ercises an injurious influence on the foetus, which in many
cases dies during the early months of intra-uterine life, so that
miscarriage results, and this may take place in repeated pregnancies,
the date at which the miscarriage occurs becoming later as the virus in
the mother becomes attenuated. Eventually a child is carried to full
term, and it may be still-born, or, if born alive, may suffer from
syphilitic manifestations. It is difficult to explain such vagaries of
syphilitic inheritance as the infection of one twin and the escape of
the other.

_Clinical Features._--We are not here concerned with the severe forms of
the disease which prove fatal, but with the milder forms in which the
infant is apparently healthy when born, but after from two to six weeks
begins to show evidence of the syphilitic taint.

The usual phenomena are that the child ceases to thrive, becomes thin
and sallow, and suffers from eruptions on the skin and mucous membranes.
There is frequently a condition known as _snuffles_, in which the nasal
passages are obstructed by an accumulation of thin muco-purulent
discharge which causes the breathing to be noisy. It usually begins
within a month after birth and before the eruptions on the skin appear.
When long continued it is liable to interfere with the development of
the nasal bones, so that when the child grows up there results a
condition known as the "saddle-nose" deformity (Figs. 43 and 44).

[Illustration: FIG. 43.--Facies of Inherited Syphilis.

(From Dr. Byrom Bramwell's _Atlas of Clinical Medicine_.)]

_Affections of the Skin._--Although all types of skin affection are met
with in the inherited disease, the most important is a _papular_
eruption, the papules being of large size, with a smooth shining top and
of a reddish-brown colour. It affects chiefly the buttocks and thighs,
the genitals, and other parts which are constantly moist. It is
necessary to distinguish this specific eruption from a form of eczema
which occurs in these situations in non-syphilitic children, the points
that characterise the syphilitic condition being the infiltration of the
skin and the coppery colour of the eruption. At the anus the papules
acquire the characters of _condylomata_, also at the angles of the
mouth, where they often ulcerate and leave radiating scars.

_Affections of the Mucous Membranes._--The inflammation of the nasal
mucous membrane that causes snuffles has already been referred to. There