King Henry IV of France touching a number of sufferers of scrofula who are gathered about him in a circle. André de Laurens, 1609

Scrofula (Scrophula or Struma) refers to a variety of skin diseases; in particular, a form of tuberculosis, affecting the lymph nodes of the neck. In adults it is caused by Mycobacterium tuberculosis and in children by nontuberculous mycobacteria. The word comes from the Latin scrofulae, meaning brood sow. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... Image File history File links Copperplate engraving by André Du Laurens (1558-1609), an anatomist and Paris court physician, showing King Henry IV of France touching a number of sufferers who are gathered about him in a circle. ... Image File history File links Copperplate engraving by André Du Laurens (1558-1609), an anatomist and Paris court physician, showing King Henry IV of France touching a number of sufferers who are gathered about him in a circle. ... Dermatology is a branch of medicine dealing with the skin, its structure, functions, and diseases (from Greek derma, skin), as well as its appendages (nails, hair, sweat glands). ... Tuberculosis (abbreviated as TB for tubercle bacillus) is a common and deadly infectious disease caused by mycobacteria, mainly Mycobacterium tuberculosis. ... Lymph nodes are components of the lymphatic system. ... Binomial name Mycobacterium tuberculosis Zopf 1883 Mycobacterium tuberculosis is the bacterium that causes most cases of tuberculosis[1]. It was first described on March 24, 1882 by Robert Koch, who subsequently received the Nobel Prize in physiology or medicine for this discovery in 1905. ... Nontuberculous mycobacteria (NTM), or atypical mycobacteria or mycobacteria other than tuberculosis (MOTT), are mycobacteria which do not cause tuberculosis or Hansens disease (leprosy). ... Latin is an ancient Indo-European language originally spoken in Latium, the region immediately surrounding Rome. ... Sow may refer to: A female pig. ...

History

In the Middle Ages it was believed that "royal touch", the touch of the sovereign of England or France, could cure the disease. Scrofula was therefore also known as the King's Evil. The kings were thought to have received this power from descent from Edward the Confessor, who, according to some legends, received it from Saint Remigius. From 1633, the Book of Common Prayer of the Anglican Church contained a ceremony for this, and it was traditional for the monarch (king or queen) to present to the touched person a coin — usually an Angel, a gold coin the value of which varied from about 6 shillings to about 10 shillings. King Henry IV of France is reported as often touching and healing as many as 1,500 individuals at a time. Middle age is that stage in life when physical decline has started but a person cannot be called old. ... Motto (French) God and my right Anthem No official anthem - the United Kingdom anthem God Save the Queen is commonly used England() – on the European continent() – in the United Kingdom() Capital (and largest city) London (de facto) Official languages English (de facto)1 Unified  -  by Athelstan 927 AD  Area  -  Total... This article does not cite any references or sources. ... Saint Remigius (French Saint Remi or Saint Rémy), Bishop of Reims, Apostle of the Franks, (ca 437– January 13, 533) effected the conversion to Christianity of Clovis, King of the Franks, at Christmas, 496, one of the turning points in the success of Trinitarian Christianity and a climacteric moment... For the novel by Joan Didion, see A Book of Common Prayer. ... The Anglican Communion is a world-wide organisation of Anglican Churches. ... Armenian king Tigranes the Great. ... This article does not cite its references or sources. ... Henry VIII: angel An Angel is a gold coin, first used in France (where is was also known as an Angelot and an Ange) in 1340, and introduced into England by Edward IV in 1465 as a new issue of the noble and so at first called the angel-noble... General Name, Symbol, Number gold, Au, 79 Chemical series transition metals Group, Period, Block 11, 6, d Appearance metallic yellow Standard atomic weight 196. ... Henry IV of France, also Henry III of Navarre (13 December 1553 – 14 May 1610), ruled as King of France from 1589 to 1610 and King of Navarre from 1572 to 1610. ...

