Treatment

I would add one word of caution in regard to the use of poultices. The poultices should be confined as much as possible to the exact seat of local inflammation. Nothing is more common than the springing up of fresh around old boils from the neglect of this precaution.

The same local measures as recommended in furuncles are useful here. In addition consider the following:
The early application of ice and salt bags to the swelling is said to lessen the extent of the disease. If the sloughing is extensive charcoal and yeast poultices may be used. The sloughs should be picked out as fast as they loosen, and the ulcer washed out once or twice a day with a weak solution of carbolic acid, or peroxide .of hydrogen.

Dr. Owen, of London, treats large carbuncles with extensive sloughs by removing the sloughs, under an anaesthetic, scraping the sores and the diseased undermined skin with Volkmann's spoon and trimming off the ragged edges. The wounds are then washed with a 1-1000 sublimate solution, dusted with iodoform, and covered with moist perchloride gauze and blue wool. Do not use the knife to open a car­buncle.

The indications for internal remedies are as follows:
Aconite. - As an occasional remedy, when there is much inflammation with high fever.

Anthracinum. - When the burning pain is violent and not relieved by Arsenicum; cerebral or typhoid symptoms; evidences of blood poisoning; sloughing, abundant discharge of ichorous, terribly smelling pus.

Apis. - Continued extension of the erysipelatoid inflammation with stinging burning.

Arctium lappa. - Has great reputation; used both inter­nally and locally.

Arsen. alb. - Large, painful and malignant carbuncles; great prostration; great restlessness; great thirst, drinking but little at a time; all the symptoms are worse in the night, and better from external warm applications.

Bellad. - Bright redness, with throbbing pain; when cerebral complications arise; erysipelatous inflammation around the carbuncle; drowsiness with inability to go to sleep.

Bufo, at the commencement very efficient.


Carbo veg. - Dark blackish appearance of the sore; fetid odor of the discharge; hippocratic face; blood poisoning.

Cinchona. - When the asthematic character of the disease is well marked; debility from excessive suppuration.

Hyoscyamus. - When there is great restlessness, caused by excessive nervous excitement; itching around the swelling; in nervous and hysterical individuals.


Lachesis. - Bluish purplish looking curbuncles, with evidences of blood poisoning; nightly burning, obliging one to rise and wash parts in cold water; inability to bear any bandage around the neck; cerebral symptoms.

Muriatic acid. - Carbuncles in scorbutic individuals, with ulcers on the gums; frequent desire to urinate with profuse emission of clear urine.

Nitric acid. - When there is a predisposition to anthrax.

Phytolacca. - Tendency to carbuncles, especially on the back and behind the ears.

Rhus tox. - Great restlessness; feels somewhat relieved of the violent pain as long as he is in motion; burning itching around the carbuncle, with vertigo; bloody, or serous, frothy, diarrhoea; typhoid symptoms.

Secale corn. - Carbuncles on the arms; aggravated by warm applications; gangrenous tendency.

Silicea. - During the process of ulceration, to promote healthy granulation.