The skin, particularly that of the face, becomes, in very many cases,
affected either primarily or secondarily with scrofulous ulceration,
which commonly extends to the neighbouring textures. The disease has
sometimes been mistaken for cancer, and other affections of a malignant
nature, and has received various names accordingly. The integuments
in the neighbourhood of the ulcer are of a purple hue, and become
undermined, from the extension of the disease in the subjacent cellular
tissue. The discharge is thin and gleety—the sore is of an unhealthy
and debilitated character, and makes but little attempt at reparation;
its surface is covered by a viscid fluid, and sloughing occasionally
occurs in consequence of the extreme debility of the parts. Numerous
sinuses frequently extend in a superficial direction, and render the
cure more tedious and complicated.
Those of a scrofulous constitution are most liable to be affected with
caries, softening, and other diseases of the bones and their coverings;
these, however, will afterwards be treated of, along with ulceration
of cartilages, diseases of ligaments and synovial membranes, lumbar
abscess, &c.; all of which affections, in the plurality of instances,
are connected with the strumous diathesis.
In the treatment of abscesses, the principal indications are, to remove
any degree of inflammatory action with which the surrounding parts may
be affected—to keep the part moist, clean, and at rest—to remove all
source of local irritation—to promote and accelerate the progress of
the matter to the surface—and, lastly, to give it free vent; for though
it sometimes happens that collections of purulent matter disappear,
still the occurrence is so rare, that to treat abscess generally when
in an advanced stage with the expectation of resolution would be highly
injudicious. By blistering and pressure, however, tumours containing a
small quantity of purulent fluid can occasionally be discussed. Warm
fomentations afford great relief, especially at the commencement, when
there still remains a considerable degree of surrounding inflammation.
These may be either what are termed anodyne, or not; in general,
fomentation with chamomile flowers or hops, contained in a woollen
bag, and wrung out of warm water, will be found the most convenient
and efficient, and is well entitled to the term anodyne, which is
usually applied to others of a complicated, and not more efficacious,
character. Poultices are of material service, particularly when the
collection is advancing to maturation; and their composition is of
little importance, provided they are moist, warm, and soft. Stale
bread soaked with hot water, or an equal quantity of grated bread and
linseed meal, (if not adulterated with mustard, as is sometimes the
case,) mixed with sufficient quantity of boiling water, form excellent
and soothing cataplasms. Their use, however, may be persevered in too
long; for, after an abscess has given way, the suppuration may be
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