Congenital syphilis could account for the mental deficiency, the skin lesions around his nose and the alopecia. In this condition he would probably have a high forehead, a flat face, a small nose (saddle nose) a small mouth and possibly outward curving of his shin bones (sabre shins). But he wouldn't have a particularly small head. I think he had microcephaly. For some unknown reason he was born with an abnormally small brain. This is associated with retarded mental development. In this condition the circumference of the cranium rarely exceeds 45cm (18 inches) while the face and the rest of the head tend to be of a more normal size. A person with one congenital abnormality may have others and the alopecia may have been another. The skin lesions around his nose could have been due to a chronic nasal discharge. [Textbook of Paediatrics, Mitchell Nelson, 4th edition, 1946, p.431-4 and 1053-4.) See also page 94 line 29 below. (G.S.)