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The author excludes syphilis, tuberculosis, rheumatism, gout, hemophilia, etc., and considers it to have been a trophic affection of cerebral origin. Cases of pneumonia osteoarthropathy simulating acromegaly have been reported by Korn and Murray. Megalocephaly, or as it was called by Virchow, leontiasis ossea, is due to a hypertrophic process in the bones of the cranium.
Hemophilia is rarely fatal in the first year. Of the hemorrhagic diseases of the new-born three are worthy of note. In syphilis haemorrhagica neonatorum the child may be born healthy, or just after birth there may appear extensive cutaneous extravasations with bleeding from the mucous surfaces and from the navel; the child may become deeply jaundiced.
It is, moreover, extremely frequent. Others exist, but are more rare as peculiar congenital predisposition to hæmorrhages, with or without true hemophilia . If the menstrual crisis finds the uterine blood-vessels already deprived of tonicity through nervous exhaustion or other cause, hæmorrhage is as likely to occur as if that tonicity were only exhausted at the epoch of menstruation.
Oliver Appleton, the first reported American bleeder, died at an advanced age, owing to hemorrhage from a bed-sore and from the urethra. Fortunately the functions of menstruation and parturition are not seriously interfered with in hemophilia. Menstruation is never so excessive as to be fatal. Grandidier states that of 152 boy subjects 81 died before the termination of the seventh year.
Woakes also speaks of "ear-giddiness" and offers a new associate symptom superficial congestion of the hands and forearm. A case of anomalous sneezing immediately prior to sexual intercourse is mentioned on page 511. Hemophilia is an hereditary, constitutional fault, characterized by a tendency to uncontrollable bleeding, either spontaneous or from slight wounds.
Such is the case with insanity, with epilepsy, with hemophilia, or "bleeders," and with certain rare and curious disturbances of the nervous system, such as the hereditary ataxias and "tics" of various sorts.
Osler has been advised of instances already occurring in the seventh generation. Kolster has investigated hemophilia in women, and reports a case of bleeding in the daughter of a hemophilic woman. He also analyzes 50 genealogic trees of hemophilic families, and remarks that Nasse's law of transmission does not hold true.
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