ally not cancerous have been confounded with | geons from the doubt and difficulty they forthe cancerous. merly experienced. At the same time, it cannot be denied that considerable obscurity still hangs over our knowledge of the pathology of cancer, and that there are no means of diag. nosing a cancerous from fibrous and other forms of cancroid growth at their commencement. It seems to me certain that a cancerous may supervene upon a cancroid growth, and that both for a time may be local, so that, under all circumstances, where the nature of the tumour is doubtful, after means of retardation and resolution have had a fair trial, excision should be at once had recourse to. As there is no possibility at early period of knowing whether the growth may or may not ultimately become cancerous, prudence demands that as soon as it becomes evident that these means have failed to arrest its progress, an operation should be performed. If early excision were more practiced, many of the lamentable cases which occur would never appear."-(Op. cit., p. 242.) This is sound advice; and the same eminent physician farther remarks: "The practical rule, then, which pathology and experience unite in causing us to adopt, seems to be this, that so long as cancer remains fixed in a part which is capable of being removed, and the strength of the patient is not too much reduced, so long is the surgeon warranted to interfere. If this ap 118. Dr. NEIL ARNOTT has greatly facilitated the employment of pressure by the invention of an instrument for this purpose, and which has been described by Dr. WALSHE. It consists of a spring, an air-cushion, supported by a flat resisting frame or shield, a pad, and two belts. It does not interfere with the movements of the thorax, and the amount of pressure can be nicely regulated and equably applied; causing great relief from pain, and restraining hemorrhage in ulcerated cases. It has been proved useful in cases in which I have seen it resorted to. Dr. BENNETT remarks, that, if pressure alone be capable of producing such good results, its conjunction with one or more of the other means capable of retarding growth may be attended by even greater utility; and thus the apparatus invented by Dr. J. ARNOTT, by means of which pressure may be combined with external cold and dryness, is directly indicated, and deserves to be tried; or his apparatus, applied when the patient is at rest, may be alternated with that of Dr. NEIL ARNOTT, when exercise is desirable. I believe, however, that pressure will be found most efficacious when conjoined with those measures which are the best calculated to improve the general health, and to enable the vital power to throw off the parasitic formation. (See art. CAN-plies to cancerous, it does with ten-fold force CER, 40, et seq.) 119. D. Locality has been shown, in the article CANCER, to have considerable influence in favouring the development of this malady. Cold, humid, and malarious situations, unwholesome food, insufficient nourishment, and mental anxieties and depression, are among the most influential causes of scirrho-cancer. Therefore a choice of locality, and, with reference to season, prevailing winds, and exposure, should be made with due care; a dry, moderately warm, and bracing situation and air, being selected. A clay soil, or a low alluvial, wet, and swampy soil should be avoided, even to a considerable distance; and food, exercise, and the regimen of both the body and mind, should be such as are most calculated to give due tone to the former, to refresh and agreeably engage the latter; interesting occupations being calculated to promote both intentions, while the want of occupation leaves the patient a prey to ennui and to his own depressing anticipations, or his still more lowering fears. to cancroid growths, which, everything that we know warrants us in asserting, are much less fatal and malignant."-(Op. cit., p. 245.) 121. F. Chemical Applications, &c.