Identifier: journaloflaryngo14londuoft (find matches)
Title: The Journal of laryngology and otology
Year: 1887 (1880s)
Authors:
Subjects: Ear Nose Throat
Publisher: London (etc.) Headley Brothers (etc.)
Contributing Library: Robarts - University of Toronto
Digitizing Sponsor: University of Toronto

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Text Appearing Before Image:
, and late forms are recorded even after twenty
years of age. The appearances correspond to the symptoms which
characterize the common tertiary form of the disease, but are less
definite, so that sometimes it is quite impossible to form an exact
diagnosis from the appearances. These have to be supplemented
by a full consideration of the history of the family and the history
of the patient's general condition and previous illnesses.
The little girl whose photograph is here reproduced first
came under my observation when she was six and a quarter years
old. She was brought for an attack of subacute otitis media,
from which she soon recovered. Shortly afterwards (September,
1897) her mother returned with her, complaining that the mucus
from the child's nose was thick, and that the bridge of the nose was
becoming depressed. Nothing was found in the nasal fossae, except
some dry rhinitis, and the change in the configuration of the bridg
eof the nose was so slight that it could not be appreciated by anyone
Text Appearing After Image:

August. 1899] Rhinology, and Otology. 397

except the mother. At that date the child had all her temporary
teeth, and nothing amiss was noticed with them. Unfortunately,
the family history was not inquired into. The case was seen in
consultation with a colleague, but regarded simply as one of early
atrophic rhinitis. It was treated with alkaline nasal lotions, and
the syrup of the iodide of iron.
The patient disappeared from observation, and only came under
notice again in February, 1899. She was then seven years and
nine months old, and during the interval had shed her temporary
upper incisor and canine teeth. These had been replaced only by
the two central incisors. These latter presented incontestable
evidence of congenital syphilis. A reference to the photograph will
show how typical they are of Hutchinson's teeth. The charac-
teristic peculiarities are that they are dwarfed ; the portion of the
upper jaw from which they grow is stunted in its development,
giving a certain under-hung appearance ;

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