Boyleston prize dissertations for the years 1838 and 1839 : on scrofula, rheumatism, and erysipelatous inflammation / by Edward Warren.

  • Warren, Edward.
Date:
1840
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Licence: Public Domain Mark

Credit: Boyleston prize dissertations for the years 1838 and 1839 : on scrofula, rheumatism, and erysipelatous inflammation / by Edward Warren. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    the powers of digestion impaired. A scrofulous person who had a healthy appetite and digested and assimilated his food perfectly well, would bean anomaly; nay more, ho would be a contradiction, for where these functions were well performed, the patient could not be scrofulous. But it may be said, scrofula is the cause of dyspepsia, not the effect of it. The debility of the system pre^nts perfect digestion, and the digestive organs become involved through the means of other organs, the heart, lungs, etc. However this may be, the imperfect performance of the digestive function must keep up and aggravate the cachexia. As long as no organic lesion has taken place,—as long as there is only debility of the organs, if we can but give vigour to the digestive powers, we may give strength to the whole system. We may now return to the consideration of the theories of the disease, and particularly to the third which we proposed to discuss ; namely, the preponderance of the white fluids over the red. Sir James Clark, in his work on climate, states his belief that a small heart is the frequent predisposing cause of consumption, and in his more recent work, he notices the serous condition of the blood, and its deficiency of fibrine, which has been pointed out by Andral. This condition of the blood has given rise to the views which are briefly stated by Dr. Maunsell, who attributes scrofula to the pre- ponderance of the lymphatic over the arterial system. The strength of the individual, his vital powers, and capacity of resisting disease, he remarks, are in the reverse proportion to this preponderance, of the white tissues. It is well known that individuals of sanguine constitution and full of red blood, are the most robust, and that those of a pale, white countenance, are uniformly feeble and unhealthy. Whatever favours the developement of this preponderance of the lymphatic system, is, therefore, a cause of scrofula. Confinement in a damp situation, with a diminution of light and fresh air, is be- lieved by those who hold this opinion to be a principal cause of scrofula. Neither of these three theories is irreconcileable with the other. Debility from birth is not in all cases a sufficient cause of scrofula. The preponderance of the white tissues is to be attri- buted to the want of fibrine, and colouring matter in the blood, which may be considered as arising- from imperfect digestion : for let the action of the heart and lungs be healthy, still if the stomach and its dependent organs do not perform their functions properly, the blood will not be perfectly formed, and will be deficient in its proper qualities. That scrofulous children are apt to be of small size, or, if of na- tural size, with organs small, thin, loose in texture, with feeble capacities for the discharge of their functions, is naturally to be in- ferred from what has been said of the causes of congenital predis- position—to wit: whatever causes may interfere with the develope- ment and growth of the foetus. The main difference between the two first mentioned theories is, therefore, that those who hold the