—The destruction of morbid growths by various cauterizing or dissolving applications can scarcely be accomplished, unless at very early periods of their production; and, as regards cancerous formations, these applications would increase rather than arrest the disease. Dr. BENNETT remarks, that "Acetic acid dissolves the cellwall more or less, and strong potash reduces the whole to a granular mass. The continued application of these agents, therefore, would tend to dissolve if brought in direct contact with the cells, and need not necessarily excite such irritation as to cause fresh exudation. The only objection is, the utter impossibility of affecting the whole mass, even in cases of ulceration, and preventing the formation of deep-seated cells, while the superficial ones are destroyed. In certain cancroid growths, especially epithelial ones. the application of acetic acid is an established remedy, and should always be tried when it is thought possible to bring the fluid successively in contact with the entire mass of the disease" (p. 250). The external application of the chloride of zinc has been advised, and of iodine, and of several of its preparations. Probably the application of an iodide of zinc may deserve a trial. 120. E. Excision.-The propriety of excising tumours, from a belief in their cancerous nature, or dread of their assuming this nature, or as the best mode of removing them, has been much discussed by both physicians and surgeons, especially in recent times. It may have been supposed that the discoveries of the histologists would have gone far to determine the 122. G. Internal Remedies.-Before excision question of excision, in as far as the nature of is attempted, and often contemporaneously the growth may be concerned. But they have with a judicious recourse to external means, left the matter pretty much in the same state several internal remedies, either singly or vaas that in which they found it. Professor riously conjoined, may be tried, more especialBENNETT, after alluding to the discussion only those which tend to promote the digestive, this subject, and the differences of opinion expressed by the most eminent surgeons of Paris, remarks, that "a knowledge of the structure and natural progress of cancerous and cancroid growths must in future exempt sur assimilative, and depurative functions, and to develop the powers of life. As respects cancerous growths, this principle of treatment has been fully insisted on (see arts. CANCER, § 40, and FUNGOID DISEASE, ◊ 21); it therefore only ficial in a case which was considered cancerous disease of the os and cervix uteri; but the patient enjoyed at the same time the advantages of removal to a good air, and her sanguine temperament and full habit of body favoured the change of diet. When, however, the patient is of the melancholic, lymphatic, or nervous temperature, or if anæmia or a cachec judicious combination of animal with vegetable food, and the promotion of the assimilating and excreting functions, are most beneficial. In all cases of a malignant or contaminating nature, and in all cases which are likely to assume this nature, the chief indication of treatment is to enable the vital energy, by the aid of diet, air, and exercise, to resist the extension of the local evil, and to favour its transformation or resolution. remains briefly to notice the importance of adopting it in our attempts to remove other morbid growths, especially before the constitution is subjected to the shock of an operation; and in cases where the situation of a tumour or other circumstances may render the success of an operation either extremely improbable or impossible. In three cases of large tumoursone seated superficially, evidently a fatty tu-tic habit of body be manifest, I believe that a mour, and about the size of a person's head, the others seated very deeply among the muscles of the upper half of the thigh-and in one case of tumour, apparently attached to the pericranium, a course of internal medicines entirely removed the disease. I