Page:Transactions of the Provincial Medical and Surgical Association, volume 2.djvu/212

 of blood. Their friends, also, when reminded by our enquiries of observations which they had formerly made, though without reflecting upon them, will tell us that they remember having occasionally noticed an alteration of the complexion, a “ faded look,” that a loss of flesh had certainly taken place, and that the intonation of the voice had been, in some measure, changed; all these circumstances not having been striking enough to detain attention at the time, though sufficiently impressive to be remembered afterwards. Now all these symptoms indicate the commencement of a morbid action prior to the bronchitic or pneumonia seizure; but the action is just such an one as readily invites the operation of inflammatory causes, and this is the reason we imagine why persons, both in and out of the profession, are so disposed to look upon tuberculous deposits as uniformly the results rather than the causes of phlogistic action. We are by no means so exclusive as to maintain that tubercles always take their very beginning in a derangement sui generis; on the contrary, we are of opinion that very frequently inflammation is the first of that series of capillary aberrations, which terminate in the substitution of tubercular for the proper interstitial secretion; in other words, that inflammation developes the peculiar diathesis. Perhaps the declaration of this opinion may appear irrelevant here, unless we can offer any grounds for it, derived from circumstances more immediately connected with this locality. We are, however, not aware of the existence of any such circumstances. It might not unnaturally be conjectured that scrofula is so prevalent here,