Queen Anne touched the Infant Dr. Samuel Johnson in 1712^[1], but King George I put an end to the practice as being "too Catholic." The kings of France continued the custom until 1825. Anne (6 February 1665 – 1 August 1714) followed Englands only joint monarchy to become Queen of England, Scotland and Ireland on 8 March 1702 after the passing of both William and Mary. ... For other persons named Samuel Johnson, see Samuel Johnson (disambiguation). ... // Events Treaty of Aargau signed between Catholic and Protestants. ... George I King of Great Britain and Ireland George I (George Ludwig von Guelph-dEste) (28 May 1660–11 June 1727) was Duke of Brunswick-Lüneburg (Hanover) from 23 January 1698, and King of Great Britain and King of Ireland from 1 August 1714, until his death. ... Opening of the Stockton and Darlington Railway 1825 (MDCCCXXV) was a common year starting on Saturday (see link for calendar). ...

In 1768 the Englishman John Morley produced a handbook "Essay on the nature and cure of scrophulous disorders, commonly called the King's Evil". The book starts by listing the typical symptoms and indications of how far the disease had progressed. It then goes into detail with a number of case studies, describing the specific case of the patient, the various treatments used and their effectiveness. The forty-second edition was printed in 1824. 1768 was a leap year starting on Friday (see link for calendar). ... 1824 was a leap year starting on Thursday (see link for calendar). ...

In 1924, the French historian Marc Bloch wrote a book on the history of the royal touch: The royal touch: sacred monarchy and scrofula in England and France (original in French). Year 1924 (MCMXXIV) was a leap year starting on Tuesday (link will display the full calendar) of the Gregorian calendar. ... Marc Léopold Benjamin Bloch (July 6, 1886 – June 16, 1944) was a French historian of medieval France in the period between the First and Second World Wars, and a founder of the Annales School. ...

The disease

Scrofula of the neck

Scrofula is the term used for tuberculosis of the neck, or, more precisely, a cervical tuberculous lymphadenopathy. Scrofula is usually a result of an infection in the lymph nodes, known as lymphadenitis and is most often observed in immunocompromised patients (ca. 50% of cervical tuberculous lymphadenopaty). In ca. 95% of the scrofula cases in adults are caused by Mycobacterium tuberculosis, but only 8% in children. The rest are caused by atypical mycobacterium or nontuberculous mycobacterium (NTM). With the stark decrease of tuberculosis in the second half of the 20th century, scrofula became a very rare disease. With the appearance of AIDS, however, it has shown a resurgence, and presently affects ca. 5% of severely immunocompromised patients.^{[citation needed]} Image File history File links Scrofula of the neck. ... Image File history File links Scrofula of the neck. ... Lymph nodes are components of the lymphatic system. ... Lymphadenopathy is swelling of one or more lymph nodes. ... Immunosuppression is the medical suppression of the immune system. ... (19th century - 20th century - 21st century - more centuries) Decades: 1900s 1910s 1920s 1930s 1940s 1950s 1960s 1970s 1980s 1990s As a means of recording the passage of time, the 20th century was that century which lasted from 1901–2000 in the sense of the Gregorian calendar (1900–1999... Acquired Immune Deficiency Syndrome or acquired immunodeficiency syndrome (AIDS or Aids) is a collection of symptoms and infections resulting from the specific damage to the immune system caused by the human immunodeficiency virus (HIV). ...

Signs and symptoms

The most usual signs and symptoms are the appearance of a chronic, painless mass in the neck, which is persistent and usually grows with time. The mass is referred to as a "cold abscess", because there is no accompanying local color or warmth and the overlying skin acquires a violaceous (bluish-purple) color. NTM infections do not show other notable constitutional symptoms, but scrofula caused by tuberculosis is usually accompanied by other symptoms of the disease, such as fever, chills, malaise and weight loss in ca. 43% of the patients. As the lesion progresses, skin becomes adhered to the mass and may rupture, forming a sinus and an open wound. The term symptom (from the Greek meaning chance, mishap or casualty, itself derived from συμπιπτω meaning to fall upon or to happen to) has two similar meanings in the context of physical and mental health: Strictly, a symptom is a sensation or change in health function experienced by a patient. ... A human neck. ... This article needs additional references or sources for verification. ... Look up chill in Wiktionary, the free dictionary. ... Malaise is a feeling of general discomfort or uneasiness, an out of sorts feeling, often the first indication of an infection or other disease. ... This article needs additional references or sources for verification. ... Superficial bullet wounds In medicine, a wound is a type of physical trauma wherein the skin is torn, cut or punctured (an open wound), or where blunt force trauma causes a contusion (a closed wound). ...

