SCROFULA. 



unclcanlinefs ; negledl of falutary exercifo ; confinement in 

 cold damp (Ituations ; and the want of fiifficiently warm 

 clothing. 



But one of the moll frequent occafional caufes of fcio- 

 fula is external violence. Many accidents, which would not 

 be followed by any ferious confequence to a perfon in health, 

 produce fevere fcrofulous afFeftions in perfons predilpofed 

 to thefe difeafes. 



It is almoft unneceffary to mention, that all thofe circum- 

 ftances which have been fpecified as occafional caufes, mull 

 be avoided. 



There is no medicine which, internally adminiftercd, has 

 the power of completely correcting the peculiarity of con- 

 ftitution implied by the e^^r^^Sian fcrofulous habit. But there 

 are many medicines which feem to improve this Itate of 

 the fyltem, and to promote the fpontaueous amendments, 

 which ftrumous afFeftions frequently undergo. Scrofulous 

 patients, for the moft part, have conltitutions in which the 

 natural aflions do not proceed with vigour, and perhaps 

 it is on this account, that every thing tonic is more or lei,s 

 ufeful in cafes of (trumous dife.'.fe. This obfervation is not 

 meant, however, to forbid the judicious employment of 

 evacuations, which, when the habit is difpofed to plethora 

 and coftivenefs, are indilpenlably r.ecefFary. 



The medicines which are given for the cure, or preven- 

 tion of fcrofula, are either fuch as are fuppofed to adl upon 

 fome general principle, or fuch as are iuppofed to poilefs a 

 fpecific virtue in the cure of this diitrefTmg difjafe. 



A draught of falt-water is recommended almoll indifcri- 

 minately to every patient who is advifed to ufe fea-bathing. 

 It acts as a purgative, and proves a ferviceable medicine, fo 

 far as purging is indicated. The water of the fea, however, 

 is not nearly fo palatable, as the folutions of many of the 

 neutral falls, and its medicinal virtues do not appear to be 

 fuperior. Hence Mr. RulTell believes, that it is prefcribed 

 rather from accidental convenience, than from its being in 

 reality a better medicine than feveral others. 



In fome cafes of hereditary predifpofition, fcrofula feems 

 engrafted on a conltitution, otherwife healthy and vigorous, 

 where the patient feels no wcaknefs, has no diforder of the 

 ftomach, and at the fame time has tendency to fulnefs and 

 corpulency. In cafes of this kind, a continued courfe of 

 purgative medicines often proves highly beneficial by pro- 

 curing a frequent and c®pious evacuation ot the bowels, 

 and thereby reducing that difpofition to fulnefs, which very 

 much promotes the formation of glandular fwellings. But, 

 in general, fcrofula is not combined with the foregoing fort 

 of conltitution, and purgatives are then only ufeful for the 

 purpofe of obviating coftivenefs. 



Several mineral tprings, befides faline ingredients, contain 

 fulphureous impregnations, which are fuppofed to increafe 

 the medicinal virtues of the waters. The reputation of the 

 waters of Harrowgate and Moffat is univerfally known. 

 Mr. Rufiell acknowledges that their efficacy may have been 

 over-rated ; but he lliU thinks favourably of their efl'cfts in 

 cafes of fcrofula. 



Calomel, or, as it is now called, the hydrargyri fubmurias, 

 is the moil celebrated of all the purgative medicines, which 

 have ever been employed in the treatment of fcrofula. In' 

 order to derive the greateft benefit from it, however, it 

 fhould not be given in fo large a quantity as to produce the 

 fpecific effefts of mercury in their full extent ; for, as Mr. 

 Ruflell obferves, a deep and lafting impreffion on the fyitera 

 aggravates every fymptom of icrofula. Calomel, taken in 

 moderation, contributes more than any other medicnie to 

 difcufs tumours, and refolve fcrofulous indurations. An 

 alterative courfe with this medicine, however, mull be main- 



tained a fufficient length of time, in order to prove fnccefs* 

 ful ; conftant attention being paid that the effefts of th« 

 calomel do not amount to fafivation, and fevere mercurial 

 ad ion. 



