Page:Transactions of the Provincial Medical and Surgical Association, volume 4.djvu/292

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190
MEDICAL TOPOGRAPHY


In the Dispensary table the affections classed under the present head amount to about one-thirty-fifth part of the whole diseases; and the proportion might be considerably increased if we include cases of ophthalmic of a scrofulous nature, the great proportional prevalence of which disease I have already noticed. As, however, the disease termed strumous ophthalmia may originate in children having no original scrofulous taint, under circumstances of insufficient and unwholesome food, air, and exercise, and may readily disappear under proper management, without leaving behind it any fixed constitutional lesion or even predisposition, I have not thought it proper to class these cases of ocular inflammation under the present head. Their great prevalence, nevertheless, I regard as unequivocal evidence of much strumous predisposition in the locality where they prevail.

It appeared to me that the common external indications of the scrofulous constitution, visible in the complexion, texture of the hair, configuration of the body generally, and of the features of the face more particularly, were more marked among the inhabitants generally, and especially among the better classes, than in other parts of England, where I have had opportunities of observing the condition of the people; and I thought I could discover a larger proportional number of white swellings, incurvations of the spine, hip cases, and glandular tumours there than elsewhere. Of the very general and great prevalence of these diseases throughout the district, the answers of the resident practitioners, under the heads scrofula, rickets, white swelling, hip