I still regard the changes in these cases as being due to congenital lues. In the case of Archie, aged twenty-nine, the appearance of the knees is quite characteristic of the Charcot joint (Figs. 21, 22, 23, 24 and 25), a condition that is not supposed to occur in congenital lues. The knees in Rena, aged thirty-one are also strongly suggestive of a Charcot (Figs. 28, 29, 36, 37, 38 and 39), certainly a dystrophy of some type. Gladys, aged nineteen, Wassermann positive in February, 1927, has improved without treatment and at present has no disability, although the right knee shows some variation from the normal (Figs. 11 and 12).
The diagnosis of a hitherto unknown dystrophy, probably due to lues, is made on the following points.
1. The early history of the three children.
2. The appearance of the tongue and lips in all three children (Fig. 14).
3. The pathological report, following biopsy, on Archie's knee.
4. The Wassermann tests, made in 1927.
5. The radiographs, as embodied in this report.
6. The exclusion of tabes and syringomyelia.
7. The failure to find any similar condition described in the literature as occurring in congenital lues.