File:The diseases of children - medical and surgical (1900) (14781042361).jpg

English:
Juvenile rheumatoid arthritis as described by G. F. Still: Chronic Arthritis with Glandular Enlargement. The dotted lines show the lower limit of the liver and spleen. Boy aged 3 years.

Identifier: diseasesofchildr00ashb (find matches)
Title: The diseases of children : medical and surgical
Year: 1900 (1900s)
Authors: Ashby, Henry, 1845-1908 Wright, G. A. (George Arthur), b. 1851 Northrup, William Perry
Subjects: Pediatrics
Publisher: New York : Longmans, Green
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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senlargement of the glands andspleen. This glandular hyperplasiasuggests Hodgkins disease ; theaxillary glands and glands in thegroin and posterior triangle ofthe neck are most often affected.The mesenteric, hepatic, andsplenic glands may also be en-larged. The spleen seems con-stantly to be enlarged. Anaemia is present, and there is periodical pyrexia.The course of the disease is chronic. There seems to be a special liabiHtyto pericarditis and pleurisy. In our own case, we were suspicious of Hodg-kins disease on account of the enlarged glands and spleen, and erratic febrileattacks. At the post-mortem the enlarged glands were pale and by no meansunlike the glands seen in that disease. It seems unhkely that the glandularenlargement is merely secondary to the arthritis, but what the connectionis it is not possible to say. The following case evidently belonged to the same group of cases asthose described above : 1 On a form of chronic joint disease in children, Med. Chi. Trans., vol. 80.
Text Appearing After Image:
Fig. 94.—Chronic Arthritis with Glandular Enlarge-ment. The dotted lines show the lower limit ofthe liver and spleen. Boy aged 3 years. Chronic Arthritis—Diabetes Mellitus 463 Joseph M., aged 3 years, was admitted to the Childrens Hospital, November 2, 1896.The mother states that both the father and brother have had rheumatism. In February 1896the child had scarlet fever badly ; the attack was followed by dropsy. Three months afterhe suffered from rheumatism, a number of joints becoming affected at the same time;they were painful, but are not so now. He has always been a pale child. There was nohistory of syphilis. On admission, it was noted that both wrist joints were puffy andswollen, having a pulpy feel, more like a tubercular joint than rheumatism ; both knees werealso swollen and flexed, though they could be straightened without pain. There was nopain or tenderness in the joints. The glands in the axilloe, Scarpas triangle, and posteriortriangle of the neck were enlarged, but

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