DISEASES OP THE BLOOD. 125 



often be found. Though they may take place in other tissues 

 the lymphatic glands are their most frequent seat; thus^when 

 the tumours are in the parotid region these are primarily 

 affected^ the salivary gland being only secondarily involved. 

 They increase in size slowly as a rule_, but may manifest a 

 first acute stage, which change to a phase of less activity. 

 Softening often occurs, but the inflammatory action aroused 

 by the presence of the scrofulous matter is often not active 

 enough to cause bursting of the abscess, which, therefore, 

 assumes the " cold " character. When it has burst or been 

 opened surgically it gives exit to white, flaky, grumous 

 pus, and the abscess cavity manifests scarcely any tendency 

 to heal. The tumour may undergo calcification or caseation, 

 and thus remain in statu quo for a long time. The explor- 

 ing needle is here very useful for diagnosis, for when drawn 

 out of such a tumour it contains in its groove the peculiar 

 white scrofulous pus, and if this presents the ordinary 

 appearances of scrofulous matter when examined micro- 

 scopically there can be little doubt of the nature of the case. 



Scrofulous Inflammation of the Supra-fharyngeal Glands 

 requires a special notice, since when these organs are 

 enlarged there is an impediment to swallowing, and fre- 

 quently even to respiration. They seem to suppurate or 

 soften readily, but do not come to a point externally. 

 Insertion of the hand through the mouth will enable us to 

 detect the abscess, and its wall may generally be broken 

 down with the fingers. '^ Abscesses of the guttural 

 pouches of the ox,^^ described by some practitioners whose 

 anatomy has rather gone to the wall in the rush of general 

 professional practice, are of this nature. 



Scrofulous lesions are often congenital. Tabes and 

 phthisical tubercle are frequently present at birth. It 

 will be observed that in all cases of scrofulous lesion 

 we find tubercle present, this, then, is deemed the distinc- 

 tive product of scrofula. If taken in its earliest state a 

 tubercle is a rounded mass of cells of a peculiar kind, 

 united together by a stroma, which is often very scanty, 

 and penetrated to a certain distance from the periphery by 

 blood-vessels. Though the outer part of the tubercle is 



