Clinical lectures: on scrofulous neck, by T.C. Allbutt; and on the surgery of scrofulous glands / / by T.P. Teale.

  • Thomas Clifford Allbutt
Date:
1885
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Licence: Public Domain Mark

Credit: Clinical lectures: on scrofulous neck, by T.C. Allbutt; and on the surgery of scrofulous glands / / by T.P. Teale. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    the enlarged cervical glands of scrofula, lymph-adenoma, and of rickets, and some points of distinction then severally noted may be summed up in scrofula as features of chronic inflammation. In it not only do they inflame with a slow destructive process within, but a capsular inflammation extends from gland to gland, matting them together; this, in its turn, propagates inflammation to the cellular tissues and the skin; glands, subcutaneous tissues and cutaneous becoming involved in a general process of low inflammation. We have then chronic caseating adenitis, chronic suppurative cellulitis, and chronic suppurative dermatitis. These inflam- mations being, as I say, only partially adhesive in nature, and largely necrobiotic, lead not only to the softening of the glands themselves, but to the formation of cellular abscesses, more or less sinuous in distribution, between and around the glandu- lar necrosis. As the glands soften and burst, then a system of channels and pockets, of cells and passages, is formed, some pockets lying deep where glands lay deep under a muscle, such as the sterno-cleido-mastoid, others lying more super- ficially. From the lower to the upper source channels of communication may be established, or some of the deeper glands may be imprisoned in surrounding adhesions, and their products of degeneration have no outlet. Some glands are partially hyperplastic, with but nodules of caseation; others have softened in part, are caseated in part, and are simply hyperplastic in part. Others have wholly softened, and are represented by pockets of corrupt pus. As the skin is in- volved and becomes reddened and tender, the outward deter- mination of the morbid products is hastened, the skin gives way, and cellular or glandular abscesses are emptied gradually as the establishment and the drainage of sinuses may permit. Nature thus works some kind of cure, sometimes a perfect cure, sometimes a very partial one; as from deeper glands or cellular abscesses no free issue to the light may ever be established. Some parts of the mass, and these probably the remoter, and therefore the more dangerous, may remain unemptied, and abide in their breaches as means of offence in time to come. Nature’s cure is thus seen to be of a
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