SCROFULOUS DISEASE OF THE MESENTERIC GLANDS. 599 



derive their lymph from the intestinal mucous membrane usually par- 

 ticipate in its diseases, just as the small lymphatics located in the walla 

 of the intestine itself do. In acute and chronic catarrh of the intestine 

 and cellular hyperplasia, the increased absorption of fluid causes them 

 also to swell, but this swelling is usually slight and temporary ; but, 

 under some circumstances, it becomes more decided and obstinate, and 

 as, in such cases, there is also a large collection of cellular elements in 

 the mesenteric glands, they readily undergo cheesy degeneration. 



The caseously degenerated intestinal follicles deliquesce after a 

 time, and form small abscesses, filled with cheesy pus, in the walls of 

 the intestine ; when the covering of these is perforated small ulcers 

 are left, which may subsequently enlarge by the continuation of the 

 cell-production and the disintegration. 



In the caseously degenerated mesenteric glands, deliquescence and 

 perforation of the capsule of the gland and of the peritonaeum are more 

 rare ; but, on the other hand, condensation and final transformation of 

 the cheesy mass to a chalky pulp, or to a hard chalky concrement, are 

 very frequent. 



If we more attentively regard the persons in whom decided and 

 obstinate swelling and cheesy degeneration of the intestinal follicles 

 and mesenteric glands particularly occur, we find that the larger part 

 of them are children, and especially those children in whom the periph- 

 eral lymphatic glands and the bronchial glands incline to swell and 

 undergo cheesy degeneration during the course of moist exanthe- 

 mata, otorrhoea, bronchial catarrh, etc., and which are usually called 

 scrofulous. This circumstance and the entire correspondence of the 

 pathological changes render it consistent to designate this swelling 

 and degeneration of the intestinal follicles and mesenteric glands and 

 intestinal ulcers, consequent upon the former, as scrofulous diseases of 

 the intestines and mesenteric glands. 



The wide-spread error, that scrofulous ulcers of the intestines are 

 due to tuberculosis, is easily explained : firstly, the caseously infiltrated 

 solitary glands have the greatest similarity to cheesy miliary tubercles ; 

 and, secondly, on post-mortem examinations, we often find miliary tu- 

 bercles in the portion of peritonseum corresponding to the ulcers of the 

 intestine. But, if we examine these free from prejudice, and then ask 

 ourselves when the ulcers and when the tubercles probably occurred, 

 we shall often come to the conclusion that the ulcers have existed for 

 a long while, perhaps for years, while the tubercles have been depos- 

 ited shortly before death. Hence it is just the same in the intestines 

 as in the lungs, where tubercles are finally added to cheesy infiltra- 

 ions and cavities. 



As we have previously explained at length, in some persons the 



