SCROFULA. 827 



coryza, otorrhoea, conjunctivitis, or ulceration of the cornea. Catarrhs 

 of the intestine and bronchi, and the rarer affections of the genito- 

 urinary apparatus by their obstinacy, may readily excite a suspicion of 

 a more malignant destructive process ; and indeed scrofulous catarrh 

 of the bronchi, by extending into the air-cells of the lung, and by in- 

 ducing caseous metamorphosis, with subsequent destruction of the 

 pneumonic deposits, not unfrequently terminates in pulmonary con- 

 sumption. Besides, it often happens that enlarged bronchial glands 

 soften and break down, forming vomicse, which discharge their con- 

 tents into the bronchi. Scrofulous ulceration of the bowels has already 

 been described in detail. 



Scrofulous inflammation of a joint sometimes takes the form of a 

 simple hydrarthrosis, sometimes that of a so-called tumor albus, while 

 at others it assumes the nature of a malignant arthrocace, accompanied 

 by suppuration, caries of the articular surfaces, burrowing of pus, and 

 the establishment of fistulas. The disease of the bones sometimes 

 begins in the periosteum, sometimes in the bone itself, now presenting 

 the character of periostitis and ostitis, and now that of caries, necrosis, 

 or of the two combined. 



As long as the existence of cheesy masses was regarded as char- 

 acteristic of the tuberculous nature of a disease, it was of course neces- 

 sary to ascribe many of the inflammations of the joints and bones of 

 scrofulous persons to a complication of scrofulosis with tuberculosis. 



Among the organs of special sense, the eyes and more particularly 

 their superficial tissues, the Meibomian glands, the conjunctiva palpe- 

 brarum, the conjunctiva bulbi, and the cornea, are often afflicted by 

 obstinate inflammation. Indeed, in doubtful cases, the presence of 

 opacity or of scars upon the cornea, has been accepted as important 

 evidence that a patient has been scrofulous during childhood. In the 

 nose, excepting the rare instances in which that organ is destroyed by 

 lupus, scrofulous inflammation merely takes the form of an obstinate 

 coryza, which, however, is hardly ever absent. In the ears, besides 

 the inflammation of the external auditory canal, already alluded to, 

 caries of the petrous bone, with all its mischievous consequences, is 

 apt to ensue. 



The objective symptoms of scrofulous disease of the lymphatic 

 glands have been described above. The adenitis and the phlegmonous 

 inflammation of the parts about them may be attended with great 

 pain and by more or less of fever, with evening exacerbations. In 

 consequence of this, not only does the patient's general health suffer, 

 but, if the inflammation and its attendant pain continue for weeks and 

 months, as they often do, his strength is consumed, and his nutritive 

 condition is greatly impaired. After the abscesses which form have 



