Common disorders and diseases of childhood / by George Frederic Still.

  • Still, George Frederic, 1868-1941.
Date:
1909
Catalogue details

Licence: In copyright

Credit: Common disorders and diseases of childhood / by George Frederic Still. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    also are not very rare even in infants a few weeks old and may be associated with some catarrh causing snuffling respiration. Ihere are also some forms of idiocy, particularly Mongolian imbecihty and microcephaly, in which a small naso-pharynx with a special tendency to catarrh is responsible for snuffling and snorting respiration quite apart from syphihs. Skin eruptions. These generally appear soon after the snuffles and almost always within the fhst three months They are certainly very uncommon after the age of six months ; in one of my cases the rash appeared at eight months and in another at one year. Some characteristic eruption was present in 69 per cent, of my cases. I shall not attempt to describe all the skin aflPections which have been observed in congenital syphihs ; the most characteristic might be grouped as follows : 1. Macular, small reddish-brown, 'raw-ham-coloured' areas, generally roughly circular, but running together into irregular areas, dry and sometimes finely desquamating on the surface ; occasionally these patches are yellowish-brown or fawn-coloured and have a dry, glazed surface. This eruption may be present on any part of the body but is particularly characteristic in its tendency to affect the middle tliird of the face, i.e. if the face be divided into three parts vertically, the middle portion including the cliin and upper Hp, the nose, and inner end of the eyebrows, is specially affected and sometimes the only part affected by the syphilitic rash. 2. Erythematous, diffuse in distribution and occurring specially about the perineum and down the inner side of the tliigh and leg as far as the instep of the foot ; the skin may be dry and glazed and at the edge of the affected area there are often outlying small round patches of similar character. 3. Desquamative; either of the preceding is sometimes asso- ciated with a httle fine branny desquamation of the affected areas, but apart from these there is a profuse desquamation of the palms and soles which, occurring in an infant under the age of three months, is very characteristic of congenital syphihs. 4. Fissures, usually radiating outwards from mucous surfaces, e. g. the mouth and anus; these generally occur witliin the fu-st few weeks of life and are often deep enough to leave scars which last for the rest of life. 5. Bullous, the ' syphihtic pemphigus ', which, as already mentioned, is present at birth or within the next few days. 6. Condylomatous ; these moist warty-looking, flat-topped slightly raised patches usually of about the size of a threepenn}'--