Scrophulous tumors and ulcers more readily disappear during the winter, and return again on the approach of summer; but this is by no means an universal law of the disease.
It is likewise observable, that swellings of the glands are very apt to subside pretty rapidly in one place, and appear equally quickly in some other glands, in the vicinity of these originally affected. Ulcers likewise frequently heal upon the appearance of the disease in other parts.
When the joints become affected, the cartilages swell, and the quantity of the lubricating matter is increased; the tendons are surrounded with a glairy matter, like the white of egg; and, lastly, the bone becomes enlarged. These effects are attended with stiffness and pain in the joint, which is sometimes intolerable, especially during the night, and confined to a single spot, from the disease residing chiefly there. In some time after this, small abscesses form in different parts of the inflamed joint, which gives it a spongy elastic feel. These bursting into one another, form a larger cavity, which communicates with the articulating surface of the bones, and reaches to the skin, through which a fluctuation may be felt. This abscess at last bursts, and discharges a curdy matter. Long before this happens, the bone generally ulcerates, and becomes rough. This disease is uniformly attended with hectic, which terminates the patient’s misery.
Not unfrequently, in scrophulous people, eruptions appear on different parts of the body, especially on the face, which is covered with pustules of a dark red colour, suppurating slowly, and sometimes never.
At other times, we find incysted tumors on different parts of the body. These may appear in any habit; but when they occur in scrophulous people, they assume the specific action of the constitution; in which case, instead of containing an uniform fluid, like thin jelly, of a yellowish colour, as the simple incysted tumor does, they are filled with a thick curdy purulent-looking matter, or with serum, containing white flakes, little lumps, of a white substance.
All the causes capable of inducing simple inflammation will of consequence induce the scrophulous inflammation, provided that the inflammation be not induced in such a way, and in such organs as make it heal rapidly, as will be afterwards noticed. Specific inflammation is likewise modified when it takes place in a scrophulous constitution, and is much more tedious in its cure. This is evidently seen in the small pox and venereal disease.
Although the effects of a scrophulous constitution, in modifying action, be most distinctly observed in the inflammatory action, yet it does not operate exclusively on this; on the contrary, we find, that typhus fever, and some other actions, which may exist without any perfect local inflammation, are, cæteris paribus, more violent in scrophulous habits than in others.
This constitution is more easily acted on by certain agents, particularly such as tend to induce inflammation, than healthy constitutions in the same circumstances. It would likewise appear, that, on the contrary, there are other agents which operate with more difficulty. It is in general observable, that scrophulous people are less easily affected with mercury. On a few, indeed, it operates readily; but, when we attend to the general habitude of these people, we must consider the aptitude of some individuals to assume the mercurial action to depend on some peculiarity of constitution, unconnected with the scrophulous condition.