ncle?#

There is rarely more than one lesion present. It begins, usually with
preceding and accompanying malaise, chilliness and febrile disturbance,
as a firm, flat, inflammatory infiltration in the deeper skin and
subcutaneous tissue, spreading laterally and finally involving an area
of one to several inches in diameter. The infiltration and swelling
increase, the skin becomes of dark red color, and sooner or later,
usually at the end of ten days or two weeks, softening and suppuration
begin to take place, the skin finally giving away at several points,
through which sanious pus exudes; the whole mass finally sloughs away
either in portions or in its entirety, resulting in a deep ulcer, which
slowly heals and leaves a permanent cicatrix.

In some cases, especially in old people, constitutional disturbance of a
grave character is noted, septicaemia is developed, and a fatal result
may ensue.

#What is the cause of carbuncle?#

The same causes are considered to be operative in carbunculus as in
furuncle; general debility and depression, from whatever cause,
predisposing to its formation, and the introduction of a microbe,
probably the same as in furunculus, being at present looked upon as the
exciting factor.

#What is the pathology?#

The inflammation starts simultaneously from numerous points, from the
hair-follicles, sweat-glands or sebaceous glands. The inflammatory
centres break down, and the pus finds its way to the surface; finally
the process ends in gangrene of the whole area.

#How would you distinguish carbuncle from a boil?#

By its flat character, greater size, and multiple points of suppuration.

#What is the prognosis of carbuncle?#

Occurring in those greatly debilitated or in late life, and in those
cases in which two or more lesions exist, or when seated about the head,
the prognosis is always to be guarded, as a fatal result is not
uncommon. In fact, in every instance the disease is to be considered of
possible serious import.

#What constitutional treatment is usually employed in carbuncle?#

A full nutritious diet, the use of such remedies as iron, quinia, nux
vomica, with malt and stimulants, if indicated. Calx sulphurata,
one-tenth to one-fourth grain every two or three hours, appears, in some
instances, to have a beneficial effect. If the pain is severe, morphia
or chloral should be given.

#What external measures are employed?#

In the early part of the formation, i