The Symptoms of Scrofula, Or King's Evil

Skin eruptions, particularly about the head and face; enlarged lymphatics, especially those of the neck; nasal catarrh; thickened upper lip; discharges from the ears; enlarged tonsils; inflammation of the eyelids; capricious appetite; disease of the joints and bones.

Scrofula is a disease common to all countries, and in some one of its many forms of manifestation it is probably more common than any other constitutional disorder. According to careful estimates, twenty-four per cent of the inhabitants of England are affected by this disease. The name scrofula is supposed to have been derived from the fact that the hog, sus scrofa, frequently presents enlarged lymphatic glands similar to those, observed in this affection, or perhaps from the fancied facial resemblance to the hog produced by the thickened glands and upper lip and enlarged neck which are exhibited in many cases of this disease. The first symptoms of the disease most frequently appear between the ages of five and seven years, though they may appear at any period of life from early infancy to old age. Not infrequently the disease appears in early childhood and disappears at puberty, though in many cases the period of puberty is marked by a decided increase in the activity of the disease, or the appearance of tuberculosis or consumption as a complication, or, perhaps, as another development of the constitutional affection. Until recent times, scrofula has been regarded as a blood disease, but modem researches have shown it to be a depraved condition of the nutritive processes, the exact character of which remains to be demonstrated. That it is closely allied to consumption and some other constitutional affections, is, however, clearly proven. Eruptions on the skin, especially about the face and head, are among the earliest symptoms of the disease. Severe nasal catarrh, accompanied with a profuse and thick discharge of an irritating character, is also one of the earlier symptoms in many cases. In consequence of the irritating effects of the catarrhal discharge, the nostrils and upper lip become much thickened and enlarged. Next appear enlarged lymphatic glands and enlargement of the throat, com ing on rapidly or by almost imperceptible degrees, most frequently involving the glands of the neck, sometimes those of other parts of the body. Discharge from the external ear, sore eyes, enlarged tonsils, and other morbid conditions mentioned under the head of symptoms, are all noticed in marked cases of the disease, so that it is by no means difficult to distinguish.

The term scrofula has, however, been much abused, not only by unprofessional people, but also by physicians, being charged with nearly all the ills to which human flesh is heir. It is the fashion with many persons, and not a few physicians, to attribute almost every obscure affection, especially those of children, to this disease. This fashion has, perhaps, arisen from the fact that, in different cases of this disease, disturbances are produced in nearly every organ and function of the body. In surgery especially, it has been the custom to attribute nearly all diseases, of the joints and bones which occur in childhood to scrofulous infection, but we believe it has been clearly shown by Dr. Sayre and other eminent observers, that in a large share of the so-called scrofulous diseases of the joints and bones, some mechanical injury has been the real starting-point of the disease. No doubt in many of these cases the injury might not have resulted in serious disease had it not been for the constitutional tendency to scrofula; and yet if the injury had not occurred, very likely the disease would not have been manifested in the particular manner observed, if, indeed, it had not remained dormant altogether. When the disease has been well marked in infancy, and does not disappear at puberty, it is very likely to continue, progressively increasing and gradually undermining the constitution. The majority of scrofulous persons finally die of consumption. As has been before remarked, there has been traced a distinct connection between these two diseases, although it should not be supposed that a scrofulous person must necessarily die of pulmonary disease.

Respecting the real nature of the disease, it should be said that the results of the most thorough researches upon the subject seem to show that it consists rather in a peculiar susceptibility of the system to the morbid influence of disease-producing agents from without. This abnormal vulnerability, as the morbid condition may be called, is especially manifested in the lymphatic glands, the affection of which, so characteristic of this disease, is supposed to arise from their absorption of irritating matters from the exterior of the body, as the reception of germs or the absorption of morbid matter from a diseased skin.