Diagnosis

Diagnosis is usually performed by needle aspiration biopsy or excisional biopsy of the mass and the histological demonstration of stainable acid-fast bacteria in the case of infection by M. tuberculosis (Ziehl-Neelsen stain), or the culture of NTM using specific growth and staining techniques. In general, a diagnosis (plural diagnoses) has two distinct dictionary definitions. ... Needle aspiration biopsy is a procedure performed to diagnose and treat certain kind of illnesses. ... Brain biopsy A biopsy (in Greek: bios = life and opsy = look/appearance) is a medical test involving the removal of cells or tissues for examination. ... A bacillus is a rod-shaped bacterium: an acid-fast bacillus (or AFB) is a rod-shaped bacterium which, when stained with certain compounds, retains that stain despite treatment with an acidic solution. ... The Ziehl-Neelsen stain, also known as the acid-fast stain, was first described by two german doctors; Franz Ziehl (1859 to 1926), a bacteriologist and Friedrich Neelsen (1854 to 1894), a pathologist. ...

Therapy

Treatment approaches are highly dependent on the kind of infection. Surgical excision of the scrofula does not work well for M. tuberculosis infections, and has a high rate of recurrence and formation of fistulae. Furthermore, surgery may spread the disease to other organs. The best approach then is to use conventional treatment of tuberculosis with antibiotics. Scrofula caused by NTM, on the other hand, responds well to surgery, but is usually resistant to antibiotics. The affected nodes can be removed either by repeated aspiration, curettage or total excision (with the risk in the latter procedure, however, of causing cosmetically negative effects or damage to the facial nerve, or both). In mathematics, a recurrence relation, also known as a difference equation, is an equation which defines a sequence recursively: each term of the sequence is defined as a function of the preceding terms. ... In medicine, a fistula (pl. ... The standard short course treatment for tuberculosis (TB) is isoniazid, rifampicin, pyrazinamide and ethambutol for two months, then isoniazid and rifampicin alone for a further four months. ... An antibiotic is a drug that kills or slows the growth of bacteria. ... “Surgeon” redirects here. ... In surgery, the use of a curette to remove tissue by scraping or scooping. ... The facial nerve is seventh of twelve paired cranial nerves. ...

Prognosis

Prognosis: with adequate treatment, clinical remission is practically 100%. In NTM infections, with adequate surgical treatment, clinical remission is greater than 95%. It is recommended that persons in close contact with the diseased person, such as family members, should undergo testing for tuberculosis. Prognosis (older Greek πρόγνωσις, modern Greek πρόγνωση - literally fore-knowing, foreseeing) is a medical term denoting the doctors prediction of how a patients disease will progress, and whether there is chance of recovery. ...

See also

• Tuberculosis diagnosis
• Tuberculosis treatment
• Touch Pieces

A complete medical evaluation for tuberculosis (TB) must includes a medical history, a physical examination and a chest X-ray. ... The standard short course treatment for tuberculosis (TB) is isoniazid, rifampicin, pyrazinamide and ethambutol for two months, then isoniazid and rifampicin alone for a further four months. ... Touch Pieces are coins and medalets that have attracted superstitious beliefs, such as those with holes in them or those with particular designs. ...

Notes

1. ^ Henry Hitchings “Dr Johnson's Dictionary:The extraordinary story of the book that defined the World” Pub. John Murray 2005 P.11

References

• Crawfurd, R.H.P., The King's Evil, Oxford University Press, (Oxford), 1911.

External links

• Scrofula from eMedicine medical article