The treatment of scrofula divides itself naturally into the preventive and curative. With regard to the former, it must be applied both to those who have a scrofulous tendency and those in whom it has not yet been developed. The progeny of ecrofuleus parents require the greatest care and attention, if an outbreak of some form or other of the disease is to be avoided.. All writers on this subject recommend that the children of scrofulous parents should not be suckled by a scrofulous mother, and that a healthy wet-nurse should be secured. Where this is not possible, it is perhaps better for the child to take its mother's milk than to rear it by hand, attention being paid to the health of the mother during the suckling of the child. In the preven tive treatment of scrofula it should be recollected that cold, moisture, bad or deficient food, and impure air, are the great factors of the tuber culous deposits. Children and adults should be warmly dressed, and no exposure to cold should be allowed unless under circumstances where the reaction of the system can be secured. Thus cold bathing and exercise in the cold air are commendable as long as the natural heat is kept up. A moist and cold atmosphere acts most unfavourably. Climates that are dry, and gravelly and chalk soils, are preferable to moist climates and clay soils. The food of those predisposed to scrofula should be nutritious. It should especially abound in the oleaginous element. Children should not be allowed to reject fat, and the taking butter, cream, and fatty food, where positive indigestion does not interdict, should be encouraged. Exercise regular and constant in the open air should be taken every day. This should be sufficient to employ the muscles, to increase the capillary circulation, to promote the function of the skin, and maintain healthy uutritionary change. Of all the causes of scrofula that of impure air from over crowding and imperfect ventilation is the most constaut and prevalent. It presses most heavily on the poor, because they cannot prevent it, but the more opulent suffer from it from their ignorance of its existence. Close rooms, beds with curtains, rooms lighted with gas, crowded assembly rooms, and pieces of worship, all contribute to bring on a state of the body from which there is too often no escape when once it comes on. In this respect the whole of the internal arrange ments of the majority of houses in our towns and cities require reform. It is not till this subject is thoroughly understood by the great mass of the community, that the devastations of scrofukt amongst our city populations will cease.
The curative treatment of scrofula may be divided into constitutional and local applications. With respect to the former, it would be im possible here to notice all the numerous remedies that have been recommended for the cure of this disease ; we must be content with pointing out those that are most generally esteemed. Of all the remedies employed in the treatment of scrofula, perhaps none have enjoyed a greater reputation than mercuriale ; but it is only from their purgative and alterative effects that they prove beneficial, and not when they produce that powerful influence ou the frame which so rarely fails to ensue from their free exhibition. Tonics are amongst the most valuable remedies ; of these, cinchona is perhaps the most efficacious, and from the concentrated form in which it can now be exhibited (namely, the disulphate of quina), the most generally avail able. Other vegetable tonics and bitters have been administered with advantage in scrofula, such as ealumha, gentian, and hop. Of the metallic tonics used in scrofula, iron is that which has been found the most beneficial ; and the beet forms of exhibiting it are the Velure Ferri, the Tincture Ferri and the Ferri Seequioxidum, in powder. Iodine, as prescribed by Lugol, is at present in consider
able repute. It is successfully employed both internally and locally, in each of which modes it increases the action of the absorbents; and in the latter it likewise often induces suppuration of strumous tumours, and thus hastens their removal. Allusion has been made to the use of fatty food as a preventive of scrofula, and cod-liver oil has been found of no less value as a medicine. ft may be combined with medicines or system of treatment that may be thought necessary.
The evidence in favour of its use in most forms of scrofula is so decided, that It never ought to be overlooked as part of any general system of treatment. The use of baths in the treatment of strumous affections is of great value, the kind of bath to be made choice of being deter mined by the existing state of the patient. Sudden immersion in cold water, and especially eea-water, has long been an approved remedy in scrofula ; but when the strength of the patient is so reduced that no kindly glow follows, and when there is decided feverishness, the cold plunge-bath is not admissible. In most cases the warm-water bath, and still more that of vapour, will be found highly soothing and restorative.
With respect to the local treatment, indolent scrofulous tumours, when the health is little reduced, may be dispersed or made to suppu rate by continued pressure or by blistering, which can be employed when the situation of the swelling will not admit of pressure. In the treatment of scrofulous ulcers, the simplest and mildest dressings answer best. Cold spring water is a favourite application with many practitioners ; and preparations of lead are, upon the whole, very con venient and useful applications, provided the used in a state of eufficient dilution to prevent irritation. Formerly, the extir pation of scrofulous tumours was advised, but this method is now considered as being for the meet part injudicious and unnecessary, with the exception of diseased joints and a few other parts which fre quently require being amputated for the sake of saving the patient's life. Caustics have been employed for the mine purposes, Instead of the knife ; but as they efleet the object in view less certainly, more painfully and tediously. and cause extensive ulcers, they are disused by all the best surgeons of the present day. Some authors advise making issues, and keeping them open, in order to prevent any ill effects from the healing of the scrofulous ulcers. issues may perhaps be unnecessary for any purpose of this kind; but they are eminently useful as a part of the loral treatment of scrofulous joints and abscesses.
When all hope of recovering a diseased portion of the body is at an end, the question immediately presents itself whether such part ought not to be removed by an operation. In considering the propriety of amputation, it is necessary to determine how far the continuance of the affections brings the patient's life into harmed, and whether he has still sufficient strength left to undergo the operation. When another important joint, or a vital organ, as the lungs or bowelssis already the seat of incurable disease, such operation is nugatory, and in such cases unquestionably it should not be performed. Great caution however is required in making our final decision ; for every practitioner of ex perience has seen instances where the symptoms of visceral disease a almost to preclude hope, and yet have yielded on the removal o rescal irritation, and a cure has been the happy result.
(Cooper, Sorg. Diet. ; Cydop. of Prod. Ned. ; Aueell, 7'reatisr on Tuberculosis ; Dr. Bennett, Principles and Practice o j .Medieine ; Paget, Surgical Pathology ; Lugol on Scrofula, by Dr. Rankin ; II. Phillips, Un Scrofula and its Treatment.)