Scrofula – Causes, Symptoms & Treatment


In the Middle Ages, scrofula was a widespread skin disease with glandular tumors. Today, this clinical picture is associated with skin tuberculosis and allergic reactions. During the Middle Ages, therapy consisted primarily of the laying on of hands by the king.

What is scrofula?

Scrofula is the historical term for a skin disease involving glandular growths and enlargement or destruction of the lymph nodes . In this context, today’s medicine is most likely to speak of skin tuberculosis . The term scrofula was a common term for various diseases of the skin of the neck and face, especially during the Middle Ages. The incidence of the disease was endemic in many places in the country.

So scrofula was persistent and frequent in certain places. In connection with this, it is now assumed that the causes are infectious, as are also assumed for tuberculosis of the skin. Today’s physician understands skin tuberculosis to be a chronic or acute bacterial infection of the skin and subcutaneous tissue. According to Dornblüth’s clinical dictionary, scrofula meant on the one hand an inflammatory and genetically determined overreaction of the skin to environmental stimuli and on the other hand skin tuberculosis in childhood, which was associated with chronic inflammation.


Caseous destruction of tissue is typical of tuberculosis. If there is a tendency for these tissues to melt down, this can manifest itself in the form of skin tuberculosis, which was described as scrofula in the Middle Ages. Tuberculosis of the skin is usually caused by the bacterium Mycobacterium tuberculosis. An infectious cause like this could explain the endemic nature of the disease, which was described in the Middle Ages.

However, some scientists have now completely moved away from a connection between tuberculosis and scrofula and instead speak of a causal allergy . An allergic cause would at least explain the swelling of the lymph nodes described in the Middle Ages in combination with chronic colds and inflammatory immune reactions. According to medieval writings, children up to the age of 13 were particularly affected by scrofula. In connection with this, some scientists are still questioning an allergic cause and are still in favor of infections.

Symptoms, Ailments & Signs

The leading symptom of scrofula was the inflammation of the glands. This inflammation was typically accompanied by eczema . Inflammation of the nose, ears or eyes often accompanied symptoms. Prolonged indigestion and loss of appetite were also ranked among the most important symptoms. Sometimes there were also breathing difficulties .

The patient’s symptomatic rash often developed into raised lumps from which purulent discharge oozed. Even joint inflammation and other inflammatory symptoms of the skeleton have been described in various writings for scrofula. Today, however, it is difficult to assess which symptoms were really associated with scrofula and which were possibly due to a disease that occurred at the same time as scrofula. Some writings refer to cold and sweaty feet in small children as early symptoms of scrofula. However, the reliability of this statement is in question.

Diagnosis & disease progression

The disease was extremely protracted during the Middle Ages. Some writings speak of a duration of illness of around ten years. The diagnosis was usually made by visual diagnosis, since the typical eczema of the disease offered a diagnostic criterion that could be recognized with the naked eye. In some cases during the Middle Ages, scrofula has spread to the entire lymphatic system, causing the appearance of pseudoleukemia.


Scrofula is usually associated with various skin conditions and disorders. Those affected suffer from recurring inflammation, which is usually associated with itching, redness and pain. This is sometimes accompanied by tonsillitis or inflammation of the ears.

An ear infection also causes intense pain that can radiate to the head or neck. In general, scrofula can spread to different parts of the body, causing symptoms such as appendicitis, sinus infections, and other ailments. Problems with eating can occur if the jaw and teeth are misaligned.

Treating scrofula also carries risks. The prescribed medication can cause side effects and interactions. After taking phytotherapeutics, isolated disorders of the immune system can occur. Even classic medicines sometimes cause symptoms – such as headaches, muscle and body aches, gastrointestinal problems or skin irritations.

Allergic reactions can also occur, which in connection with the original symptoms sometimes cause further symptoms. If natural remedies are taken without consulting a doctor, this can lead to discomfort and, under certain circumstances, trigger complaints of the skin, the immune system, the cardiovascular system or the gastrointestinal tract.