had advised a recourse to surgical aid, but the patients having been desirous of trying medical treatment before any surgical means were adopted, a course of the medicines about to be mentioned was prescribed, very nearly the same substances having [According to WENDT, HELM, and others, the been employed for the four cases. Those preparations of gold have been found very usecases occurred some years ago; but the per- ful in scirrhous induration of the tongue. The sons who were the subjects of them had not, usual form of administration is to rub them on up to recent periods, experienced a return of the tongue. A case of scirrhus of the pylorus is these growths. The medicines which were related by H. HOFFMAN, in which the chloride of prescribed consisted chiefly of the iodide of po- gold effected a perfect cure; and frictions of tassium, conjoined with solution of potash, the the chloride, as well as the oxide, on the labia decoction or compound tincture of cinchona, pudendi, in cases of cancer of the uterus, have the internal use of tar-water, and the fluid ex-been recommended by HUFELAND, HERRMANN, tract or other preparations of sarsaparilla, with MEISNER, GROTZNER, Gozzi, and others. KRIdue attention to diet and to exercise in the MER advises that they be applied to the os uteopen air. When treating of CANCER ( 34-41), ri. According to German writers, scirrhosities the propriety of prescribing the preparations of have frequently been dispersed through their iron was insisted upon, especially in such com- agency, and even in open cancer marked imbinations as the peculiarities of the case would provement has been perceptible. suggest; and the iodide of iron was then for the first time recommended in the treatment of cancerous diseases. This medicine has frequently been given by me in these maladies with sarsaparilla, or dissolved in the sirup of sarza, with more or less benefit; and the nitrohydrochloric acids have been sometimes prescribed with vegetable tonics or bitter infusions. Considerable advantage has been derived, in several cases, from the use of inspissated oxgall, as recommended in the first part of this work, and prescribed in numerous and varied formulæ in the APPENDIX which accompanied that part, more especially in correcting and promoting the functions of the digestive canal. Conium, and other narcotics formerly much praised for cancerous maladies, have rarely proved of advantage beyond the temporary relief to pain, or to other urgent symptoms they have sometimes afforded. Dr. A. T. THOMSON has described a case of scirrhous mamma, which, after protracted and fruitless treatment by other agents, as other preparations of iron, with conium, ultimately was cured by a combination of iodide of iron and conium. The Calendula officinalis, garden marigold, has considerable reputation in Germany for the cure of scirrhus and cancer. WESTRING, a Swedish physician, called attention to it in 1817, having found it very useful in cancer of the breast and uterus. He used a decoction of it internally, and also applied the fresh plant to the part affected, when practicable, and it was found to allay the burning pain. RUDOLPH afterward used it with much benefit, in a case of induration of the mamma, in a young female, applying the acetate of iron in solution, at the same time, externally. FEнr also found it useful both in incipient and advanced scir123. H. Diet and Regimen.