File:The practice of pediatrics (1906) (14596106628).jpg

Identifier: 39002086410504.med.yale.edu
Title: The practice of pediatrics
Year: 1906 (1900s)
Authors: Carr, Walter Lester,1859-
Subjects: Children
Publisher: Philadelphia : Lea
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library

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hows most plainly during the latter half ofthe first year and the first half of the second. In other words, ricketstakes time to develop, while congenital syphilis begins to present symp-toms soon after birth. Hutchinsons triad, or any two of the three signs, are very typical.The hony lesions are very difficult to separate from similar changesdue to tuberculosis. Often only a therapeutic test will decide thequestion. Deformities of the nose and hard palate are always aids, 572 INFECTIOUS DISEASES and likewise thickenings and deformities of the tibiae. Paralysisdue to syphilis is not symmetrical and will yield to specific treat-ment. Prognosis.—This is a much more fatal disease than acquired syphilisof adult life. Malnutrition is a frequent cause of death, and the loweredvitality due to this cause makes such infants very susceptible to otherdiseases; they often die of complications that a normal infant wouldsurvive. The earlier after birth the symptoms develop the worse the Fig. 1-J8
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Hutchinsons teeth. (Stowell.) prognosis, and naturally the earlier and more vigorous the treatmentthe better the chances for survival. Even if they escape death through a mild infection, or as the resultof active treatment, children the victims of this disease never seem todevelop entirely normally. They show evidences of malnutrition ofone kind or another, and they often develop rickets. Their growthmay be stunted, their mentality may never be all that it should, andfinally we often, even after most careful treatment, see some of the late CONGENITAL SYPHILIS 573 signs of the disease developing about puberty. So that in no way canthe prognosis be looked on as other than unfortunate. Treatment.—If a woman known to be syphilitic should becomepregnant, or if a woman should be pregnant by a man known to besyphilitic, antisyphilitic treatment should be begun as early in pregnancyas practicable, and should be continued until the beginning of labor.This treatment should be the ordinarily a

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