Among the changes which may occur are the following: The _skin_ becomes loose and resembles that of an old person. This is partly because it grows even faster than the tissues beneath it, so pronounced is the emaciation. _Snuffles_, or _nasal catarrh_, is one of the earliest features. This is due to specific swelling of portions of the Schneiderian membrane. Snuffles _may_ occur in children without syphilis, but syphilis will nearly always produce snuffles, which may last for some time, and cause a widening at the root of the nose which will persist through life. Following the snuffles there usually appears a rash over the trunk and thighs and about the anus, accompanied by mucous patches. This will have the same bright, coppery tint as roseola syphilitica, already mentioned, which it much resembles. Sometimes it assumes the mixed type of eruption, while upon the palms and soles appears the so-called pemphigus syphiliticus. Should the child live nodular or gummatous syphilides may develop. In the bone and cartilage characteristic changes are met at the lower end of the femur and at the costochondral junctions. This consists of an _osteochondritis syphilitica_. At the affected points enlargements take place, which may disappear under treatment or may go on to ulceration and necrosis. In the fingers and toes there are manifestations already described as syphilitic _dactylitis_. The bones of the skull are likely to be involved in thickenings, especially about the anterior fontanelle, where they form the so-called Parrot’s nodes. These may disappear, with or without treatment, and the affected bone may undergo atrophy or may entirely disappear. Among the viscera the _spleen_ generally becomes affected first and then the liver. Syphilitic iritis may occur early, but is rather rare; ocular changes occur more often in the choroid. In the brain distinctive lesions may occur to such an extent as to lead to considerable thickening of the dura, with or without hydrocephalus, and subsequent imbecility or idiocy. _Deafness_ is not infrequent in hereditary syphilis. It may begin suddenly and at any age, even during infancy. It is produced by deep lesions which do not yield readily to treatment, and sometimes leads to deaf-mutism, especially when it occurs before the child has learned to talk. Among the later manifestations of hereditary syphilis are opacities of the cornea from _interstitial keratitis_. This may occur in children who are apparently in good health and free from other signs of hereditary disease. The condition is rather obstinate, but it can be made to disappear under suitable treatment. _Retinitis_ occurs frequently in young women, and is likely to lead to atrophy or detachment.