SCROFULA. 823 



the diseases of childhood, measles is especially mischievous in this 

 way. 



ANATOMICAL APPEARANCES. Having already stated that scrofu- 

 lous inflammation has no peculiar characteristics, it would now be ab- 

 surd to attempt to describe the anatomical alterations of the skin and 

 mucous membranes, induced by scrofulous eruptions and catarrh. And, 

 indeed, we may refer altogether to the article upon cutaneous diseases 

 for a description of the anatomical alterations of the skin ; and to other 

 parts of this work, for an account of the lesions found in the various 

 mucous membranes, merely adding that in scrofula the inflammatory 

 products are generally richly provided with young cells, which accounts 

 for their tendency to caseous metamorphosis. A description of the 

 esions of the bones, joints, and organs of special sense, particularly 

 those of the eye, observed in scrofulous subjects, and which, likewise, 

 are not marked by any distinctive peculiarity, belongs to the province 

 of surgery and ophthalmology. The latter science has anticipated the 

 others by the discovery of the illusory nature of the oft-described 

 symptoms of scrofulous ophthalmia. 



The alterations which take place in the lymphatics of scrofulous 

 subjects require further attention : first, because the disorders of these 

 organs as yet have received but cursory notice, no special section of 

 this work having been devoted to their consideration ; secondly, be- 

 cause, in persons thus afflicted, disease in the lymphatics is so common 

 that, among the laity, scrofula is commonly spoken of as having " en- 

 larged kernels," or simply " having kernels." 



In the first place, it happens more frequently in scrofulous persons 

 than in non-scrofulous ones, that the lymphatic glands around an inflam- 

 mation of the skin or mucous membrane become the seat of an inflam- 

 matory process, which has extended along the lymphatic vessels from the 

 skin, and has involved the glands. The connective tissue around the 

 gland next participates in the inflammation of the glandular parenchy- 

 ma, and abscesses and ulceration ensue, which, like all abscesses and 

 ulceration of glandular substance, are very intractable, and often heal, 

 leaving an irregular, ragged, unsightly scar. Owing to the extreme 

 frequence of scrofulous eruptions upon the face and scalp, and of 

 scrofulous otorrhcea, the lymphatic glands of the neck are the most 

 common seat of this form of inflammation and ulceration. 



Besides these, however, a chronic non-inflammatory enlargement of 

 the lymphatic glands is so often observed in scrofulous subjects, that 

 their presence may almost be regarded as pathognomonic. They may 

 attain a very considerable size, and, when several of them are clustered 

 together, they form huge, knotted cords, or shapeless lumps. The 

 individual tumors are regular in form, smooth of surface, and of a tol- 

 102 



