Carbuncles

1899

In a previous article it was stated that pimples, boils and carbuncles are essentially the same thing — an inflammation of the skin and of the tissues immediately beneath it — and differ only in size. But while this is true, the difference in size is fraught with consequences so serious as to constitute practically a point of distinction between two separate diseases. In a carbuncle the inflammation is usually more deeply seated than in a boil, and is spread over a much greater surface. It is also accompanied by signs of a general disturbance of the system, signs which are usually absent in the case of an ordinary boil.

The appearance of a carbuncle is generally preceded by a little feverishness, headache and a general ill-feeling, and sometimes by one or more slight chills or a chilly sensation. The first sign of the local inflammation is a swelling in the part affected. This may be nodular, as if several boils were beginning together, or even and rounded, like a pad of cloth or tightly pressed cotton.

After growing somewhat in circumference, the carbuncle begins to swell, pushing up the skin, which is of a purplish-red color and hot to the touch. Small blisters may form over it, break, and exude a clear, sticky fluid, which dries and forms scabs.

In time a number of small openings appear and discharge pus. All the tissue involved in the carbuncle dies and is thrown off. Whitish or blackish shreds are discharged through the openings already formed, and later the entire remaining mass becomes gangrenous and melts away, leaving a wide, deep hole, which may take weeks or months to heal.

The neck is the most frequent seat of carbuncles; then come the back, the scalp and the face; the trunk and limbs are seldom invaded.

The pain is at first comparatively slight, but soon grows excessive, with violent throbbing and burning sensations, as if a live coal were buried in the flesh. A person with a boil can usually attend to his regular duties, but one with a carbuncle is gravely ill.

Sufferers from carbuncles are almost never vigorous; the aged are much exposed to them, and they frequently attack sufferers from Bright's disease or diabetes.

The treatment of carbuncles coincides in part, with that of boils, but the patient is usually so ill that there should be no temporizing with simple remedies. The physician's aid should be invoked at once.