Scrofuloderma This disease does not require to be dealt with very elaborately. "It is scrofula of the skin," and only a part of the general diathetic condition, which is evidenced by the ordinary signs of struma in greater or less degree of expression. As regards the skin, scrofula is generally characterized by the appearance at the outset of indolent, dull red, soft, tubercular formations, that rapidly suppurate, and are soon covered over with darkish scabs, from beneath which oozes an unhealthy pus. Ulceration to a greater or less degree takes place, with the formation of exuberant granulations at times, and the healing is accompanied by distinct scarring. The whole disease is of the most chronic character. One can scarcely mistake the strumous ulceration for any other disease; it may spread and cover a large extent of surface, and in this case the ulcerated surface is half covered by darkish irregular crusts, whilst the ulcers discharge a thin disagreeable dark pus, and granulations are flabby and pallid, bleeding freely on being touched; the edges of the ulcers are livid, and various attempts at repair are made. The mucous surfaces of the nose or eye may be inflamed and slightly ulcerated and onychia may be present. There are old scars of former strumous disease, and the whole aspect of the patient is a sufficient tell-tale of the disease. The old school advises the use of cod-liver oil, iodide or iron, the phosphates of lime and iron, and locally an astringent ointment of tannin; or acetate of lead; or mercurial plaster; or iodide of lead ointment to the indolent ulcerated surface. Residence at the seaside is also advisable. These patients should be allowed an abundance of fresh air, plenty of outdoor exercise, and a generous diet. When the ulcers have formed, dress them with the iodide of starch paste. |
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