may be mucous patches in the mouth, or a stomatitis which is of
importance, because it results in interference with the development of
the permanent teeth. The mucous membrane of the larynx may be the seat
of mucous patches or of catarrh, and as a result the child's cry is
hoarse.

_Affections of the Bones._--Swellings at the ends of the long bones, due
to inflammation at the epiphysial junctions, are most often observed at
the upper end of the humerus and in the bones in the region of the
elbow. Partial displacement and mobility at the ossifying junction may
be observed. The infant cries when the part is touched; and as it does
not move the limb voluntarily, the condition is spoken of as _the
pseudo-paralysis of syphilis_. Recovery takes place under
anti-syphilitic treatment and immobilisation of the limb.

Diffuse thickening of the shafts of the long bones, due to a deposit of
new bone by the periosteum, is sometimes met with.

[Illustration: FIG. 44.--Facies of Inherited Syphilis.]

The conditions of the skull known as Parrot's nodes or bosses, and
craniotabes, were formerly believed to be characteristic of inherited
syphilis, but they are now known to occur, particularly in rickety
children, from other causes. The _bosses_ result from the heaping up of
new spongy bone beneath the pericranium, and they may be grouped
symmetrically around the anterior fontanelle, or may extend along either
side of the sagittal suture, which appears as a deep groove--the
"natiform skull." The bosses disappear in time, but the skull may remain
permanently altered in shape, the frontal and parietal eminences
appearing unduly prominent. The term _craniotabes_ is applied when the
bone becomes thin and soft, reverting to its original membranous
condition, so that the affected areas dimple under the finger like
parchment or thin cardboard; its localisation in the posterior parts of
the skull suggests that the disappearance of the osseous tissue is
influenced by the pressure of the head on the pillow. Craniotabes is
recovered from as the child improves in health.

Between the ages of three and six months, certain other phenomena may be
met with, such as _effusion into the joints_, especially the knees;
_iritis_, in one or in both eyes, and enlargement of the spleen and
liver.

In the majority of cases the child recovers from these early
manifestations, especially when efficiently treated, and may enjoy an
indefinite period of good he