-These require to rhus. STEIN praises it highly in cancer of the be adapted to the temperament, diathesis, hab-integuments, using an ointment made of the it of body, and other circumstances of the patient, as well as to the presumed nature of the tumour. When treating of CANCER (44), I mentioned the advantages generally derived from attention to the secretions and excretions, and from promotion of the primary and secondary assimilating processes. There can be no doubt of the good effects of moderate exercise in the open air, of a residence in a mild, dry atmosphere, and of pleasant occupations, Iodine is highly recommended in scirrhus of with a cheerful state of mind. But the nature the uterus, mammæ, &c, by HEIM, KLAPROTH, of the food admits of much more discussion. HENNEMANN, ULLMANN, HILL, MAGENDIE, WAGIn the cancerous or scirrhous forms of morbid NER, ZIMMERMANN, and many other physicians, growth, the adoption of a farinaceous and vege-applying it in the form of the compound ointtable diet has been advised by Dr. LAMBE and a ment to the part affected, and also giving it few others. I have seen this diet most bene-internally. MAGENDIE extols it in cancer of the expressed juice of the young plant and flowers, with fresh butter, giving at the same time a decoction of the plant internally. The salve causes considerable pain at first, but in a little time. the ichorous discharge is improved, the offensive odour corrected, and in from fourteen to twenty-one days the ulcer is converted into one of a benign and readily cicatrizable character. tongue, JAHN in incipient scirrhus of the stomach, while Dr. J. K. MITCHELL, of Philadelphia, has found the iodide of potassium afford very marked relief in a scirrhus tumour of the neck. -(Medical Examiner, 1846.) I have seen, also, decided benefit from the use of different preparations of iodine, particularly the iodide of iron, used both externally and internally, but I cannot say that I have witnessed any perfect cures from their employment. The preparations of platinum have been recommended by DUTTENHOFER, PREVOST, and others, in different forms of cancer and scir rhus, but I have not seen them employed, nor is there sufficient evidence in their favour to recommend them to our notice. I have more confidence in attention to the loss of health, as connected with proper food, exercise, pure air, suitable clothing, freedom from anxiety, &c., than in all the drugs of the Pharmacopoeia. The late Dr. TWITCHELL, of New Hampshire, was cured of a cancer of the face by an exclusive bread and milk diet; and since his case was published in the journals, I have known several others in which the disease was arrested by the same diet and regimen, without the use of any remedies whatever. | tion.)-C. Parry, Mechanical Account of the Hysteric Pas- There can be no doubt that early excision is in all cases advisable, where practicable, great care being taken to remove every portion of the scirrhous part. If this be done, they are not likely to return unless there be a strong hereditary tendency to the disease; in this case, however, excision is advisable, inasmuch as it tends to protract life, if it does not save the patient. There is danger that too much reliance be placed on the means of retardationilton, Observations on Scrofulous Affections, with Reand resolution, mentioned by our author, to the neglect of the more important and radical treatment. But we are not to forget that cancer, like scrofula, is often a constitutional disease, and that if there be any remedy for it, it must be found in agents which influence the intimate structure of the body more generally and intimately than any medicinal substance can do, as proper diet, a healthy state of the excretory apparatus, a pure atmosphere, and exercise of the muscular system, suited to the constitution of the patient.] BIBLIOG. AND REFER.-Galenus, De Tumoribus præter Naturam, Op., t. iii. —Avicenna, Canon., L. iv., Fen. iii., Tr. 2, c. iv.-Rueff. De Tumoribus Phlegmaticis non Naturalibus, 4to. Tigur., 1556.-J. P. Ingrassias, De Tumori bus præter Naturam, Neap., 1553; in Haller's Biblioth. Med. Pract., vol. ii., p. 69.-D. Leonus, Methodus Medendi Tumores præter Naturam, 8vo. Bonon., 1562.- Lami, Ergo Molles Tumores boni. Paris, 1571.-4. Read, Chi rurgical Lectures on Tumours and Ulcers, &c., 4to. Lond., 1635.-F. Thevenin, Œuvres contenant un Traité des Tumeurs, 4to. Paris, 1658.-E. Rudins, De Tumori-servations on the Cure of Cancer, 8vo. Lond., 1810.-C bus præter Naturam, 4to. Venet., 1600.