" Now whether we disuse or still use in its vagueness the term scrofula,' we may make a group of the ' tuberculous ' diseases, defined by the peculiar morbid product of which I have described the chief characters. Only at present we must be content, I believe, to be some times in doubt whether the substance found in lymphatic glands and commonly known as scrofulous matter be truly tuberculous matter or degenerate lymph or pus." In the case of glands affected with what is called scrofulous inflam mation, the same peculiar exudation is observed as is found in the lungs of those who are affected with phthisis.
This exuded matter generally presents a yellowish or dirty-white colour and varies in consistence from a substance resembling cheese to that of cream. It is sometimes soft in one place and hard in another. It also presents itself in masses of various sizes, from a millet seed to a hen's egg. It is friable on pressure and may break down into a pulpy matter. If a small piece is squeezed between two pieces of glass and placed under a microscope it presents a number of irregular-shaped bodies, varying from the nth to the nth of an inch in diameter. These bodies contain from one to seven granules, and are unaffected by water, but rendered transparent by acetic acid. These have been called tuberculous corpuscles. They are surrounded with minute points or granules, which are more abundant in the softer tuberculous matter. These corpuscles are often accompanied by deposits of mineral matter, consisting of phosphate and carbonate of lime. They occur, for the most part, in young persons, and may occur in any part of the body ; but they are most frequent in the lymphatic glands. After these parts the fibrous textures are most frequently attacked, as the lungs and serous surfaces. These exudations are very slow in their progress, and are thus distinguished from the exudation of ordinary inflammation. They exhibit little or no tendency to the production of perfect cells or normal tissues, and the cells are slowly formed and slowly break down. They have little tendency, when once formed, to absorption ; but show a great tendency to breaking up and ulcerating.
Scrofula, though not a contagious disease, is unquestionably hereditary; and hence very generally dependent upon a peculiar diathesis. Yet, like many other hereditary diseases, it is also occa sionally generated as a primary affection, without any hereditary taint that eau be discovered. When it occurs as a primary or ingenerated affection, it ie by no means always limited to any particular tempera ment or habit of body. But where scrofula appears hereditary, and especially where it does not show itself very early, it is often accom panied with a peculiar constitution. "The character of a scrofulous child," says Sir Aetley Cooper, "is as follows :—You will find the skin thin, if you pinch it, which is quite different from the skin of children who are not scrofulous ; in them the skin is solid and dense, and the fibres strong ; but in scrofulous the skin Is thin, and the vessels may be under it ; and It is on this account that persons with this disease frequently have a rosy colour, arising from the thinness of the akin, which allows the vessels to be seen under it.
The hair is also light coloured. If you observe, in a family of five or six children, one among them who has a delicate thin skin, with light hair and complexion, you will find that if they are all exposed to the same causes, they will escape from any scrofulous affection, with the exception of the one stamped by nature, and that this, during its growth, will be affected by the disease. The hair is also extremely fine, the eyelashes long, the pupils dilated, and tho fingers are what is called clubbed, similar to the fingers In phthisical persons, that is, they are extremely long and thin, but at the extremities are broad and flat. The upper lip is of considerable thickness, and this is a mark of debility." In considering the causes of a disease so deeply rooted in the con stitution as scrofula is universally acknowledged to be, it is necessary to direct our attention to circumstances very remote in the history of those who are its subjects. The foundation of a scrofulous habit is frequently laid during the fretal state, by the transmission of that peculiar organisation of the frame from parents who themselves possess it. Scrofula is also observed to originate in the healthy offspring of healthy parents, under certain circumstances, the principal of which are habitual exposure to cold and damp, privation of free air and light, and want of healthful exercise. A moist, cold, and variable climate, like that of Great Britain or Holland, is particularly favourable to the development of scrofula; in proof of which it is sufficient to adduce the great prevalence of the malady in both of those countries. A very cold or a hot climate, on the other hand, serves rather to protect us against scrofula ; the former, dry and bracing, invites to exercise, and promotes digestion, and thus strengthens the system ; while the latter favours the excretions, particularly that of the skin, and preserves the body from those sudden changes of temperature which in our island so often lay the foundations of scrofulous affec tions. Among the causes which appear to give rise to scrofula in children, are the practices of rearing them by the baud and suckling them too long; two extremes, both of which often lead to the same result,—the imperfect nourishment of the child. Another cause of this disease is confinement in ill-ventilated apartments; for the deficiency of pure atmospheric air cannot be long endured, especially diming youth, without the most injurious consequences. Acute diseases, especially those accompanied with cutaneous eruptions, as smallpox, measles, and scarlet-fever, are often observed to have the effect of producing the development of scrofula ; and the more tedious the convalescence, the more frequently do symptoms of this disease ensue.