Diagnostic Essentials for Tuberculous Lymphadenitis (Scrofula) in Chinese medicine:
(1) It is often seen in children and young adults with weak constitution and mostly related to a history of general debility (pulmonary tuberculosis).
(2) It occurs frequently at the side of the neck, or in front of the ear, behind the ear, and also involves submaxillary region, clavicle and axillary region.
(3) In accordance with the clinical manifestations at the different periods, it can be divided into three stages.
Initial Stage: The node is like a bean and appears solely or in patches, in hard nature and movable condition, neither red, nor heat and nor painful, with the skin in normal color. It can exist for months without any change.
Middle Stage: The node enlarges gradually and is adhered with the skin, coagulated into a mass by several nodes and difficult to push, accompanied by aching pain or tenderness.-In suppuration, the skin color becomes red and feels slightly warm, with a fluctuating sensation when pressing.
Late Stage: Mter abscess is incised or ruptures itself, the pus discharged is as thin as sputum, mixed with bad cotton-like substance, and moves underneath theskin. The granulation is gray in color and not fresh and is easy to form an empty shell or a sinus. Then, the wound is difficult to heal. Even after it is cured, mostly it will create a depressed scar.

(4) The general symptoms are not remarkable in the initial stage of this disease and become obvious in the middle and late stages. In the laboratory examination, erythrocyte sedimentation rate can be increased and bacillus tubercle can be found in smear of purulent fluid. The focus of pulmonary tuberculosis can be found in the radiograph of the chest.