-F. Blondel, Epis- T. Johnson, A Practical Essay on Cancer, 8vo. Lond., tola de Cura Carcinomatis, absque Ferro vel Igne, 4to. 1810.-R. Stocker, Observations on the Cure of Cancer, Paris, 1666.-Brown, Of Preturnatural Tumours, &c., 8vo. 8vo. Lond., 1810.-J. Howard, Practical Observations on Lond., 1678.- Wiseman, Chirurgical Tracts, &c., fol. Lond., Cancer, 8vo. Lond., 1811.- Bayle and Cayol, Dict. des 1676.-J. A. Helvetius, Lettre sur la Nature et la Guérison Sc. Méd. (art. Cancer), t. iii. Paris, 1812.-G. L. Bayle, du Cancer, 4to. Paris, 1691-Galloys, In Mém. avant 1699. Vues Théoriques et Practiques sur le Cancer, 8vo. Paris, (Common salt dissolved in urine and honey to tumours.)- 1812.-J. L. M. Robert, L'Art de Prévenir le Cancer au G. Deshayes, Sur la Nature et la Guérison des Cancers, Sein chez les Femmes, &c., 8vo. Paris, 1812.-W. Lambe, 12mo. Paris, 1701.-Maurel, Traité des Tumeurs et des Additional Reports on the Effects of a Peculiar Regimen Obstructions. Paris, 1702.-W. Beckett, New Discoveries in cases of Cancer, &c., 8vo. Lond., 1815.-J. Rodman, relating to the Cure of Cancer, wherein a Method of Dis- A Practical Explanation of Cancer in the Breast, &c., 8vo. solving Cancerous Substance is recommended, 8vo. Lond., Lond., 1815.-C. Wenzel, Ueber die Induration und das 1711.-Deidier, Traité de Tumeurs contre Nature, 12mo. Geschwür in indurirten Theilen, 8vo. Mainz, 1815.- C. Paris, 1738.-A. Louis, Observat. sur les Effets du Virus Boyen, Cancer considéré comme Maladie du système nerCancéreux, &c., 12mo. Paris, 1747.-Rey, Traité des Tu- veux, 8vo. Paris, 1816.-S. Young, Minutes of Cases of meurs enkistées, 8vo. Brux., 1752.-W. Norford, Essay Cancer, &c., 8vo. Lond., 1816.-E. T. A. Baumann, Ueber on the General Method of treating Cancerous Tumours, den Krebs, &c., 8vo. Leips., 1817.-F. J. L. Rouzet, Re12mo. Lond., 1753.-W. Ogle, Letter to Dr. Young concherches et Observations sur le Cancer, 8vo. Paris, 1818. cerning the Cure of encysted and other kinds of Tumours-S. Young, Farther Reports of Cases of Cancer treated without the knife, 8vo. Lond., 1754. (A secret applica by the New Mode of Pressure, 8vo. Lond., 1818.-F. J. Fr. Kropf, Skropheln, Skrofelkrankheit, Germ. Scrofula, Scrofole. Ital. Scrofula, the King's Evil, the Evil. External Scrofula or Struma. TUBERCLES-Tuberculum (from tuber, a tumour); Tuberculosis, Morbus tuberculosus, Strumosis; Cachexia tuberculosa, Dyscrasia tuberculosa; Diathesis seu Constitutio Strumosa; Tubercular or tuberculous Cachexy, Diathesis, or Vice, &c.; Internal Scrofula or Struma. CLASSIF.3d Class, Cachectic Diseases. 3d Order, Impetiginous Affections (Cullen). 3d Class, Diseases of the Sanguineous Function. 4th Order, Cachexies (Good)-CLASS IV., ORDER I. (Author in Preface). 1. DEFINIT.-Constitutional asthenia; a weak or an atonic development of the frame, with a flabby state of the soft solids and predominance of cellular and lymphatic conformation; and a disposition to, or the presence of, swellings of the lymphatic glands, of disorder of the mucous surfaces, and of deposits, in various organs or parts, of small masses, varying in size, consisting of a firm, friable, inelastic substance resembling cheese, and denominated tubercles. Beyenle, Ueber den Krebs der Gebärmutter, 8vo. Maunk., 1819-Ferminelli, Giambalt, Sulla Natura ed i Remedii de' Carcinomi, 8vo. Terni, 1820.-E. G. Patrix, Traité sur le Cancer de la Matrice, &c., 8vo. Paris, 1820.-A. Scarpa, Sullo Scirrho e sul Cancro, 8vo. Milan, 1821.-C. Bell, On the Varieties of the Diseases comprehended under the Name of Carcinoma (Med. Chir. Trans., xii.), 8vo. Lond., 1822.-Breschel and Ferrus, Dict. de Méd. (art. Cancer), t. iv.-Paris, 1822.-Vorstmann, Verhandeling over de Kan. ker, 8vo. Utrecht, 1824.-W. Farr, A Treatise explanatory of a Method whereby Occult Cancers may be cured, 8vo. Lond., 1825.-R. Pruss, Recherches Nouvelles sur la Nature et le Traitement du Cancer de l'Estomac, 8vo. Paris, 1828.