Identifier: 39002011128551.med.yale.edu
Title: The diseases of infancy and childhood
Year: 1920 (1920s)
Authors: Holt, L. Emmett(Luther Emmett),1855-1924
Subjects:
Publisher: New York, D. Appleton
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library

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age, is considerable and the periostitis ratherslight. By means of the X-ray it can be seen that the phalanx involvedis much thickened and of denser structure than the normal. Except forthe fact that more than one and frequently several phalanges are in- 1116 THE SPECIFIC INFECTIOUS DISEASES volved, the symptoms closely resemble the tuberculous form. The en-largement is spindle-shaped, involving the entire phalanx It is usuallynot painful. It slowly increases in size and but rarely goes on to sup-puration or necrosis. The disease may be arrested and cured by consti-tutional treatment. Lymph Nodes.—These are often palpable. Marked enlargement isuncommon. No aid in diagnosis can be obtained from any but theepitrochlear glands. If these are considerably enlarged in infancy with-out evident adequate explanation, a suspicion of syphilis should always bearoused. They may be at times almost the only evidences of the disease. The only visceral symptoms of importance are, enlargement of the
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Fio. 187. Fig. 188. Figs. 187, 1S8.—Syphilitic Dactylitis. On right hand first phalanges of forefinger andlittle finger affected; on left hand first phalanx of thumb and second phalanx of secondfinger. spleen, which is almost invariably present in the active stage of hereditarysyphilis, and jaundice with or without enlargement of the liver (seeIcterus of the Newly Born). Late Hereditary Syphilis.—The symptoms may come on at anyperiod during childhood or about the time of puberty, but rarely at alater time than this. They are seen both in those who have had theusual symptoms of hereditary syphilis in early infancy, and in otherswhere the most careful examination into the history fails to disclose anysymptoms whatever of early syphilis. It is fair to assume in such caseseither that early symptoms were absent or that they were of trivialimportance. Late hereditary syphilis shows itself by symptoms which in acquireddisease would be classed as tertiary. The most characteristic are the

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