. A practical treatise on medical diagnosis for students and physicians . in cases ofrheumatic endocarditis. They are common in the young. They may SYPHILITIC NODES. 237 occur iudepeudently of the articular symptoms. They may be present inlarge numbers, and vary in size from that of a small shot to that of alarge pea. They are of fibrous structure, and are attached to the ten-dons and fasciiv, particularly on the fingers, hands, and wrists, but maybe found over the elbows, knees, scapula^, and spines of the vertebra\ Syphilitic Nodes. Gummata arc observed during the tertiary periodof syphilis.
. A practical treatise on medical diagnosis for students and physicians . in cases ofrheumatic endocarditis. They are common in the young. They may SYPHILITIC NODES. 237 occur iudepeudently of the articular symptoms. They may be present inlarge numbers, and vary in size from that of a small shot to that of alarge pea. They are of fibrous structure, and are attached to the ten-dons and fasciiv, particularly on the fingers, hands, and wrists, but maybe found over the elbows, knees, scapula^, and spines of the vertebra\ Syphilitic Nodes. Gummata arc observed during the tertiary periodof syphilis. They must not be confounded with the enlarged are attached to the skin, and may from time to time ulcerate. Theymay be seen on the back or buttocks; less frequently on other parts ofthe body. CHAPTER XXV. EXAMINATION OF THE LYMPHATIC GLANDS. Enlargement of the lymphatic glands may be general or local. Theformer points to a systemic infection, as syphilis or glandular fever, to ablood disease, as leukaemia, or to malignant disease. Enlargement of a Fig. Showiug location of lymphatic glands. single gland or group of glands indicates an infection or carcinoma in thearea drained by the affected glands. Lymphatism. Poor physical development has recently been observedAvith lymphatic over-growth, or the consfifutio lymphatica. In this statesudden death is liable to occur. It is believed that one of the causes of 238 GENERAL ENLARGEMENT OF THE LYMPHATIC GLANDS. 239 death from anaesthesia and from the antitoxin of diphtheria is a conditionknown as status lymphaticus. Hyperplasia of the lymphatic glands, thespleen, the thymus, and the bone-marrow constitutes the condition, andrarely is found in patients with rhachitis, and in hypoplasia of the heartand aorta. The internal lym])hatic glands and the lymphatic structuresof the alimentary tract are more frequently involved than the moresuperficial glands. With this over-growth of lymph tissue the spleen andthe thymus gland
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