-Gouvert, Archives Génér. de Méd., t. xvi., p. 282. (For Scirrhous Tumours, Pills of Ammoniacum, Conium, Aconitum, Pilula Rufi, et Sapo Castil.). A. Cooper, Illustrations of Diseases of the Breast, 4to. Lond., 1829. -J. Cruveilhier, Anatomie Pathologique du Corps Humain (liv. 4, 8), fol. Paris, 1829.-J. A. Recamier, Recherches sur le Traitément du Cancer par la Compression (2 vols.), 8vo. Paris, 1829.-Begin, Dict. de Méd. Prat. (art. Cancer), t. iv. Paris, 1830.-E. Home, A Short Tract on the Formation of Tumours and the Peculiarities of those become Cancerous, 8vo. Lond., 1830.-Ullmann, Encyc. Wörterb. (art. Cancer), b. vi. Berlin, 1831.-Ure, In Lancet, No. 663, p. 252. (Applicat. of Chloride of Zinc.)-Medical Gazette, No. 442, p. 287.-Carswell, Cyc. of Pract. Med. (art. Scirrhus), vol. ii. Lond., 1834.-And Illustration of the Elementary Forms of Disease. Lond., folio; t. xii., 1833-1837; t. iii., et pluries.-T. Battaye, Cancer extirpated without the Knife, 8vo. Lond., 1838.-J. Warren, Surgical Observations on Tumours, 8vo. 1838.-J. Müller, Ceber den feineren Bau der Geschwülste, &c. Berlin, 1838.- Paget, In Lond. Med. Gaz., vol. xxiii., p. 287.-J. 2. From the synonyms enumerated above, it Cruveilhier, Anat. Path., &c. Livr. xxvi., pl. 3.- Jobert, Brit. and Foreign Med. Review, vol. ix., p. 260.- Gluge, may be inferred that the terms Scrofulous diathAnatomisch-physiologische Untersuchungen zur Patholo- esis, or cachexy, or vice; Strumous taint or congie, b. i., 1838, p. 134; b. ii., 1841, p. 137, 190.-Valentin, stitution; Tuberculous cachexy or evil, TubercuRepertorium, &c., t. ii., p. 116, 275, et pluries. — Goodsir, Edin. Med. and Surg. Journ., vol. lv. 1841.-4. Berard, losis, Scrofulosis, may be considered as nearly Diagnostic Différential des Tumeurs du Sein, 8vo. Paris, synonymous, although the scrofulous taint or 1842.-L. Mandl, Manuel d'Anatomie Générale appliquée cachexy may be viewed as sometimes existing à la Physiol. et à la Pathologie, &c. Paris, 1843, pluries. without the tubercular deposit being yet form-Andral, Hématologie Pathologique, 8vo. Paris, 1843, p. 163. Vogel, Icones Histologia Pathologica. Lips., ed, this deposit, in some one or more of its nufol., 1843. Henlé, Anatomie Générale, 8vo. Paris, 1843, merous seats or manifestations, being the comt. i., p. 230. -J. Müller, Treatise on the Structure of Canmon structural change resulting from this taint cer and other Morbid Growths, translated by Dr. West, 8vo. Lond., 1840.-Henlé, Zeitschrift für rationelle Medi--resulting so generally as to render it doubtcin., 1844, p. 190.-Nasse, Zur Analysis und Synthesis der Pseudo-plastischen Prozesse. 1844.-H. Lebert, Physiologie Pathologique, ou Recherches Cliniques, Experimentales, et Microscopiques sur l'Inflammation, la Tuberculation, les Tumeurs, la Formation du Cal, &c. Accomp. d'un Atlas, &c. Deux Tomes, 8vo. Paris, 1845, vol. i., Tumours, &c. - Heller, Archiv. für Physiol. u. Pathol. Chemie u. Mikroscopie, b. i. 1846.-G. Macilwain, On Tumours, their General Nature and Treatment, 8vo. Lond., 1845.-W. Walshe, On the Nature and Treatment of Cancer. 8vo. Lond., 1846.- Bruch, Die Diagnose der Bösartigen Geschwülste, 1847, p. 287.-Vogel, Pathological Anatomy of the Human Body, transl. by Dr. Day, 8vo. Lond, 1847, pluries.-C. Sedillot, Recherches sur le Cancer, 8vo. Paris, 1846.-Reinhardt, In Archiv für Pathologische Anatomie und Physiologie, &c., b. i., p. 20.-- Virchow. In ibid., b. i., p. 112-142.-J. Hughes Bennett, In Monthly Journ. of Med. Science. Sept., 1847.-On Cancerous and Cancroid Growths, &c., with numerous Illustrations, 8vo. 1849. (An original and very able Work on the Microscopic Appearances of Morbid Growths.) (See, also, BIBLIOG. AND REFER. to art. CANCER.) ful whether or not this taint ever exists without [AM. BIBLIOG. AND REFER.-Anson Smith, in Medical Repository, vol. xiii., p. 246.-W. Morrill, Cancerous Ulceration of the Esophagus, Am. Journ. Med. Sci., vol. 3. i. Of the Scrofulous diathesis or taint-Laxxiii.-Leonard Peirce, Case of Cancer, Am. Journ. Med. Sci., vol. iv.