalSyphilis, having an annular or gyrate outline. Note its occurrence at the angles of the mouth, where there were severalfissures. The individual patches were soft, raised, reddish-brown incolour, and some were covered with scab. INHERITED SYPHILIS. 425 Craniotabes is often met with in infants the subject of inheritedsyphilis, but not in them alone; the mal-nutrition associated withricketsJs quite as important a factor in its production. (See page 367.) Periostitis and epiphysitis,—It is particularly at the growingends of the long bones that inherited syphilis is prone to causeinflammatory lesions. The disk of cartilage between the epiphysisand shaft, and still more the delicate spongy bone immediately abovethis, become inflamed, and in a few cases actual suppuration mayensue. Commonly, the affection is recognised only by thickeningand tenderness about the joint end of the bone involved, though theepip
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