SCROFULA. 



• ,,cv in changing the condition and forwarding the cure of 



rtain malignant fcrofulous ulcers, which counterfeit the 



. jpcarance of cancer. He has likewile found it of fervice 



■J promoting the cure of certain fcrofulous affeftions of the 



tongue, which bore a near refemblance to fome rare venereal 



cafes. In a few cafes, Mr. Ruflell has had reafon to alcribe 



to cicuta fome (hare of efficacy in promoting the refulution 



cf fcrofulous fwellings of the breail. The medicine mull 



'c given in as large dofes as the conftitution can hear. The 



'load being afF.-dted with a degree of giddinefs, and the 



1 imach witli a little naufea, is the criterion of the dofe 



ocnig fufficicntly powerful. 



The muriated barytes has been recommended by Dr. 

 Crawford ; but though it has been frequently exhibited, its 

 reputation is far from being increafed ; a fare proof that its 

 virtues were originally exaggerated. 



The muriate of lime is another remedy that has been of 

 late much talked ot, for its good elfefts as a fpecific in cafes 

 <it fcrofula. In order to derive the utmoll benefit from it, 

 Mr. Rullell is of opinion that it is neceflary to prefcribe it 

 in much lartjer dofes than thofe which have ulually been 

 .iirerted. One of the mull fuccelsful inllances of its efficacy 

 ■..vas the confequence of an ounce of the faturated fohition 

 having been taken, for many weeks, three times a day. It 

 well deferves attention, however, that profeObr Thomlon 

 employed muriate of lime in various cales of Icrofula, with- 

 out a lingle example of its having any efficacy. He admits 

 that fume patients got well, while under a courfe of muriate 

 of lime ; but then he had no reafon to afcribe the cure to 

 the efpLCl of the medicine. In other cafes, on the contrary, 

 he found that the muriate of lime produced fevere ficknefs 

 and oppreflion of the llomach, and that the patients got 

 daily worfe, till the medicine was left off, and other re- 

 medies employed. The relief, experienced from the dif- 

 continuance of the muriate of lime, left no doubt with 

 regard to the injurious effects which the ufe of it had pro- 

 duced ; and from extenfive experience and accurate obferva- 

 tion, profellor Thomlon is fatisfied th.at, in many cales of 

 fcrcfula, the muriate of lime is attended with prejudicial 

 effects. 



With rcfpeft to the local treatment, llimulant applications 

 are found not to be in general advantageous for Icrohilous 

 complaints. For ulcers, the m .11 fnuple and mild drelfings 

 are the bell. When the patients are ufing a courfe of fea- 

 bathing, it is ufual to wafh the fores with fea-water fre- 

 quently every day. Cold fpriiig water is likewife a favourite 

 application ; and experience feems to prove that the opera- 

 tion of cold is well fuited to counteradt the ilate of inflam- 

 mation which accompanies fcrofulous fores. Preparations 

 of lead are, upon the whole, very convenient and ufeful 

 applications, provided the lolutions be ufed in a Hate of 

 fuffitient dilution to prevent irritation. Liquid ajiplications 

 are made by means of wet linen, which is renewed whenever 

 it dries, fo that the furface of the fore is kept conllautly 

 moill. 



Upon the fime principle, fimple ointment and Goulard's 

 cerate are, in ordinary cafes, the bell dreilings. 



The employment of fimplc applications and of cold, 

 however, is more properly adapted to the mild and pure 

 forms of fcrofulous fores ; for when thefe are more malig- 

 nant, or combined witli any other difeafe, a different mode 

 of dreflinij becomes neci'ffi'ry. Venereal lores, tor inllance, 

 brc.iking out in a perfun of a ferofiiioiiscoiillitutioii, partake 

 of the nature of both diforders, and require correlpondent 

 treatment. Even a pure fcrofulous fore, attended with 

 more inveteracy tiian ufual, may demand particular forts of 

 drelDngs, different from fuch as are found to be moll proper 



for common cafes. When the ulcer is extremely indolent, 

 gentle llimulants may be neceffary ; and when there are 

 fungous granulations, they mull be dellroyed by efcharotics. 

