. The diseases of children : medical and surgical. aroused. Lupous ulcers are the only other condition likely to be mistaken, and as Treatment of Tubercular Adenitis 241 these arc also tuberculous, the mistake is of little importance. The presenceof well-defined lupous tubercles is the distinguishing feature. Tuljerculous abscess of the skin, scrofuloderma, scrofulous gunmia,and strumous node, are the names applied to small tuberculous foci pro-bably in the lymphatics which, at first hard and solid, usually break down,though sometimes they are absorbed. These little swellings are oftenfound in
. The diseases of children : medical and surgical. aroused. Lupous ulcers are the only other condition likely to be mistaken, and as Treatment of Tubercular Adenitis 241 these arc also tuberculous, the mistake is of little importance. The presenceof well-defined lupous tubercles is the distinguishing feature. Tuljerculous abscess of the skin, scrofuloderma, scrofulous gunmia,and strumous node, are the names applied to small tuberculous foci pro-bably in the lymphatics which, at first hard and solid, usually break down,though sometimes they are absorbed. These little swellings are oftenfound in the thickness of the skin itself about the limbs, face, or the mischief spreads, and a large cold abscess or tuberculousulcer may result. Chronic tonsillar hypertrophy is considered by Treves to be almostpathognomonic of scrofula ; though very common in tubercular children, wethink it is otten met with in those who show no other signs of tuberculosis ;it mav occur during the first few months of life. Infantile leucorrhoea and. Fig. 46a. —Tubercular Ulceration of the Skin of the Foot, showing imperfectly formed scar-tissueoverlying the tuberculous granulations. A form of so-called Lupus hypertrophlcus. certain vulvar ulcers have been supposed to be tuberculous ; no doubt manycases of aural suppuration are so. Treatment.—The treatment of tuberculous adenitis consists at first incarefully removing all sources of irritation ; carious teeth, enlarged tonsils,patches of eczema, nasal catarrh, otorrhoea, chafed heels, and so on, shouldall receive attention according to the seat of the enlarged glands andthe source of the trouble. Next, the general measures of diet and healthalready mentioned must be carried out. As to the local treatment of theglands themselves, this must be managed according to the stages of thedisease, (i) In the early stage, before caseous foci have appeared, afterremoval of the source of irritation, the glands should be left quite alone, in
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