522 PEDIATRICS 



syphilis differs from the acquired form in this that several parts 

 of the nervous system are affected simultaneously; and that arte- 

 ritis, meningitis, gummata, and simple sclerosis occur in com- 

 bination. Simple cerebral meningitis and apoplexies are very rare. 

 Encephalitis is more frequent. Probably spinal diseases are more 

 frequent, according to Gilles de la Tourette, Gasne, Sachs, and 

 others. Tabes dorsalis is not frequent, but may rather depend on 

 an atavistic syphilitic basis; for altogether the nerve syphilis of 

 the second previous generation as a cause of disease in the young 

 is not very rare. (E. Finger, W. klin. Woch., 13, 1900.) 



What we call neuroses are not infrequent in infants and children. 

 Neuralgias are not so common as in the adult, but would be more 

 frequently found if sought for. Even adipositas dolorosa has been 

 observed in childhood. Hysteria is by no means rare and its mono- 

 symptomatic character, so peculiar to early age, adds to its noso- 

 logical importance. Its early appearance is of grave import. Its 

 often hereditary origin makes it a serious problem, under-alimen- 

 tation or ill-nutrition, rachitis and scrofula, frequently connected 

 with and underlying it, may make it dangerous and a fit subject 

 for the study of educators, psychologists, judges, and all those 

 whose direct office it is to study social and socialistic problems. 

 Hysteria is not quite unknown amongst males, though the large 

 majority are females. 



Some of the vaso-motor and trophic disturbances are less, others 

 more frequent, in the young than in the adult. Amongst 129 cases 

 of akrosparesthesia there is only one of Frankl Hochwart in a girl 

 of 12 years, and one of Cassirer in a girl of 16. Sclerodermia is met 

 with mostly in mature life, but the cases of Neumann at 13 days, 

 and those of Cruse, Herxheimer, and of Haushalter and Spielmann, 

 who observed two cases in one family, all of them when the infants 

 were only a few weeks old, prove that the same influences which 

 are at work in advanced age, namely, hereditary disposition, neu- 

 ropathic family influence, low general nutrition, colds, trauma, 

 and so on, may play their role in infant life. Nor are infant ery- 

 thromelalgias numerous. Henoch saw one in a teething infant, 

 Baginsky in a boy of 10, Heimann one in a girl of 13, Graves one 

 in a girl of 16; that means three or four cases below 13 or 16 years 

 of age, out of a number of 65 collected by Cassirer in his mono- 

 graph. (Die Vasomotorisch-trophischen Neurosen, Berlin, 1901.) 

 In half a century I have seen but one that occurred in early age, 

 namely, in a boy of 12, who got well with the loss of two toes. On 

 the other hand, the symmetrical gangrene of Raynaud and acute 

 circumscribed edema of Milton and Quincke, 1882, treated of by 

 Collins in 1892, are by no means relatively rare in infancy and child- 

 hood. There are a few cases of the former that occurred in the newly- 