When should you go to the doctor?

Treatment by a doctor is always necessary for scrofula. Self-healing is not possible with this disease, so that the person affected is always dependent on medical treatment by a doctor. The earlier scrofula is detected, the better the further course of this disease. A doctor should be consulted if the patient suffers from severe inflammation of the ears or eyes. If these occur for no particular reason and do not go away on their own, a doctor must be consulted in any case.

Digestive disorders and breathing difficulties also indicate scrofula and must also be treated by a doctor. The affected person often has a rash on the skin, which can spread over the entire body. Scrofula can be diagnosed by a general practitioner . For further treatment, however, a specialist is necessary.

Treatment & Therapy

From the Middle Ages to early modern times, scrofula in France and England was primarily treated by the king himself. At that time, the people believed that the king was called by God and thus assumed that he was able to cure scrofula by the mere laying on of hands. The healing of scrofula patients was therefore part of the everyday royal rites in both France and England. So the duly anointed king laid hands on the patients daily.

The sick often traveled from far away places to be healed by the king. Under the English King Charles II, the laying on of hands reached its climax. He laid hands on an estimated 100,000 people during his reign to represent the restoration of sacred kingship. In folk medicine, scorfuosis was sometimes treated with arsenic, silicon, medicinal plants or other natural substances.

Physical exercise and sunlight were considered therapy recommendations. A diet based on dairy products was also said to have some healing effects. In addition, salty skin care was of particular importance. A mixture of cod liver oil, egg yolk, and sugar was supposed to reduce the swelling of the glands. Later, surgical measures were sometimes suggested to the patients against inflammation of the bones, joints and glands.


In the Middle Ages, folk medicine believed that a strict diet and hygiene could prevent diseases such as scrofula. Hot, spicy and heavily salted foods, for example, were banned in this context, as was alcohol. A lukewarm bath twice a week was advised. The sea air and mountain air were also often said to have preventive effects.


Scrofula requires extensive follow-up care. Depending on the trigger, natural remedies from folk medicine can also be prescribed as part of the aftercare. Some of the effective remedies include figwort (Scrophularia). Since the cause of the skin complaints can be very different, the aftercare must be geared towards the trigger. If the symptoms are caused by tuberculosis, for example, the follow-up care usually lasts two or more years.

Check-ups are carried out at regular intervals during this period. The doctor measures the weight, collects sputum and, if necessary, conducts an X-ray examination. The skin problems themselves disappear sooner. Follow-up care for scrofula is carried out by a dermatologist or a general practitioner. In the case of chronic complaints, massages or the use of ointments can be part of the aftercare.

If scrofula has caused scars, cosmetic removal of the scars may be an option. The doctor in charge can inform the patient about the possibilities depending on the case. Follow-up care is not always necessary for scrofula. In some cases, the condition will heal on its own. Spontaneous healing does not require extensive follow-up care.

You can do that yourself

There is hardly any help against scrofula in everyday life, even if the history of this disease points to some possibilities for self-help. Nowadays, it is especially important that patients take the prescribed medicines according to the doctor’s recommendation. Possible side effects must be taken into account so that the immune system is not impaired.

In this context, those affected should have regular examinations carried out in order to detect allergic reactions and other interactions in good time. It is also essential to discuss the use of natural remedies with your doctor. Otherwise, the risk of skin problems and weakening of the cardiovascular system increases. In connection with an accurate, long-term control of the state of health, it is possible to detect problems at an early stage. In this way, standard therapy is well supported.

In earlier times, according to folk medicine, a diet combined with avoiding alcohol and better hygiene was helpful. Doctors now know that alcohol can actually be harmful. How positive the previously promised preventive effect of fresh sea or mountain air actually is cannot be proven exactly. In everyday life, self-help groups are more in demand today to strengthen health awareness and make the illness easier to bear.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.