SCROFULA. 821 



A. person having merely a tendency to such diseases may also be 

 called scrofulous, although not actually suffering from any one of the 

 above symptoms. 



The hypothesis that scrofula depends upon a faulty composition of 

 the blood (dyscrasia), and that the lesions found in scrofulous persons 

 were due to the deposit in the tissues of a matter circulated by the 

 blood, and called a " scrofulous material," is almost universally aban- 

 doned. The alterations which take place in the skin, mucous mem- 

 brane, joints, bones, and organs of special sense, are of an inflamma- 

 tory nature, and cannot be distinguished from similar affections of a 

 non-scrofulous character, excepting by their intractability and the 

 tediousness of their course. It is impossible to point out any charac- 

 teristic features in a scrofulous eruption or arthritis, or to find any dif- 

 ference between them and similar non-scrofulous affections. Even the 

 caseous metamorphosis, to which the inflammatory products are so 

 prone, is by no means pathognomonic of scrofula, but is common to all 

 diseases of a chronic character which have a tendency to disintegra- 

 tion or destruction. Notwithstanding, however, that such inflamma- 

 tion presents no distinguishing mark whereby its scrofulous nature 

 may be recognized, yet there will rarely be any doubt as to whether 

 or not a case of this kind is entitled to the name. If its exciting cause 

 have been so slight as to be overlooked ; if we are informed that " the 

 disease came on of itself;" if this attack, or other similar ones, have 

 arisen repeatedly without assignable cause ; if it be accompanied by a 

 series of other disorders, especially chronic inflammation and persistent 

 enlargement of lymphatic glands, it is to be called scrofulous. If, on 

 the contrary, there be known external conditions, whose action upon 

 the system sufficiently accounts for the occurrence and the obstinacy 

 of the affection, without necessitating the supposition that there is any 

 special morbid tendency ; if it exist independently, and be uncompli- 

 cated with chronic enlargement of the lymphatics, then it is not to be 

 called scrofulous, notwithstanding the great similarity, nay, the abso- 

 lute resemblance, of its external symptoms to those of a scrofulous 

 disorder. 



In its origin, scrofula, perhaps, is quite as often a congenital mal- 

 ady as an acquired one after birth. 



Congenital scrofula is particularly common among offspring of 

 scrofulous parents. There are families, nearly or quite all the children 

 of which inherit the disease. This hereditary form of scrofula is close- 

 ly allied to that in which parents were tuberculous at the time of be- 

 getting the child, or in which the mother was so during pregnanc}', or 

 else suffered from cancer, tertiary syphilis, or some other malady, as 

 well as that form of scrofula occurring in children begotten of aged 



