Text Appearing Before Image: in all stages, but especially inthe second stage. Hereditary syphilis is more common. When born thechild at times has large blebs on the skin surfaces andscars develop around the lips called rhagades. Symptoms.^—The Bones.—Epiphysitis, an inflammationof the ends of the bones, is present. Later in the diseasechronic osteoperiostitis and syphilitic dactylitis are seen. The liver and the spleen are enlarged. The Respiratory Tract.—Pneumonia is common. Ulcersof the larynx are sometimes observed. Digestive Tract.—A chronic catarrh of the pharynxis present, causing snuffles. The Organs of Special Senses.—Otitis media andinterstitial keratitis are common. 2^6 DISEASES OF CHILDREN FOR NURSES Nervous Symptoms.—Often absent, but there may beimpairment of mentality. The children are weak and sickly and usually dieyoung. If three months pass after a child is born from syphil-itic parents without the appearance of any characteristicsymptoms, the child will, in all probability, escape. Text Appearing After Image: Fig. 84.—Hereditary syphilis: radiating fissures of the lips (after A. Fruhinsholz). Hutchinsons Teeth.—If a child suffering from heredi-tary syphilis lives, the second or permanent teeth arecharacteristic (see Fig. 4). The teeth most frequently affected are the uppercentral incisors. They have a dull, opaque color andhave a roughly rounded and stunted appearance. The THE INFECTIOUS FEVERS 2/7 cutting edge of the tooth is narrower than its neck. Overthe tips of these stunted and conic teeth the enamel isirregular and forms a semilunar notch. The Wassermann reaction is a test made with bloodfrom an individual suspected of having syphilis. It isrehable in about 80 to 90 per cent, of cases. The physician will take from 4 to 8 c.c. of blood froma vein, or less from a stab of the finger, toe, or ear, andlet it stand at the room temperature for one hour untilfirmly clotted, then it should be put on ice. Be sure andlabel the tube and reference card, as all blood specimenslook the same. I
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