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Tuberculosis and Scrofula

disease, glands, bowels, body, nodule, growth, tubercle and lungs

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Tuberculosis is the term applied to a general disease, due to the formation of tuber cles in various organs of the body. The nature of tubercles has been shortly explained on p. 255, and at greater length on p. 372, but to give a complete idea of the disease, the chief points of these explanations may be again men tioned. A tubercle is a little nodule, gray in colour, about the size of a millet seed, con sisting of a collection of round cells. It is to be considered as a new growth, foreign to the part in which it is present. The little nodule tends to increase in size by the growth of others round it. By its growth it destroys the sub stance of the part in which it is placed, occa sioning also inflammation in the surrounding parts. It has no great vitality, and undergoes changes which begin in the centre of the nodule, the result of which is to convert the firm gray mass into yellow cheesy material. The process may go on till the nodule becomes quite broken down into soft matter, and, if the matter can break out from the part, an ulcer is left. Instead of softening, the nodule may be come hard by the deposit of lime salts in it, and become converted into a little solid mass in the substance of the tissue where it is lodged.

Now the effects produced by the formation of such tubercles depend on the organ or tissue of the body iu which the diseased process is going on. In the general disease tuberculosis the formation of the gray nodules proceeds in most of the organs of the body—lungs, liver, kidneys, lymphatic glands, bowels, membranes of the brain, &c., and the symptoms produced are those of a fever, and strongly resemble symp toms of typhoid fever. This form of the disease may last two or three weeks, and its termina tion is death.• The true nature of the disease it is extremely difficult to recognize during life.

On the.other hand, the formation of tubercles may be limited to one organ of the body, at least at first. Thus if the formation is princi pally in the lungs, it produces consumption (p. 372). In the bowels it produces consump tion of the bowels (p. 255). The same process going on in the membranes of the brain is the cause of acute water-in-the-head (p. 155); and a similar tubercular deposit in lymphatic glands is believed to be the cause of the swell ing and breaking down of the glands that are the main features of scrofula.

Recent investigations have tended to estab lish a relationship between the growth of tubercle and the activity of sonic peculiar form of germ. That tubercle spreads by contagion

is evident.. In cases of tuberculous consump tion the throat is commonly affected by tuber cular ulceration, so that the voice is hoarse and may be lost; and this is due to the contact of the spit from the lungs. Moreover, in such cases tubercular ulcers are usually found in the bowels, probably because the contagious matter is swallowed and the ulceration thereby ex tended. But definite experiments have con clusively proved the truth of the contagious character of the disease (refer to p. 501).

Tubercle is then due to an infection, but there may be a hereditary susceptibility to its attack ; while no age is free, it is most common in early life.

It is needless to discuss the symptoms or treatment of the general disease, and the special affection of lungs, bowels, and brain have been considered elsewhere. Where the tendency to this form of disease is known to exist in fami lies, much may be done to avoid its appear ance. The general treatment is the same as that suggested for scrofula, which, as has been already indicated, is a manifestation of the tubercular taint.

Scrofula (Strunia—King's Evil) is a consti tutional condition in which the general health is much weakened, and in which there is a great tendency to slow inflammation of various parts of the body and to the formation of ab scesses and ulcers slow to heal. (The disease was called King's Evil from the idea that it could be cured by the king's touch.) The organs of the body specially apt to suffer are the lym phatic glands, which become enlarged, softened, and readily break down, becoming converted into cheesy material. When it is the glands about the neck (p. 285) that are specially affected the disease is evident, but other glands, deep seated and not within reach of examination, are equally prone to the affection, which may, there fore, not be so evident. Scrofulous persons are often in early life of a pasty complexion, pale and flabby, with sluggish circulation, stunted in -growth, with short narrow chest, and prominent belly, and soft muscles. Others again are of bright fair complexion, with light red hair, and are unusually bright and clever. Many children, though apparently scrofulous, gradually grow out of this condition and be come vigorous men and women.

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