SCROFULA. 829 



should not wed their near relatives. But the representations of the 

 physician, that the issue of such alliances are likely to be scrofulous, 

 will rarely deter a man from marrying. On the other hand, it is not 

 only an imperative, but a grateful task to the physician, to endeavor to 

 provide, by proper precautionary measures, against the extension of 

 acquired scrofula. How to fulfil this duty becomes apparent from what 

 has already been said regarding the causes of acquired scrofula. Above 

 all, it should be borne in mind that the development of this disease is 

 promoted, not by one particular noxious influence merely, but by every 

 condition incompatible with health, to which the system, especially 

 during childhood, can be exposed. It often happens that, from the 

 moment when the first tokens of scrofula appear, or even as soon as 

 the parents begin to dread its attacks, the child is carefully deprived 

 of every particle of bread and butter, potato, and the like, and dosed 

 with huge prophylactic spoonfuls of cod-liver oil, while at the same time 

 he is suffered to sit all daylong in a close chamber, or upon the benches 

 of an overcrowded school-room. A sufficiency of fresh air and muscular 

 exercise are prophylactic measures of quite as much importance as 

 regulation of the diet is ; and we shall here call attention to an error 

 upon this subject, to which we have referred once before while discuss- 

 ing the prophylactic treatment of consumption : namely, the belief that 

 the use of bread and potatoes favors the development of scrofula and 

 tubercle, and the consequent complete privation of children of this kind 

 of food ; while in reality the mischief is due to an insufficient supply 

 of animal food a diet of potatoes and other articles, containing little 

 nourishment in proportion to their bulk, not being injurious unless it 

 forms their sole or at least their principal subsistence. This error is 

 so prevalent, that the discovery that the child has surreptitiously eaten 

 a potato has cost many an anxious mother a sleepless night, and many 

 a child has uselessly been sent to bed hungry on this account. 



The treatment of pronounced scrofula, where the prophylaxis has 

 been neglected or unsuccessful, requires, first of all, a careful regulation 

 of the regimen upon principles already laid down. Children with con- 

 genital scrofulosis must not be the subjects of experiment with artifi- 

 cial food ; but, if the mother have not milk enough, or if she be sickly 

 or feeble, so that, both in her own interest and in that of the babe, she 

 must be forbidden to suckle it, a good wet-nurse must be selected with 

 the utmost care. There is no substitute for the mother's or nurse's 

 milk, and the first year of infancy is perhaps the most important to the 

 constitution of the whole life. When the child is older, the directions 

 as to the diet and the mode of life must be given with the utmost pre- 

 cision. It is not advisable to order that "the patient shall eat but 

 little bread, and a good deal of meat, soup, milk, and the like;" and 



