PATHOLOGY. 2 89 - 
or ninth month of the child’s age. The feveral parts of and imperfectly, and healing with difficulty; upper lip 
the body by degrees become difproportioned ; the fkin thickened ; fkin fmooth ; countenance ufually florid, 
grows lax, the belly flaccid ; the mufcles are extenuated, The belt divilion of Strumais derived from its external 
particularly thofe of the neck ; the joints of the hands, or internal appearance. Dr. Good’s claffification accords 
arms, knees, and feet, are enlarged, fo that there feem with this principle. It is long flnce Mr. Abernethy re- 
to be excrefcences on the bones of the wriftsand ankles ; ferred to diforder of the digeltive organs fcrofulous dif- 
the bones and the f'pine, too weak to fupport the body, eafe; and the fame opinion has been taken up by Dr. 
are at length incurvated ; the child walks with more Carmichael Smyth, and more recently by Mr. Lloyd, 
difficulty, until this exercife becomes too troublefome to Neither of thefe authors, however, has advanced the 
be continued ; the carotids and jugulars fwell, but the etiology of the difeafe one ilep. Its connexion with 
other blood-veflels difappear; the head grows large ; the diforderof the digeftive organs no one can fail to fee ; 
futures are more vifible ; the fontanel is often membra- but the mode by which the latter aft on the former is by 
nous; the neck too weak to fupport the head fteadily. 
The countenance is, however, lively, and the child is 
more fenfible than ufual at the fame age ; the breaft is 
ftraif, and compreffed on its fides; the Tternum riles up 
in a point, and the extremities of the ribs are enlarged 
and crooked ; the hypochondria fwell ; fever, with fymp- 
toins of conlumption, comes on, and the patient finks 
from debility. In children predifpofed to rickets the 
teeth come forward llowly, and foon decay. The appe¬ 
tite, however, feldom fails; but digeflion is moftly im- 
perfeft. 
The rickets chiefly prove fatal from the attending 
heftic, confumptive fymptoms, or afthma. If the dif¬ 
order continues after the fifth year of the child’s age, 
the body ufually continues weakly hnd deformed for the 
whole life. The bones of the legs, though very crooked, 
will become nearly, often perfeftly, ftraight during the 
growth of the child, if it becomes ftrong and healthy. 
On diffeftion, the mufcles are found pale and flaccid, the 
liver indurated, the mefenteric glands enlarged and 
hardened, the bones fpongy. Its ufual period of attack 
is from fix months to two years; but it has attacked 
adults. The top of the fpinal marrow is faid to have been 
uncommonly hard and obftrufted ; water is fometimes 
found between the dura and pia mater; and the brain is 
enlarged. 
The immediate caufe of rickets is the want of a due 
proportion of phofphate of lime in the bones. The re¬ 
mote caufes of this deficiency are difordered ftate of the 
digeftive organs, in confequence of which bad blood is 
prepared, and inaftion in the veflels which fecrete the 
healthy part of bone. The means employed in the treat¬ 
ment are the fame as in that of dyfpepfia; viz. regular 
pajfive exercife, bathing, medicines which flightly ftimu- 
late the ftomach, thofe which open the bowels, and thofe 
which promote the fecretion of bile ; nutritive diet, and 
country air. Months and years will often elapfe before 
a cure is eft’efted ; it is in all cafes a tedious affair. 
Genus V. Alphofis, [from ahtpo;, white.] White lepro- 
fy. Generic characters—Cuticle, among negroes, white 
and colourlefs; hair white and woolly; irids white; pu¬ 
pils rofy; fight ftrongeft in the fliade; corporeal faculties 
feeble; mind unimpaired. 
There is but one fpecies, which is the Albino, or 
White Moor. See the article Albinos, vol. i. p. 240. 
A variety is found among Europeans with fair cuticle; 
flaxen hair; irids blue; pupils rofy; corporeal powers 
weak; mind unimpaired. Trail, in Nicholfon’sJournal, 
Feb. 1808. 
