I 



THE SECONDARY OR GRANULOMATOUS STAGE 1551 



pressions remain, and the palms acquire a peculiar pitted appear- 

 ance. This condition of the palms may remain unchanged for 

 several years after all symptoms of framboesia have disappeared. 

 A somewhat similar appearance of the soles of the feet is occasionally 

 met with. 



Lesions of the Hair and Nails. — We have never noticed any 

 change in the appearance of the hair, or alopecia. A few hair- 

 follicles may be destroyed when the granulomata develop on the 

 scalp, which, however, seldom occurs. 



Lesions of Mucosa.— These are not very common. During the 

 secondary stage small granulomatous nodules may develop at the 



Fig. 699. — Frambcesia : Dactylitis. 



base of the tongue, also whitish patches closely resembling syphilitic 

 leukoplakia. Small granulomata may develop on the nasal 

 mucosa. 



Constitutional Symptoms— P'^y^r. — As already stated, fever is 

 frequently present, of intermittent or remittent type, before the 

 general secondary eruption begins. During the secondary stage it 

 is usually absent, unless complications supervene. 



Lymphatic Glands. — -In a number of cases in our experience 

 various groups of lymphatic glands are found to be enlarged. The 

 enlarged glands are roundish or spindle-shaped, hard, painless, and 

 never come to suppuration, unless a secondary pyogenic infection 