-M. Spalding, Case of Scirrhous Testicle, tent or inactive Scrofula; ii. The Causes of ScrofMass. Med. Transactions. Charles Knowlton, Scirrhus ula and Tubercles; iii. The Structure and Comof the Pancreas, Boston Med. and Surg. Journ., vol. xxix. -M. Spalding, Case of Scirrhous Testis cured by Elec- position of Tubercles; iv. The Pathology of detricity, Trans. Mass. Med. Soc., vol. ii, 1808.-J. C. War.veloped, open, or manifest Scrofula and Tuberculoren, Surgical Observations on Tumours, 16 plates, 8vo. See AM. BIBL. to art. CANCER.] -- sis; v. The Pathogenesis of Tubercles; vi. The Comparative Pathology of Tubercle; vii. The SCROFULA AND TUBERCLES. SYNON. Scrofulous Taint as predisposing to, and influenStruma, Celsus, Pliny, Linnæus, Good. cing the Symptoms, Course, and Terminations of Scrophula (from Scropha or Scrofa, a pig or various diseases; viii. Diseases attack the Scrofsow), Sauvages, Vogel, Sagar, Cullen, Mac-ulous diathesis, without being essentially scrofu bride, Darwin, Young. Xoipàs, Hippocrates. lous or tubercular, although more or less nearly alScrophula, Pinel. Scrophulosis, Scrophulosus lied to Scrofula; ix. The associated alterations Morbus, Vitium Scrophulosum, Dunglison. Ca- and complications of Scrofula and Tuberculosis; cheria Scrofulosa, Adenosis Scrofulosa; Glan-x. The prevention of Scrofula and Tubercles; xi. des, Strumes, Ecrouelles (Cruels, Scotticè), The Treatment of Scrofula and Tubercles. readily split, and often become carious. 4. I. INDICATIONS OF THE SCROFULOUS DIATHE-able redness of the cheeks; in others a waxy yelSIS OR TAINT.-The strumous or scrofulous taint lowness, with a dirty pallor round the mouth.". was no farther recognized by the ancients than (BREDOW). Bluish rings round the eyes; the in connexion with swollen external or lym- eyes most frequently large, oftener blue than phatic glands, the constitutional vice being dark; the pupils are commonly large; the tuoverlooked until the writings of FERNEL, PLA-nica albuginea of a pearly whiteness, traversed ter, Baillou, and others directed attention to by injected blood-vessels, especially if the mesa more correct pathology of the disease. More enteric glands are affected (HUFELAND), or of recently, numerous writers have furnished in- a bluish whiteness, and the pupils large when teresting information respecting strumous af- the lungs are diseased. The eyelids are often fections, especially HOFFMAN, HUBER, VAN SWIE- oedematous, the eyelashes are long, the MeiboTEN, LACOUETTE, HUFELAND, and HECKER; and, mian secretion is increased. The nose is wide in the present day, the writings of CARSWELL, or swollen, or red or shining; the upper lip is GLOVER, PHILLIPS, BENNETT, WALSHE, TYLER thick and projecting, and the furrow between SMITH, and others, are especially deserving an it and the nose is deep. The general expresattentive perusal. Dr. GLOVER very justly re- sion of the countenance indicates indolence and marks, that "a careful distinction should be want of energy. The first teeth are small, and made between the scrofulous diathesis or pre subject to caries. The second are broad, often disposing constitution and the actual process-covered by a glairy secretion, are very white, es of the disease-between the Ens in potentia and the Ens in actu." The scrofulous diathesis may, by the debility or the susceptibility accompanying it, predispose to other diseases besides those which are more strictly strumous or tuberculous; and a distinction should therefore be drawn between the latent or inactive scrofulous taint, the diseases which are not strictly attributable to this taint, and those maladies which are actually the structural manifestations of it. But is this distinction readily drawn? I believe not; and that the descriptions and distinctions adduced by HUFELAND, LLOYD, LUGOL, and many others, are so loose, and present so numerous exceptions, that they deserve, in many particulars, but little credence, and certainly some of them, at least, require a more particular investigation: Several of these have