CONSUMPTION OF THE LUNGS. 217 



from its attacks. The frequence with which the various organs of the 

 body are affected by disease differs according to the age of the indi- 

 vidual. Persons who, during childhood, have often suffered from croup, 

 pseudo-croup, cerebral irritation, and moist eruptions, are liable during 

 and after the period of puberty to bronchial haemorrhage and to in- 

 flammatory disorders of the lungs. 



But delicacy and a liability to pneumonic and other inflammatory 

 disorders are not the only distinctive marks between feeble, ill-nourished 

 subjects and those who are well nourished and strong. All the inflam- 

 matory derangements of nutrition occurring in the former class give 

 rise to a very profuse formation of young, indeterminate and perish- 

 able cells. It is said of such persons, that their " flesh does not heal," 

 that is, that a trifling wound is apt to be followed by severe irritation, 

 and copious suppuration of the wounded part. This peculiarity is 

 partially attributable to an increased irritability which accompanies 

 constitutional weakness, and partially to the fact that badly-nourished 

 or ill-developed organs, when inflamed, are more prone to the formation 

 of cells of a decrepit and perishable nature, than to the formation of 

 such as are capable of development into new tissue. 



The main points of the subject hitherto discussed may, then, be 

 summed up as follows: The consolidation and destruction of the 

 lungs, which form the anatomical basis for consumption, are 

 usually the products of inflammatory action, and the greater the 

 quantity of cellular elements collected in the vesicles, and the longer 

 the duration of the inflammation, so much the more readily will 

 pneumonia lead to consumption, since these are the conditions most 

 favorable for the production of caseous infiltration. Secondly: 

 pneumonia resulting in caseous infiltration occurs most frequently, 

 but not exclusively, in puny, badly-nourished subjects. This is par- 

 tially because such persons are especially delicate, and, in part, because 

 all inflammatory nutritive disorders by which they may be affected 

 show great tendency to copious cell-formation, with subsequent caseous 

 degeneration. 



We may now, in few words, define our position with regard to 

 that greatly-vexed question, the relations of scrofula and pulmonary 

 consumption. 



It very frequently happens, especially during childhood, that the 

 lymphatic glands participate in this morbid tenderness, which, as a 

 rule, is accompanied by augmentation of irritability and a strong ten- 

 dency to profuse cell-production. While, in persons exempt from this 

 peculiar tendency, the lymphatic glands neither enlarge, inflame, nor 

 suppurate, excepting in case of intense and malignant inflammation of 

 the parts from which they derive their lymph, very trifling irritants, 