“ The whitenefs is probably produced by a want of the 
fecretion of the pigment that renders the rete mucofum 
black ; and which does not ufually take place till feveral 
weeks, fometimes months, after birth; the negro-child 
being fair when firft born.” The Spaniards and Portu- 
guefe denominate thofe who are thus affefted Albinos; 
the French, Blafards; the Dutch, Kacklacken. 
Genus VI. Struma, [from cflpupet, Gr. coacervation ; 
not, lays Good, from Jiruo, Lat. to heap up.] Scrofula, 
or King’s Evil. Generic charafters—Indolent glandu¬ 
lar tumours, chiefly in the neck 5 fuppurating flowly, 
no means apparent. We are very well able to afcertain 
how dyfpepfia difturbs the nervous and vafcular fyftems 
of remote parts; but, when we come to confider it in 
relation to fcrofulous difeafe, we afk why every intenle 
dyfpepfia does not produce fcrofula in fituations and ex¬ 
ternal circumftances favourable to its development. If 
it be anfwered, that dyfpepfia produces fcrofula only in 
conftitutions predifpofed to the latter malady, we aik in 
what this predifpofition confilts. We have already fliovvn, 
that a predifpofition to inflammation confifts in a want or 
an excefs of contraftile power in the vafcular fyftem ; 
and that a predifpofition to nervous difeafe confifts in an 
habitually higher degree of fenfibility in particular nerves. 
But the predifpofition to fcrofula is by no means clearly 
made out. Brouffais indeed refers the fcrofulous confti- 
tution to a preponderance of the lymphatic fyftem over 
the nervous and vafcular fyftems. Upon the whole, it 
muft be allowed by all, that the nature of the difeafe 
called fcrofula is at prefent unknown. 
Some recent authors have comprifed under the term, 
fcrofula a very large proportion of the chronic phlogoti- 
ca ; but, it feems to us, without juft caufe. We ffiaU 
confine ourfelves in this article to the term in its oider 
and more reftrifted fenfe. There are two fpecies. 
1. Struma vulgaris : confined to the external conglobate 
glands: tumour pea-fized, or chefnut-fized ; appearingin 
infancy or-youth ; fubfiding on mature age ; hereditary. 
Two conditions of the body are to be defcribed in 
treating of fcrofula. The firft, the appearance of the 
perfon predifpofed to fcrofula ; and the fecond, the ap¬ 
pearance of the difeafe when formed. The fcrofulous 
conftitution is obferved to be, in many inftances, denoted 
by particular fymptoms. It has been faid that the com¬ 
plexion is fair, and the colour of the hair either reddifti 
or of fome other light tint; but people with dark com¬ 
plexions and black hair are equally i'ubjeft to fcrofulous 
complaints. The fkin is remarkably foft and white, and 
the face often has a fhining polifhed fmoothnefs. The 
cheeks are in general florid ; and the tunica albuginea is 
frequently of a dead white colour, and more pale than 
ufual. The edges of the eye-lids are affefted with a de¬ 
gree of tendernefs which eafily degenerates into a trouble- 
lome inflammation, that diftreftes the patient by its con¬ 
tinuance, and produces a difagreeable degree of deformi¬ 
ty. This rednefs is very common and remarkable. There 
is likewife very frequently a fwelling of the upper lip, 
with fome thickening of the noftrils and point of the note,- 
One of the moft frequent fymptoms of fcrofula is a 
fwelling in the fuperficial lymphatic glands, efpecially in 
thofe of the neck. Such glands fwell without any pre¬ 
vious complaint, and often attain a large fize before the 
fwelling attrafts notice. The fwellings are frequently 
unaccompanied with pain or difcolouration. The fame 
indolence and abfence of inflammatory fymptoms, which 
charafterize fcrofulous fwellings of their glands, likewife 
diftinguifh fimilar affeftions in other parts of the body. 
The commencement of the attack is, in general, unper¬ 
ceived, and the progrefs flow; though the tumefaftion 
which follows is frequently very conliderable. 
The greater number of fcrofulous affeftions are accom¬ 
panied with a preternatural fwelling of the parts attacked. 
The tumour is of two kinds; one remarkable for its foft- 
:oefs, 
1 
