In that very rapid, and generally fatal form of phthisis, described as acute pulmonary tuberculosis, or tubercular pneumonia, the symptoms correspond to Phosphorus. Iodine or Hepar-sulphur.

Phosphorus in health produces emaciation, glandular affections, scrofula, hectic fever, night-sweat, falling off of the hair, dry and burning throat, hawking of mucus, chronic looseness of the bowels, aphonia, cough with rawness and hoarseness, cough with purulent expectoration, also of blood or tenacious mucus, heavy fullness and tightness of the chest, palpitation of the heart, pneumonia, phthisis. TREATMENT.-Our principal remedies in this disease are, Phosphorus, Iodine, Kali-hyd., Kali-bichrom., Bryonia, Kali-phosphite, Sanguinaria, Carbo-veg., Hepar-sulph., Calcarea-carb., Ammoniacarb., Senega, Mercurius-hyd., Drosera, Belladonna.

We have witnessed the best results from the first and second attenuations of these medicines.

Prussiate of Potash.-We find this remedy strongly recommended for phthisical catarrh and also in pulmonary tuberculosis attended with "excessive cough and expectoration; inordinate action of the heart and hectic fever." (Dr. Dutcher, Med. Reporter, Vol. VIII., p. 408. Lancet, Cincinnati, Feb. 1362. Dr. Smart, Maine Amer. Jour. Med. Sci. No. 13.)

Permanganate of Potash.-This is a new remedy not yet well proved. It is the best of all known disinfectants and is believed to possess the depurative and other useful properties of other preparations of Potassa.

GENUS VI.-STRUMA.

1. SCROFULA.-KING'S EVIL.

This disease was described by the Greeks under the appellation Koipales from xoipos, hog, and by the Latins scrophules, (from scropha, female swine.) This name had its origin in the well-known fact, that scrofula was a disease peculiar to the above-named animal.

The blood of scrofulous subjects has been found to differ materially from that of healthy individuals. In the former, there is a superabundance of serum and a deficiency of the fibrinous portion, and the solids which are generated from this blood are, in consequence, lax, feeble, and incapable of resisting exposure, fatigue and disease.

Scrofula is for the most part hereditary, but the physician is frequently presented with well-marked cases of the acquired disease. The circumstances which favor the formation of an original scrofulous dyscrasia, are: cold and damp habitations, want of healthy and nutritious food, constant confinement at labor in close and ill-ventilated

rooms, and finally, the use of pork in all its forms, as a principal article of food. Respecting this last cause, we submit to a few remarks: Since the time of Moses, a large portion of mankind have looked upon swine as an impure animal and unfit for food. Its impurity consists of a disorder of a purely scrofulous character which is inherent in this animal and peculiar to it, and is constantly being developed, especially during confinement and subjection to the ordinary modes of feeding.

Recent observations show that the new disease called trichinasis originates in the use of flesh of hogs, which, though appearing healthy, have in their flesh the germs of the living flesh-worms or trichina. When pork containing them is taken into the stomach the calcareous capsule which invests the parasite is digested: the fleshworms are set free; and in one day or less they begin to multiply in vast numbers. They then irritate the mucous intestinal membrane, pierce the walls of the intestines and ultimately make their way to the muscular fibres which they eat and destroy. On one occasion in Germany all persons who ate of the sausages prepared from a single hog, "died the slow death of exhaustion from nervous irritation, fever, and loss of muscular power. No case was benefitted by medical treatment."

It is absurd to argue that flesh contaminated with the scrofulous miasm, can not communicate to the healthy body, after digestion, its morbid particles. The poison pervades every atom of the affected flesh, and no washing or digestion can destroy or banish the noxious quality.

Scrofula is most common in temperate latitudes, where the changes of temperature are abrupt, and where the atmosphere is much ofthe time loaded with moisture. The miasm operates upon almost every structure; glands, skin, ligaments, membranes, muscles, and bones, all succumb to its attacks.

Diagnosis. The signs which are supposed to indicate the scrofulous habit, are: precocity of intellect; blonde hair; light complexion; blue eyes: soft and delicate cheeks; lips thick and red; "frequent swelling of the upper lip and nose," edges of the eyelids red and prone to inflammation; scurf and eruptions on the scalp; large head; sensitiveness to cold; ends of the fingers blunt instead of tapering; muscles soft and flabby; morbid sexual propensities. These marks are generally supposed to characterize the scrofulous habit, but it has occurred to us to witness far more cases of scrofula in individuals the very opposite of this description; but whether or not this is the result of accident or whether an erroneous impression has prevailed upon the subject we will not now attempt to decide. Amongst the most common and simple manifestations of scrofula may be ranked, glandular swellings of the neck.

These enlargements may occur very frequently during childhood, in the form of what are vulgarly termed "kernels," on different parts of the neck. They are excited into activity by taking cold, by currents of air upon the neck, by measles, scarlatina, and whooping cough, and either remain for a long time stationary and inactive, or run on to more violent inflammation and suppuration. These swellings sometimes attain a very large size, involving most of the glands of the neck, and remain in this condition for many years. More frequently, however, owing to injudicious allopathic treatment, the swellings are dispersed by external applications, the malady is forced to embody itself upon the lungs, and a fatal phthisis pulmonalis is the result.

