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In its early stages a gumma is a firm, semi-translucent greyish or greyish-red mass of tissue; later it becomes opaque, yellow, and caseous, with a tendency to soften and liquefy.
At a later stage, the gland tissue is studded with minute yellow foci which tend to enlarge and in time to become confluent, so that the whole gland is ultimately converted into a caseous mass.
Frequently the caseous clots are not to be seen, and the stool has a clammy look reminding one of glazier's putty, while the color varies from dirty white to pale grayish yellow. That is due to the fact that the composition of the milk from different animals is far from being constant. "The proportions of albumen to those of caseine are especially varied.
The produce of the bread-fruit tree can no more be considered as bread than plantains before the state of maturity, or the tuberous and amylaceous roots of the cassava, the dioscorea, the Convolvulus batatas, and the potato. The milk of the cow-tree contains, on the contrary, a caseous matter, like the milk of mammiferous animals.
This caseous material is surrounded by the thickened capsule which, as a result of peri-adenitis, tends to become adherent to and fused with surrounding structures, and particularly with layers of fascia and with the walls of veins. The caseated tissue often remains unchanged for long periods; it may become calcified, but more frequently it breaks down and liquefies.
If ever any one heresy should so far spread itself over the principality of Wales that the Established Church were left in a minority of one to four; if you had subjected these heretics to very severe civil privations; if the consequence of such privations were a universal state of disaffection among that caseous and wrathful people; and if at the same time you were at war with all the world, how can you doubt for a moment that I would instantly restore them to a state of the most complete civil liberty?
It amounts in effect to saying that the sea is salt because of the large amount of saline matter which it holds in solution. Cheese is also a caseous preparation of milk; the duties of an archdeacon are to perform archidiaconal functions; and opium puts one to sleep because it possesses a soporific virtue.
On comparing the milky juices of the papaw, the cow-tree, and the hevea, there appears a striking analogy between the juices which abound in caseous matter, and those in which caoutchouc prevails.
Recovery is apt to be attended with impairment of movement due to adhesions, ankylosis, or contracture of the peri-articular structures. Caseous foci in the interior of the bones may become encapsulated, and a cure be thus effected, or they may be the cause of a relapse of the disease at a later date.
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