ratio, in proportion as the simple inflammation and ulceration of
the same parts, and in the same circumstances, is tedious. Thus, a
deep wound in a healthy person is pretty long of healing; but, in a
scrophulous person, it is much more so. Simple inflammation of a gland
is still more tedious than the same extent of inflammation in cellular
substance; and scrophulous inflammation is still longer of running its
progress; but the proportion betwixt the duration of the scrophulous
inflammation, in these two cases, is not exactly as the duration of
the simple inflammation of the two, compared with each other, but is in
an increased ratio.
When scrophulous inflammation is excited in the vicinity of a part
already possessing this action, it occasionally removes the action from
that part, in the same way as inducing simple inflammation by a blister
in one part cures the same disease in another part in the vicinity. It
was an observation of this fact which made it be considered as part
of the description of scrophulous tumors and ulcers, that they not
unfrequently disappear in one place, whilst they show themselves in
another; but, in every instance, this disappearance is an effect, and
not a cause; for we uniformly observe, that, before it takes place, the
new part has begun to inflame or swell.
With regard to the diagnosis of scrophula, it is impossible to say
any thing satisfactory; because, as long as the inflammation remains
trifling, and the skin sound, it is very difficult, if not impossible,
to distinguish a scrophulous swelling from any other of a different
kind. Much assistance has been supposed to be derived from the
situation of the tumors, most of those which appear in the neck being
considered as scrophulous; but this is certainly a false principle.
From the same method of reasoning, most swellings in the groin have
been considered as venereal, whilst many are of a very different
nature, and not a few scrophulous. The best plan is to attend to the
appearance of the body in general, and to the presence or absence of
the sign of a scrophulous system; next, whether any ulceration be
present, by the absorption of matter, from which these swellings may
have been produced. If these be present in a system not possessing the
marks of scrophula, the probability of the tumor being scrophulous
is less; but, if the system be evidently scrophulous, then we must
consider, whether the glands, originally swelled by the absorption of
matter, have assumed the slow inflammation of a scrophulous nature,
or have assumed a different species of inflammation, dependent upon
the peculiarity of the matter; for they can scarcely be supposed to
be simply inflamed. Scrophulous swellings of the lymphatic glands
are generally soft and doughy, and frequently give the feel of
containing a fluid long before suppuration has taken place. They are
at first free from pain, and, in mild cases, even toward the end, the
pain is inconsiderable.
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