Surgery : its theory and practice / by William Johnson Walsham.

  • William Walsham
Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: Surgery : its theory and practice / by William Johnson Walsham. Source: Wellcome Collection.

    61/864 page 45
    STRUMA OB SCROFULA. blood-vessels, producing acute general tuberculosis. The brunt of the ai¥ection falls in this case either on the lungs {acute ]?hthisis) or upon the membranes of the bram {acute ■meningitis). , p , , i i ^ A general though brief account of tubercle has been here given to prevent repetition when treating of tuber- cular diseases of certain organs. As a surgical affection, it is chiefly met with in the bones, joints, testicle, lymphatic glands, skin, larynx, and more rarely the bladder and rectum. STRUJIA on SCROFULA. The terms struma and scrofula are here used synony- mously. To prevent confusion the former, as perhaps the one in more general use, will be subsequently em- ployed. By struma or strumous is understood a constitu- tional condition or diathesis, in which, on very slight provocation, chronic inflammations of certain tissues and organs, preferably skin, mucous membrane, lymphatic glands, bones, joints and testicle are set up, run an in- dolent course, and have a marked tendency to caseation and suppuration. By many pathologists, however, these chronic inflammatory processes, which are supposed to be characteristic of struma, are considered to be in them- selves of a tuberculous nature, and dependent on the pre- sence of the tubercle bacillus ; whilst what is here called the strumous diathesis is regarded by them merely as a phase of ill-health or malnutrition, favoui-ably disposing the subject to tubercular infection. Such observers, therefore, regard the terms strumous and tuberculous as synonj-mous. The histological characters and the general behaviour of many of the so-called strumous inflamma- tions are no doubt in many respects similar, if not identical, to those which are on all hands regarded as tuberculous, and in many of them the tubercle bacillus has no doubt Ijoon found. In others, however,, even after a careful search, it ha,s not boon discovered; and if, there- fore, the presence of the tubercle bacillus is to bo taken as distinctive evidence of tubercle, all the so-called strumous inflammations are not tuberculous. The con- stitutional condition, moreover, regarded by surgeons as strumous, is certainly something more, though difU- cult to define, than a 'mere state of debility or feeble
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