exist for years, without showing the
slightest alterations.

With renewed attacks they enlarge and may become of considerable size.
At times single glands become inflamed, hurt when pressed and develop
abscesses which perforate the skin after it has become inflamed and
reddened.

These abscesses may heal within a few days. In the majority of cases,
however, they remain for a longer period, months and even years and
result in the well-known tumid, hard and immovable scars.

Inflammation of the periosteum and of the bones is one of the instances
of scrofula. Most frequently _spina ventosa_ is found; the same consists
of a gradual, painless swelling of the diseased bones, most frequently
on the fingers and toes, so that they become bottle-shaped. The skin
covering these swellings is pale and tense. The swelling may gradually
disappear or begin to suppurate. Besides this hip- and knee-joint
inflammation are observed, also inflammations of the ankle, elbow-joint,
spine, etc.; especially in the case of diseased bones it is extremely
difficult to fix a dividing line between scrofula and tuberculosis.

The frequence of anaemia with scrofula is only a _result_ of the disease
and not a symptom. As a result of scrofula nutrition and assimilation
become impaired, mostly in the cases of extreme suppuration.

Scrofula is a chronic disease. In many cases it is completely cured, the
lighter cases after several months and the more malignant after several
years. Extreme scrofula may often remain until puberty and may be
completely healed.

_Fatal_ results are due to scrofulously diseased bones, joints or
glands, and it can not be denied that a large number of children succumb
in this manner. Fatal results may also be due to additional diseases,
such as pneumonia, pleurisy, intestinal catarrh, etc.

It has been frequently observed that _tuberculosis_ succeeds scrofula.
It is a well-known fact that scrofula furnishes the largest contingent
for tuberculosis.

As a precautionary measure against scrofula a careful regulation of the
diet is recommended. During the first nine months of life children
should be fed with human milk exclusively if possible. If scrofula is
hereditary in a family, or if the mother exhibits symptoms of the
disease, she should not be allowed to nurse the child but a strong and
healthy nurse should be engaged. Recourse to artificial nourishment must
only then be taken, when nursing the child is absolutely impos