Identifier: treatiseo00smit (find matches)
Title: A treatise on the diseases of infancy and childhood
Year: 1886 (1880s)
Authors: Smith, J(ob) Lewis, 1827-1897. (from old catalog)
Subjects: Children
Publisher: Philadelphia, Lea brothers & co.
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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e by Waldeyer and Kobner.1 Again, there is a syphilitic lesion of the bone in children, which isnot usually present or has not usually been observed at birth, but isdeveloped in the first weeks or months of infancy. The lesion alludedto is a circumscribed enlargement of one or more bones. This has beenmost frequently observed upon the long bones, including the clavicleand ribs ; but in certain children it occurs upon other bones in addition.In some cases it is one of the first manifestations of hereditary syphilis,occurring even sooner than the coryza, while in others several monthselapse before it appears. In one case, reported by Dr. Bulkley,2 of thiscity, it was first seen only a few days after birth, being perhaps con-genital ; while in another case, in which the enlargement was uponcertain phalanges, and which is represented in the accompanying figure,it appeared at the age of twelve months. When it occurs upon a pha-langeal bone, it is designated dactylitis syphilitica. Fig. 22.
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The enlargement, if upon a long bone, ordinarily begins at or nearthe point of union of the diaphysis with the epiphysis. It is locatedupon the extremity of the shaft which it encircles, and it extends over 1 See elaborate paper by E. W. Taylor, M.D., New York Journal of Obstetrics,etc., July, 1874. 2 Kare Cases of Congenital Syphilis, New York Med. Journal, May, 1874. 184 SYPHILIS. a part or nearly the whole of the epiphysis. It has an elevation ofperhaps one-half or three-quarters of an incli in typical cases ; its surfaceis smooth, or slightly undulating, and the skin over it, though distended,has its normal appearance, and is easily movable, unless ulcerations haveoccurred. These enlargements, which result from the specific inflammation,occurring in the periosteum and the bone, may resolve under propertreatment; but if neglected, and the antihygienic conditions are bad,degenerative changes may occur, ending in ulceration and destructionof the diseased part to a greater or less ext

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