The diseases of infancy and childhood : for the use of students and practitioners of medicine / by L. Emmett Holt and John Howland.
- Luther Emmett Holt
- Date:
- 1911
Licence: Public Domain Mark
Credit: The diseases of infancy and childhood : for the use of students and practitioners of medicine / by L. Emmett Holt and John Howland. Source: Wellcome Collection.
Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.
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![m m .«.• i a 1 v'i m I'iG. 215.—Syphilitic Teeth. Boy eight years old; under observa- tion several years with various syphilitic manifestations. It has already been de- incisors, but often rounded and pc<^-like. They are not properly placed, but incline eitlier toward or away from each other. They are seldom large enough to touch the adjacent teeth on both sides. Altliougli Hutchinson's teeth may generally be taken as conclusive evi- dence of syphili.s, tiiey are not invari- •ably so, as Keyes and others have shown. It is to be remembered in this connection that the absence of changes in the teeth is of no importance what- ever as evidence that syphilis is not present. Hutchinson states that they are wanting in more than lialT the cases. Bones.—The forni of disease which is usually seen at this period is an osteo-periositis, affecting principally the shaft of the long bones and the cranium, scribed elsewliere. Lymph Nodes.—They are less frequently affected than in adults, and in early infancy they are seldom mucli involved. In most cases after the first year there may be found a moderate degree of enlargement of the post-cervical and epitrochlear glands, swelling of the latter having con- siderable diagnostic value. Under normal conditions tlie latter can scarcely be felt; but in syphilitic children they may be as large as a pea or a small bean; sometimes two or three of them can be distinguished. The}' are so rarely enlarged from other constitutional conditions that, provided no local cause for the swelling exists, they should always create a suspicion of syphilis. The post-cervical glands are frequently affected, but are not so diagnostic. The degree of enlargement is rarely great. Occasionally there are seen in the neck large masses of swollen lymph glands which resemble tuberculous swellings. They are, however, very rare. Special Senses.—The most frequent affection of the eye in late syph- ilis is interstitial keratitis, the close connection of which with hereditary syphilis was first pointed out by Hntchinson. It is usually found asso- ciated with the typical notched teeth. The diagnostic value of keratitis in syphilis is denied by Fournier, who states that, while often syphilitic, it is not infrequently due simply to malnutrition. Both eyes are usually affected, and in all degrees of severity, from a slight haziness of the cornea to complete opacity. However, with an early diagnosis and ]jrompt treatment, a marked degree of improvement may be expected in most cases.](https://iiif.wellcomecollection.org/image/b21218407_1125.jp2/full/800%2C/0/default.jpg)
