Chapter 13 - Diseases of the General System and Miscellaneous Diseases
Introduction to Diseases of the General System and Miscellaneous Diseases
Blood Aneamia
Typhoid Fever
Prevention of Typhoid
Bilious Remittent Fever
Congestive Fever
Fever and Ague
Yellow Fever
Purple Disease
Bubonic Plague

13.16 Scrofula

Scrofula, or King's Evil.

THE word scrofula is derived from the word scrofa, meaning swine, and was used in this connection by early students of medicine because people affected with this trouble resembled hogs. The swelling is due to a greater or less enlargement of the glands in that region which are very numerous. It has been said to be caused by many diseases, but since the discovery of Professor Koch it is well known that the disease is identical with tuberculosis, or consumption, but in this trouble the disease is in a very mild form and if the germ does not break into the air passages and infect the lungs or throat and other parts of the body, the danger is very small. The action of the glands in the throat and throughout the body is probably to take from the circulation all poisons that it is possible to remove. This action is similar to the action of the kidneys which remove the poisons from the blood and glands in the intestines which remove the valuable elements from the food which has been taken into the body. Other glands beside these, which are known as cervical glands, are the glands in the region between the heart and lung, known as the mediastinal, those of the mesentery or fatapron which are in the abdomen to protect the bowels, and those back of the lining of the bowels known as the retroperitoneal. These glands can be affected through the tonsils, as in sore throat, bad teeth or ulcerated gums or other infections, by the lung in consumption, of the pleura of the heart and even through the bowels.

Symptoms. Their presence can be known by the presence of kernels just beneath the skin at the angle of the jaw and in the region of the windpipe and in the other regions that could only be suspected or found after careful examination. The patients are usually thin, pale, with prominent veins, small bones, large and staring eyes and hectic flush on the cheeks. They are especially liable to be feverish at night. Their circulation is poor, as shown by cold feet and hands, and very likely have some skin trouble almost all of the time, such as a rash or many pimples about the scalp, face and ears. The eyes may become affected, the hairs of the lash drop out and discharge be present.

Treatment. The treatment of the gland itself should be surgical if the presence of pus is shown by sudden tenderness appearing over it. Under perfect aseptic conditions, which is described under surgery, the gland should be opened., the pus allowed to drain out, the inside scraped and an antiseptic dressing continually kept on until the matter has all drained away.
The constitutional treatment is of great importance, as in many cases the glands can be prevented from breaking down and in others can be made smaller. Iodine in the form of the tincture may be painted on with a camel's hair brush, or better still, in the form of iodine vasogen, which is a preparation of iodine and an easily absorbed ointment, or petrogen, very similar to the latter may be rubbed into the glands in small amounts twice a day. Some preparation of iodine internally is also indicated. Iodide of potash in 5 grain doses well diluted three times a day, or a preparation called soluble iodine in 2 to 5 drop doses three times a day, or the syrup of iodide of iron in 5 drop doses given in milk. Great attention should be paid to the improvement of the general health. The diet must be nourishing, large in amount, and forced on the patient. There cannot be too much milk, cream, eggs, meats, potatoes and easily digested vegetables given; hygienic precaution must be taken, baths, exercise, sleep, place of rest, good sanitation and pure air must all be taken into account. Cod liver oil, either as the pure oil or as some of the various emulsions, tasteless, if the stomach repels, or the stronger preparation may be given.

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