With refpeft to tonics for the cure of fcrofula, the moft 

 elleemed of the vegetable clafs is the Peruvian bark. Mr. 

 RullcU obferves, that cinchona is only ufeful, when the 

 bowels have been previoufly cleared of any morbid accumu- 

 lation of feces ; and that, under other circumttances, it op- 

 preffes the itomach, asd does harm, inllead of good. 

 Neither, fays he, is it adapted to that ftate of fcrofula, in 

 which any tendency to fulnefs prevails, or when the glands 

 are fwelled and indurated, or congellions are prefent to any 

 extent. But when none of thefe objetlions to the admini- 

 llration of cinchona exilt, when wcaknefs is a principal 

 fymptom, when the llrength is to be fupported, and a 

 lana-uid aftion to be roufed into more vigorous exertion, 

 cinchona may be ufcfully employed, and has obtained the 

 character of an excellent medicine. Its virtues are beil cal- 

 culated to meet the indications of thofe cafes, where there 

 arc extenfive ulcers, or large abfcelles, with copious ex- 

 haulling difcharges of purulent matter ; and, in general, to 

 communicate tliat degree of energy to the atitions of the 

 fyllem-, which tends to fupport and confirm the patient's 

 llrength. The finiple powder is the preferable mode of ex- 

 hibition, when the ftomach can digell a fufficient quantity 

 without oppreffion ; but if a dofc in fubftance opprefies the 

 ftomach from indigellion, then the lighter preparations of 

 infufion, or decoiilion, ought to be lubilituted. Two or 

 three dofes a-day are as much as can ever be requifite. A 

 courfe of this kind may be continued for two or three 

 weeks ; it may then be left off for eight or ten days, and 

 afterwards refumed again. 



01 the mineral tonics, iron and fulphuric acid are the 

 moft valued for their efficacy in cafes of fcrofula. Iron is 

 Icfs liable than cinchona to opprcfs the ftomach, or produce 

 accumulation in the bowels. Mr. RufllU alfo thinks that 

 it aftn more fpeedily and powerfully on the conllitution. 

 The dofe may be increafed fo long as the ilomach can bear 

 the quantity without oppreffion ; and the medicine may be 

 given without intermiffion for fome weeks. The carbonate 

 of iron, the muriatic folution, and the chalybeate waters, 

 are the belt forms in which the medicine can be given. 



The fulphuric acid is grateful to the ilomach, and agrees 

 with all forms and ftages of fcrofula. It is, according to 

 the experience of Mr. Rullell, peculiarly adapted to that 

 ftate of fever, which is connefted with the putrid Houghs, 

 that are often formed on the infide of large tumours, wheu 

 firll expofed to the air ; and to that ftate of weaknefs, which 

 difpofes to copious perfpiration, upon every moderate exer- 

 cife. The beft mode of taking it is diluted with water, and 

 fwectened, fo as to form a common beverage. 



Having noticed the eftcdls of purgative and tonic medi- 

 cines, we proceed to the confideration of remedies, which 

 have been Iuppofed to poflels fpeciilc virtues in tlie cafe of 

 fcrofula. The cicuta, or conium maculatiim of Linnajus, 

 was moll highly prailed by the celebrated Dr. Storck of 

 Vienna. Upon the recommendation of this reipecftable 

 praditioner, fays Mr. Ruflell, it was univerfally tried all 

 over Europe, fo that a fair eftimate of the medicinal virtues 

 of cicuta, in the cure of fcrofula, may be made from the 

 refult of very general and extenfive experience. Its ori- 

 ginal character, as an invaluable acquifition in the cure of 

 fcrofula, was certainl)' much over-rated ; although it ap- 

 pears to pollels lome ufciul qualities, which may be advan- 

 taE^eor-lly emplaned in certain modifications of the dileale. 

 Mr. RiiUcIl ihmks favourably of this medicine, for its effi- 

 cacy 



