An American text-book of the diseases of childrenIncluding special chapters on essential surgical subjects; orthopaedics, diseases of the eye, ear, nose, and throat; diseases of the skin; and on the diet, hygiene, and general management of children . begun to walk. It attacks by preference the femur, tibia,and bones of the forearm, occurring usually from the second to the fourth orfifth year. There is more or less enlargement of the affected bone. At anearly stage of the disease the bones are attacked symmetrically, but later cir-cumscribed nodes may be placed unilaterally. Dactylitis.—The pha
An American text-book of the diseases of childrenIncluding special chapters on essential surgical subjects; orthopaedics, diseases of the eye, ear, nose, and throat; diseases of the skin; and on the diet, hygiene, and general management of children . begun to walk. It attacks by preference the femur, tibia,and bones of the forearm, occurring usually from the second to the fourth orfifth year. There is more or less enlargement of the affected bone. At anearly stage of the disease the bones are attacked symmetrically, but later cir-cumscribed nodes may be placed unilaterally. Dactylitis.—The phalanges and the metacarpal and metatarsal bones maybe enlarged to several times their natural size. After an interval of time theskin may become inflamed and break down from the formation of an proximal phalanges are more apt to be attacked than the distal, and sev-eral bones of each hand may be affected. There is not much destruction of 108 AMERICAN TEXT-BOOK OF DISEASES OF CHILDBEN. bone, even in severe cases, and, although the disease tends to run a slow course,it is always influenced favorably by treatment. Dactylitis is apt to occur in veryyoung subjects, when it takes the form of a gummatous infiltration. (Fig. 1). Fig. Syphilitic Dactylitis. Craniotahes.—The local thinning of portions of the cranial bones wasformerly attributed exclusively to rickets, but is now known to ensue as Avellin the malnutrition accompanying syphilis. As it is due to pressure of thethin skull between the brain and pilloAv, it is especially apt to involve theoccipital bone. Carpenter considers that both craniotabes and Parrots nodesare often syphilitic manifestations, although they are more frequently regardedas evidences of rickets: 74 per cent, of cases of craniotabes are syphilitic,according to this author. Symptoms.—The symptoms of hereditary syphilis vary widely accordingto the extent of the poison. When the virus is concentrated, as in cases whereboth parents are syphil
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