The history of this delusion carries with it a great lesson. It is very evident that the changed circumstances either of body or mind in which persons who submitted to the royal touch were placed produced the favourable results which have been recorded. It has been the same with popular systems of medical treatment up to the present day. The beneficial action of some agent is assumed, quite independent of any inquiry into the fact of its possessing any curative power at all, and the other circumstances by which the cured person is surrounded, which have really effected his cure, are entirely overlooked.
Scrofula is defined by Dr. Good (` Study of Med.') to be, "indolent glandular tumours, frequently in the neck, suppurating slowly and imperfectly, and healing with difficulty ; upper lip thickened; skin smooth ; countenance usually florid ; " which agrees almost exactly with the definition given by Cullen in hia • Nosology.' Later writers have, however, given a mores extended view to the term scrofula, or scrofulous, and made it to include that general state of the system of which the indolent glandular tumour is but one symptom. The swellings and ulcerations which are so common in scrofula are found to be connected with alterations in the nutrition of the tissue of a similar kind to those which take place when tubercle of the lungs is present. (Pirittsis.] Hence some writers have described a state of the whole system which they have called tuberculosis, in which either scrofula or pulmonary consumption occurs. It seems now agreed by the best pathologists that the same general state of the system which produces tubercle in the lungs produces the various forms of scrofula, including the indolent swellings of the definition of Good and Cullen. On this subject Mr. Paget, in his ' Surgical lea,' makes the following remarks :—"' Scrofula,' or • drums.; then, is generally understood as a state of constitution distinguished in some measure by peculiarities of appearance even during health, but much more by peculiar liability to certain diseases, including pul monary phthisms. The chief of these scrofulous' diseases are various swellings of lymphatic glands, arising from causes which would be inadequite to produce them in ordinary healthy persons. The swell ings are due sometimes to more enlargement, as from an increase of natural structure, sometimes to chronic inflammation, sometimes to more acute inflammation or abscess, sometimes to tuberculous disease of the glands. But, besides these, it is usual to reckon as scrofulous' affections certain chronic inflammations of the joints; slowly pro gressive `carious' ulcerations of bones ; chronic and frequent ulcers of the cornea, ophthalmia attended with extreme intolerance of light, but with little, if any, of the ordinary consequences of inflamutstion; frequent chronic abscesses; pustulas cutaneous eruptions frequently appearing upon slight affection of the health or local irritation; habitual swelling and catarrh of the mucous membrane of the nose ; habitual swelling of the upper lip.
"Now these and many more diseases of the like kinds are amongst us, both in medical and in general language, called scrofulous or strumous ; but though many of them are often coincident, yet it is very difficult to say what all have in common, so as to justify their common appellation. Certainly they are not all tuberculous diseases. Little more can be said of them than that, as contrasted with other diseases of the same forms and parts, the scrofulous diseases are usually distinguished by mildness and tenacity of symptoms ; they arise from apparently trivial local causes, and produce, in proportion to their duration, slight effects; they are frequent, but not active. The general state on which they depend may be produced by defective food, with ill ventilation, dampness, darkness, and other depressing influences ; and this general state of constitution, whether natural or artificially generated, is fairly expressed by such terms as' delicacy of constitution,' general debility," defective vital power,' 'irritability without strength.' Such terms, however, do not explain the state that they express ; for they all assume that there are in human bodies different degrees of vital power, independent of differences of material, which is at least not proved.
" Such is the vagueness of • scrofula' and of the terms derived from it as commonly used in this country. They include some diseases which arc, and many which are not, distinguished by the production of tuberculous matter. It has been proposed, but I doubt whether it be practicable to make scrofulous ' and tubereulona ' commensu rate terms; as at present generally employed the former has a much larger import than the latter. The relation between the two is, that the scrofulous constitution implies a peculiar liability to the tuber culotte diseases and they often co-exist. These differences are evident in that many instances of scrofula (iu the ordinary meaning of the word) exist with intense and long continued disease, hut without tuberculous deposit ; that as many instances of tuberculous disease may be found without any of the non-tuberculous affections of scrofula ; that as Mr. Simon has proved, while the diseases of defec tive power' may be experimentally produced iu animals by insufficient nutriment and other debilitating influences, the tuberculous diseases are hardly artificially producible ; that nearly all other diseases may coexist with the scrofulous, but some are nearly incompatible with the tuberculous.