A system of surgery . vicinityof the main ulcer may be produced. It is the insidious under-mining of the integument, and the absence of a protecting barrier ofsound lymph, which give the main features to the tuberculous ulcer. The scars that result from this form of ulceration vary, and aremost commonly drawn attention to when situated in the neck. Insome instances the resulting cicatrix is surprisingly soft, simple, andpliant. In other instances the scar left is irregular, hard, bossy,raised, and unsightly, by reason of its purple colour. Now and then,as the result of the undermining and irre
A system of surgery . vicinityof the main ulcer may be produced. It is the insidious under-mining of the integument, and the absence of a protecting barrier ofsound lymph, which give the main features to the tuberculous ulcer. The scars that result from this form of ulceration vary, and aremost commonly drawn attention to when situated in the neck. Insome instances the resulting cicatrix is surprisingly soft, simple, andpliant. In other instances the scar left is irregular, hard, bossy,raised, and unsightly, by reason of its purple colour. Now and then,as the result of the undermining and irregular destruction of theinteguments, the scar may be marked by tags of skin or bridges, orbars of skin not unlike the columnse earner of the heart. Often thescar shows—when there has been deep suppuration—a severe degreeof contraction, whereby unsightly depressions are produced on thesurface. In many instances I have made microscopical sections ofexuberant scars from tuberculous subjects, and have found that they. Tuberculous Ulcer (withGland Disease) in a Patient dyingof Phthisis. 362 TUBERCULOSIS. seldom exhibit any tuberculous change, but are rather the seat of acheloid formation. Cheloid is well known to be liable to occur inor about the neck, and especially to follow wounds that have beenslow in healing or long irritated. The tuberculous ulcer of the mucous membrane is of commonoccurrence, and, like the similar lesion on the skin, is very usuallysecondary. It is common at the orifices of the body, and is notinfrequently associated with grave tuberculous disease elsewhere, asillustrated by the ulcers of the mouth in advanced phthisis, and ofthe anus in tuberculous disease of the colon or rectum. The tuberculous ulcer is met with on the lips, the palate, thetongue, the lining of the buccal cavity, the larynx, the alimentarycanal, the bladder and urethra, and, indeed, no mucous surface canbe said to be exempt from it. In appearance the ulcer is very likethat met with on t
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