reated by constitutional
means.

Now scrofula is so insidious in its approach, and so distressing, and
often fatal, in its consequences, that the form of its commencement
ought to be known to all individuals who are liable to its attacks,
either from an hereditary tendency, or other causes. When it commences
in the glands about the neck, behind the ears, in the arm-pits, hams,
&c., it appears as hard and indolent swellings, somewhat moveable
under the skin, the colour of which is little changed; these tumours
or swellings gradually increase in number and size till they form one
large hard tumour, which often continues for a long time without
breaking, and when it does break it only discharges a thin _sanies_ or
watery humour from one or more small apertures. The disease even then
maintains its indolent character; the ulcerated parts become languid
and inactive, and the constitution begins to be affected; the patient
complains of weakness--there is a want of appetite; there are
frequently profuse night sweats, and feeling of languor and lassitude.

When from blows, bruises, sprains, or other causes, the joints of the
elbows, wrists, ankles, knees, fingers or toes, become affected, the
disease proceeds in the same slow manner, frequently destroying the
ligaments or tendons; the matter insinuating itself between the bones
till they become carious, and ultimately destroyed. What is commonly
termed _white swelling_ is of this description; it may continue for a
great length of time, and yet the patient may recover, excepting a
stiffness or contraction of the affected joint. I may also remark that
in Scrofulous constitutions there is frequently a thickness of the
upper lip, or swelling of the lower part of the nose; the eyes are
also peculiarly liable to attacks of scrofula, in which case the light
is remarkably offensive to those organs. The skin and muscles are
loose and flabby; and the mental powers of children so affected are
often prematurely displayed.

Having thus described the nature and symptoms of scrofula, I shall now
proceed to make some observations on the treatment of that disease.

The cure of scrofula is generally so difficult that it has become an
_opprobrium_ of surgery. There is not _one_ specific remedy for it;
even the medicines and applications which I am in the habit of
employing, will not be equally efficacious in persons of different
constitutions, nor in the same person at all times; and as such,