 Thofc fcrofulous fwellings which contain a fluid, when 

 they are fuperficial, and not connedled with any parts of im- 

 portance, are in general better left untouched. They are 

 very flow in their progrefs, but they moltly burll at lad by 

 a fuperficial ulceration, which forms a fmall api rture. They 

 do not often admit of refolution. The moll likely applica- 

 tions for promoting this defirable objcft, are folutions of the 

 acctite of lead, and of the muriate of ammonia. 



The progrefs of the cure, after the tumour has difcharged 

 its contents, is very various ; though, upon the whole, it is 

 flow, and the cure often incomplete. The fides of the 

 cavity feldom adhere uniformly, or granulate from their 

 whole furface ; fo that little partial leparatc cavities remain, 

 which form fmufes, and continue to difcliarge matter, ac- 

 companied with fome degree of pain and inflammatiou. At 

 lail, however, often indeed after a confidcrable time, the 

 difcharge ceafes altogether, and the fore completely heals. 

 When the finufes continue for a long time, without any 

 tendency to get well, it is fometimes proper to open them 

 to the bottom with proper incilions ; but in the generality 

 of fcrofulous cafes, fuch pratf ice is, upon the whole, fevere, 

 difadvantageous, and even dangerous. 



Scrofulous abl'celles, when not large, need not to be 

 opened ; but deep-featcd coUedtions of matter, which in- 

 creafe gradually in fize, without fliewing any difjiofition to 

 make their way to the furface of the body, ought to be 

 opened : for if this be not done, the matter fpreads, and the 

 difeafe acquires by degrees a dangerous extent. The open- 

 ing fhould not be larger than what is fufficicnt for the com- 

 plete evacuation of the matter ; becaufe a large opening 

 excites great irritation, and is often the caufe of violent 

 inflammation of the whole cyfl of the abfcefs, attended with 

 alarming, and often with fatal, confequences. The fever 

 that occurs is accompanied with a rapid train of fymptoms, 

 which fpeedily end in death. In otiier inllances, the fever 

 is lieftic, being more flow in its progrefs, tiiough not Icfs 

 certainly fatal. According to Mr. Ruff'ell, fulphuric acid 

 and faline draughts, in a Hate of effervefcence, are the medi- 

 cines which agree bed witii both forms of fever ; and he ob- 

 fervcs, that neither of them feems to be much relieved by 

 the ufe of cinchona. (P. Il6.) This author recommends 

 opening the tumour with a trocar, letting out the whole of 

 the contents, withdrawing the cannula, and brir.gmg the 

 fides of the punfture together with (licking phiHer. For 

 our own part, we prefer making the opening with a lancet, 

 and then clofing the wound with adiiefive plaller, as adviled 

 by Mr. Abernethy in cafes of pfoas abfcefs. See Pi,o.\s 

 yib/cefs. 



With refpe£l to the treatment of fwelled glands, it is to 

 be remarked, that it is always defirable to prevent fuppura- 

 tioii. When the glands are fnpirlicial, ilieir progrefs may 

 be influenced by toj ical applications; but when they are 

 deep, they are fcarcely capable of being aflVded by fuch 

 remedies. In ordinary cafis, Mr. Rulf.-U recommends the 

 ufe of fomentations two or three times a day. Sea-water, 

 vinegar, and water, dilute folutions of the acctite, or mu- 

 riate of ammonn, and a decottion of chainoiiiiic, are ehijiblc 

 for tomentations. Fridlioii with camphorated and amnio- 

 niated oils, and with marine plains, h.is alio been well 

 fpoken of. 



In fuch cafes, Mr. Rullell, Iiowever, does not place much 

 confidence in external applications, as he tonhders that the 

 cure chiefly depends upon t lie Hate of the cnllitulion, upon 



reijimen, and the efleCt of internal remedies. 

 *> When 



