Should tubercle, however, have been deposited in the glands, or other part affected, as this must be eliminated before a cure can take place, the result is more tedious and uncertain. In such cases, contrary to what often happens in the non-tuberculous cases, the swellings, whether glandular or otherwise, can very seldom be resolved; and a long process of suppurative ulceration is necessary, before the patient can recover: but even in these cases, much good is often done by preventing the further deposition, by sustaining the strength during the discharging process, and by determining healthy granulation and cicatrization afterwards.

Scrofulous Ophthalmia. Cod-liver oil is among the most efficient remedies in this obstinate affection, conjoined with the local application of nitrate of silver to any existing ulcers of the cornea, or other part of the conjunctival surface. The oil has been recommended also as a local application in these cases; but I have no experience of its use in this way.

Cutaneous Eruptions. When these are associated with scrofulous cachexia, they often yield to cod-liver oil very happily. It is more especially in the impetiginous and ecthymatous affections, and in rupia, that good may be expected; but eczema and pemphigus are sometimes similarly associated, and similarly benefited; and, in that most obstinate disease denominated lupus, this is among the most efficient remedies. In all the cutaneous eruptions, however, it is more the condition of the system that must be considered, in relation to the use of this remedy, than the particular character of the eruption itself. In these, as in ophthalmia, the oil has been recommended locally, as well as by the stomach.

Scrofulous Disease of the Bones and Joints. No other single remedy is probably so efficient as cod-liver oil in this form of scrofula. In swellings of the hip, knee, and other joints, and in disease of the bones of the spine, extremities, cranium, etc., with or without abscess or caries; though the cure is often protracted; though more or less of deformity may follow from the organic mischief done; and though death will sometimes take place from exhaustion, when the remedy is applied too late, or even, from the great amount of disease, notwithstanding its employment, yet there are few practitioners, I presume, by whom the oil has been tried, who do not consider it more effective than any other remedy previously used, and who have not found these affections much more manageable by its means than they had been before. As in scrofulous swellings of the glands, there may here also be tuberculous deposition, which adds greatly to the difficulties and dangers of the case; though, happily, it is comparatively rare.

Tabes Mesenterica, or Swelling of the Mesenteric Glands. In cachectic children, there is often much abdominal distension with more or less hardness, sometimes peritoneal effusion and enlarged liver, great emaciation, pallor, and debility, which have generally been ascribed to scrofulous disease of the mesenteric glands. Some of these cases yield quickly and most happily to cod-liver oil, and co-operating treatment; while others are more or less obstinate, and not a few end fatally. This difference of result may be readily accounted for. Some of the cases depend essentially on tubercles, either scattered in the peritoneum or beneath it, or deposited in the mesenteric glands, which they enlarge and harden, or diffused throughout the whole abdomen, causing peritoneal inflammation, which sometimes agglutinates all the viscera together. These are, in general, essentially incurable, except, perhaps, in a few instances, in which the tubercle, originally small in amount, may make its way, through ulceration, into the bowels, or possibly undergo absorption or degeneration. But not unfrequently, also, there are no tubercles; the Scrofulous affection of the liver and mesenteric glands being simply of the characteristic inflammatory character; and cases of this kind very often end favourably. The latter cases are most common in infancy, the former in children from two to ten; and, when adults are affected, it is most commonly in the tuberculous form.

Disease of the Bronchial Glands. The same remarks arc applicable to these as to the mesenteric glands. In scrofulous cases without tubercle, a cure may be expected; in the tuberculous, the result is more doubts ful, though there is reason to believe that the tubercle is sometimes eliminated through the bronchia, and that recoveries take place; but in these cases the danger arises, not so much from the tubercle in the glands, as from that deposited also in the lungs.

Disease in the Stomach and Bowels. Diarrhoea, with ulceration of the bowels, is a not unfrequent attendant on tuberculous affections. Sometimes this depends on tubercles in the substance of the bowels, leaving ulcers as they are discharged; in other instances, it has been found to be unconnected with tubercles. There is reason to believe that scrofulous inflammation sometimes attacks especially the mucous membranes, showing, when it does so, a tendency to affect the follicles, and to result in ulceration of these structures. The gastric mucous membrane may be thus attacked, as well as the intestinal, though it is much more rarely tuberculous than the latter. In these cases, whether tuberculous or not, cod-liver oil is indicated whenever it can be supported by the stomach. Even when tuberculous, there may be hope of a favourable result, if the affection is confined to this part.

Chronic Bronchitis, Laryngitis, Angina, Ozaena, etc. The remarks made in the last paragraph in relation to the mucous membrane of the alimentary canal, are applicable also to that of the respiratory passages, as well as of the pharynx, though tuberculization is uncommon. Hence, in chronic inflammation of the "nostrils or ozaema, chronic angina, and chronic laryngitis and bronchitis, when connected with the scrofulous diathesis, cod-liver oil should be tried.