. A practical treatise on medical diagnosis for students and physicians . oedema of the arm. 240 EXAMINATION OF THE LYMPHATIC GLANDS. Enlargement of the glands In the groin, if acute with inflammation,may result from the virus of chancroid or gonorrhoea. When enlargedfrom the virus of syphilis, they arc hard and painless. It must not beforgotten thai skin affections and infections of the extremities, as that ingrown toenail, cause enlargement of these glands. The enlargementmay, from pressure on the vein, cause (edema of the leg. Scars at the site of former glands point to tuberculous d
. A practical treatise on medical diagnosis for students and physicians . oedema of the arm. 240 EXAMINATION OF THE LYMPHATIC GLANDS. Enlargement of the glands In the groin, if acute with inflammation,may result from the virus of chancroid or gonorrhoea. When enlargedfrom the virus of syphilis, they arc hard and painless. It must not beforgotten thai skin affections and infections of the extremities, as that ingrown toenail, cause enlargement of these glands. The enlargementmay, from pressure on the vein, cause (edema of the leg. Scars at the site of former glands point to tuberculous destruction orformer bubo. The Supraclavicular Glands. The enlarged and indurated glandsmay cause pressure-symptoms. The only local enlargement that is ofdiagnostic significance is that which is seen above the clavicle on theleft side; ii often points to carcinoma of the stomach, as Troisier Indeed, there arc cases of this disease in which only the gen-eral symptoms of carcinoma are present. Local symptoms are wanting Fig. 37. Sublingual-Submaxillary Gland. Superficial CervicalLymphatic Showing lymphatic glands of head and neck. by which to make out the locality of the cancer. Enlarged glands abovethe clavicle are a fair indication that the stomach is the seat of thedisease. The enlargement is probably due to transmission of the infec-tious material along the thoracic duct and its lodgement in the associatedglands. The Cervical and Submaxillary Glands. Enlargement of the sub-maxillary and cervical glands points to some infection of the mouth andthroat or of the jaw and teeth. They are often the seat of nodularenlargement in actinomycosis. (See collar in adenitis of leukasmia.) Acute enlargement of the upper deep cervical glands occurs in diph-theria, follicular and suppurative tonsillitis, and in many of the eruptivefevers. (Jbronic enlargement may be tuberculous if the glands are mattedtogether and tend to suppurate; syphilitic if small and hard ; in Hodg-1 Bulleti
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