238 MORBID STATES OF THE BLOOD, ETC. 



as the proper substance of the lymphatic nodules and trabeculaB 

 takes part in the pathological proliferation, the cut surface ceases 

 to present any distinction of parts, and the whole gland appears 

 converted into a homogeneous substance of a dull-grey hue. 



This brings us to the culminating point of the whole pro- 

 C3SS ; the scrofulous bubo is about as big as a walnut when the 

 unaltered gland was no bigger than a bean ; according to the 

 amount of moisture present, it may be either soft and flabby, or 

 firm, elastic, and even springy. Meanwhile the process does 

 not long remain stationary at this point. The newly-formed 

 substance not only blocks the lymph-paths through the gland, 

 but it also squeezes the blood-vessels to such an extent that the 

 circulation is entirely arrested. It becomes impossible to force 

 injection of any kind into those parts of the gland which are 

 most swollen. With the arrest of the blood-supply nutrition 

 of course ceases, and the gland falls a prey to '^ cheesy degenera- 

 tion." Where this occurs, the grey mass loses its transparency; 

 it then becomes yellowish-white, opaque, dry and friable. 

 Should the entire gland have become cheesy, it resembles on 

 section " a fresh potato — not indeed so moist, but quite as homo- 

 geneous, and of the same yellowish-white colour" (VirchoWy 

 Geschwlilste, vol. ii. 593). 



§ 205. The fate of the cheesy glands (Tyromata) appears to 

 depend in the main upon their situation. For while in the mesen- 

 teric glands we nearly always observe a subsequent shrinking, 

 due to the reabsorption of whatever fluid they may still contain, 

 and sometimes also a deposition of earthy salts and consequent 

 petrifaction, the lymphatic glands of the neck commonly end 

 by undergoing softening. The cheesy deposit melts from centre 

 to circumference into a yellowish whey, in which fatty-granular 

 debis are suspended in flakes of variable size. When the whole 

 of the cheesy matter has thus been liquefied, the parts imme- 

 diately around the gland usually take on inflammatory action ; 

 and this prepares a way for the escape of the '' scrofulous pus." 

 When this has escaped, a '^scrofulous ulcer" is left with its 

 flabby, overhanging^ bluish and congested edges. Finally the 

 opening closes, and the point at which the abscess burst is only 

 indicated by a puckered and stellate scar. 



Vircliow has recently described a third mode of retrograde 

 metamorphosis which is certainly the most desirable one of the 



