A practical treatise on the diseases of children / By James Milman Coley.

  • Coley, James Milman.
Date:
1846
Catalogue details

Licence: Public Domain Mark

Credit: A practical treatise on the diseases of children / By James Milman Coley. Source: Wellcome Collection.

    471/492 (page 451)
    SCROPHULA. 45] false membrane, uniting the outer coats of the intestines perhaps with the peritoneum, or with each other, or the costal and pul- monary pleure, and ultimately depositing tubercular matter, and constructing tubercles of various colours and dimensions. Tuber- culization in the mucous membranes is accomplished by the same kind of inflammation as that which produces the deposit of simple muguet, the difference consisting in the condition of the circulating fluids, which vitiate the inflammatory product. Having before entered upon the subject of tubercular forma- tions in the lungs and other organs, I need not enlarge upon it here, as my object is principally to direct the attention of the pro- fession to what I believe to be the remote and immediate causes of the disease, namely, imperfect sanguification and the superven- tion of inflammation from cold or other exciting cause. The parts of the body most exposed to the influence of cold are the skin and the external glands. A peculiar disease affecting the adherent surface of the cutis vera, namely, scirrhoide, &c., will be described in the next chapter. Scrophulous inflammation in the lymphatic glands, as, in the axilla, the neck, and groin, is distinguished by its slow and indolent progress, and by the vast extent to which the accompanying swelling of the glands advances. The external appearance of these glandular swellings is at first pale. Sometimes they acquire a certain bulk, and become station- ary during many years. At other times they proceed slowly by suppuration, the skin becoming of a dark red colour, and very thin, and ultimately bursting. Whether an opening is effected spontaneously, or by art, the discharge will be found at first thin, and afterwards intermixed with masses of tubercular matter, re- sembling pus. In some cases the opening is extended by ab- sorption, in others it may heal by immediate union of the integu- ment, the subjacent parts remaining in a morbid state, and soon distending the skin with fresh accumulation of scrophulous deposit. When the integument is destroyed to any considerable extent, we observe it hollowed out at the edges, as if eaten and undermined by an insect, while the centre of the ulcer is elevated into irregular prominences. The discharge from the ulcerated surface is copious and constant, except at intervals, when cicatriza- tion is attempted by membraneous bands, projecting in various di- rections, and having no connection with the ulcerated surface. In some cases surfaces of large extent will be found covered during a single night with a fine pellicle, destined to disappoint the patient by a subsequent excoriation. L’reatment.—The modes of treatment are preventive and re- medial. The former consists in attention to food, which should Ci Cue