The next form of scrofula to which we shall call attention, is that in which the joints become affected. The most important of these affections are the

2. WHITE SWELLING. (ARTHROCACE,) AND THE HIP-DISEASE.

The approach of these maladies is commonly gradual and insidious. Occasional pains are complained of in the diseased joint, after exercise; the motions of the limb gradually become impaired, and vague pains are experienced in the neighboring joints, which induce the belief that healthy parts are the seat of the inflammation. As the disease advances, the ligaments, cartilages, and other structures composing the joint become so much thickened by the inflammatory action, that the limb after a time becomes stiff, and the joint immovable. In some instances the inflammation is arrested at this point, the suppurative process is prevented, and a recovery by what is called anchylosis, takes place. But in the majority of cases the disorder proceeds on to suppuration, the whole structure of the joint becomes involved in this action, a profuse discharge of matter takes place from the part, constitutional disturbance is manifest in the form of emaciation, debility, night-sweats, and other symptoms of hectic fever, and the patient soon succumbs. Scrofulous affections of the joints are very difficult of detection in their early stages. The pains are so vague and indefinite, as scarcely to attract attention: there is little or no swelling or discoloration over the disordered part; and there is no derangement of the general health which indicates that the organism is suffering under a serious malady. It is for this reason that the disease is allowed to make serious progress before its true nature is suspected. Like its near relative, the consumption, it strikes silently, but deeply and fatally. See p. 176.

Another scrofulous disease, common in infancy, is known as

3. STRUMOUS DISEASE OF THE MESENTERIC GLANDS.

The characteristic signs of this malady, are: Wasting of the limbs, pale and alternated appearance of the skin, tumefaction and tenderness of the abdomen, sunken eyes; irregular state of the bowels, variable appetite, passage of partially digested food, general irritability. After the disorder is seated, the process of absorption is suspended, so that only a small amount of nutriment arrives at the blood, and the sufferer is soon reduced to that condition which medical men recognize as marasmus. See Vol. I., p. 884, 890.

Although the mesenteric glands sometimes suppurate, yet much more frequently the victims to mesenteric disease die from actual starvation.

The only hope of cure in these cases is in a detection of the malady at its onset, and the services of a thoroughly competent physician.

In a previous chapter we have already treated of another, and perhaps the most dangerous form of scrofula, under the head of phthisis pulmonalis, or tubercular consumption, to which we refer the reader.

There are other scrofulous affections of the different parts of the organism, as the brain, the liver, the skin, the spleen, and the spinal marrow. The Index under proper heads may be consulted with reference to this subject.

Hahnemann has included scrofula as a form of psora, but evidently on insufficient grounds. Psora is contagious, scrofula non-contagious. The matter of psoric eruption is capable of communicating its similitude by inoculation; that of scrofula is innocuous when inoculated. Psora, in its specific development upon the skin, assumes the appearance of a vesicular eruption; scrofula makes its appearance in the form of extensive ulcers, abscesses, &c. The psoric miasm exercises its specific affinity upon the skin; the scrofulous miasm upon the glandular system. Psora is no respecter of persons, but attacks all constitutions, temperaments, and organizations alike; scrofola is supposed to select its subjects from those who are daintily formed, and possess peculiarities of organization; psora is readily cured by antipsorics; scrofula always requires much time, and is often absolutely incurable by any course of treatment. Psora can not be artificially acquired, by any particular mode of life, or any particular food: with scrofula it is the reverse. Finally, the development of the psoric miasm, when it is clear and apparent, is always specific and uniform, viz: in the vesicular eruptions of a peculiar appearance upon the surface, and the malady is unequivocally contagious; while the develop ment of the scrofulous miasm is subject to very great variations, but for the most part attacking the glands, rather than the skin, and decidedly non-contagious.

Causes. The scrofulous habit is, in most instances, inherited. In its hereditary subjects we may notice from birth radical unsoundness of constitution, an irritability, sensitiveness to slight exposures, proneness to catarrhal difficulties, and an inability to resist diseases, which is non-apparent in healthy children. The acquired scrofulous habit is generally amongst the poor, who are ill-fed, clad, and housed. We have before alluded to the causes which especially induce this variety of the disease; they are also the chief exciting influences of the hereditary dyscrasia. Atmospheric vicissitudes, abuse of stimulants, venereal excesses, masturbation, intestinal irritation, excessive mental and physical occupation, scarlatina, measles, abuse of mercury, iodine and other drugs which unduly stimulate the glandular system, also excite the latent disorder.

TREATMENT.-It has been observed that scrofulous persons are peculiarly sensitive to cold, and that abrupt changes from heat to cold, in a moist region, are especially calculated to call into active operation the latent malady. For this reason it behooves those who are liable to this affection, whether by hereditary or acquired predisposition, to dwell, if possible, in a warm and equable climate. When the lungs become affected, this course will often be necessary in order to save life. In all scrofulous diseases, too much stress can not well be laid upon the importance of a mild, dry, and uniform temperature.

The food of scrofulous subjects should always be of the most nutritious character, in order that a due proportion of fibrine may be introduced into the blood. Fresh meats, like beef, mutton, venison, fowls, and veal should constitute the principle articles of food; and bread, rice and other farinaceous substances should be made to take the place of watery and succulent vegetables. Porter, ale, and light wines may also be used moderately with advantage.

Much exercise in the open air is also essential. In taking exercise, it is of the utmost importance that the mind should be agreeably occupied, for if we walk or ride as a task, we shall obtain very little

benefit.

Bathing, both in fresh and salt water, is also a means of securing a healthy action of the skin, and of imparting tone and vigor to the whole system.

The clothing should always be adapted to the season, and in temperate and cold latitudes we strongly advise the buckskin wrapper to be worn over thin linen, silk, or Canton-flannel under-shirt. We commend the use of these garments during the winter from personal experience. Vol. I., p. 197.

The remedies most deserving of confidence in the treatment of scrofula, in its various forms, are: Sulphur, Hepar-sulph., Mercurius, Iodine, Baryta, Dulcamara, Conium, Belladonna, Lycopodium, Sepia,