been subjected to a minute examination by Mr. PHILLIPS; but, as he considers tubercles to be distinct from scrofula, much of his reasoning on this subject fails in strictness of application to the subject in the wider signification which I have assigned to scrofula. M. LUGOL assigns so many indications of the scrofulous diathesis, and those with so little justice and precision, as to have it re-bumen, which, at a later period only, diminishes marked that, of all his characters of this diathesis, there is not one which may not with equal value be replaced by a phenomenon diametrically opposed to it; yet this is one of the writers who is so much praised by the Gallic school in this country. Of the various indications of the scrofulous taint enumerated by this and other writers, many will appear to the experienced writer as possessed of little signification and dependence, and as deserving of very slight consideration. 5. The chief characters of the scrofulous taint enumerated by writers are the following: (a) A want of due bodily symmetry; small, weak, or crooked limbs; a gibbous or pigeon breast and flattened ribs; hare-lip (BREDOW); hypertrophy of the pubis, the sacrum, and the ischia (LUGOL). (b) A certain character of the head and face the jaws are said to be broad, the forehead low and angular, and the neck long and rounded; a head larger than natural, especially posteriorly; a puffed-up rounded visage; great transparency or whiteness of the skin, often with a rosy tint of the cheeks; "a pale, inflated countenance; the chief colour of the dark complexion is dull or dirty, of the fair an unnatural whiteness, frequently with an agree 6. (c) The appetite is irregular-sometimes impaired, at other times voracious; occasionally there is nausea; the tongue is often foul, the breath fetid or sour; the bowels are irregular; flatulent eructations are frequent and acid; and the excretions are also acid. The abdomen is large, tumid and flatulent on percussion. Discharges from the nose are common, and from the vagina not unfrequent. The soft solids are flabby; the adipose and cellular tissues abundant but soft, giving the surface of the body a full and rounded contour; the limbs are deficient in rigidity and firmness. The tendons are small and yielding; the capsules of the joints are weak; and the heads of the long bones are large. Hence a disposition to lateral curvatures of the spine, thick ankles and joints, large illformed hands and feet, and falling of the arches of the latter. The shoulders are high. 7. (d) According to HEUSINGER, one of the correctest writers on Pathology, the strumous taint consists of a torpid state of the nervous system. The blood, whose condition is yet but little known, appears to be from the commencement poor in globulin and hæmatin, rich in al also. There are abundance of lymph, extension of the lymphatic vessels, marked development of the lymphatic glands, and predominance of the cellular system, not only under the skin, but in all the organs, where it commences to replace the specific tissues, which is especially apparent in the muscles, the bones, &c. All the mucous secretions are augmented, and they often become albuminous. 8. (e) General lassitude, languor, and debility are commonly experienced, with an inability to sustain prolonged physical and intellectual exertion. The powers of the mind, although generally feeble, are often precocious. Dr. GLOVER remarks, that in very few of the subjects which he had examined has he found the bodily or intellectual powers fairly developed in a degree proportionate to the age and circumstances of the patient, and that a general retardation of development seems one of the most constant features of this peculiarity of constitution. According to HUFELAND and FISCHER, the generative functions are early and powerfully manifested. They may be early and frequently, but certainly not powerfully exerted. LUGOL maintains that these functions in scrofulous subjects are below the average. |