A Carbuncle is a large, flat, circumscribed, very hard, and very painful tumour, of a purplish red colour, and attended with a sensation of burning heat. Its diameter when complete, may be three or four inches, or more. It's most prominent part soon becomes soft, and numerous small ulcerated holes form in it, which give exit to a thin discharge, compared by Sir A. Cooper to flour and water.

Though Carbuncles may appear in almost any place their most common situation is the nape of the neck, the shoulders, and the buttocks. A virulent form has been described as occurring upon the face, at St. Bartholomew's Hospital, by Dr. Harvey Ludlow.

According to the records of the Registrar General; in the five years ending with 1845, the average number of deaths from Carbuncle in London alone was 5. In the next five years,ending with 1850, the number increased to 14; in 1851, it amounted to 19; 1852, to 50; in 1853, to 70, and in 1854, to 89. In that year, which was a Cholera year, the deaths from Carbuncle in England, exclusive of London, was not fewer than 300. The cause of this vast increase of these disorders has not been ascertained. Twenty-five cases were noted in six months, among the patients at St. Bartholomew's Hospital. Instances of it occurred at various periods of life, from 15 years of age to 80; among the ill-fed, and the well-fed, the temperate and the intemperate; and more than twice as often in males as in females.

Carbuncle is always an evidence of a vitiated state of the blood, and disorder of the digestive organs. It is often attended with considerable fever, and almost always with loss of appetite, and flatulence. "Carbuncles and unhealthy abscesses, are frequent consequences of what is called the water-cure; and the Germans persuade themselves that they constitute a critical evacuation of diseased humours, but it is far more probable that they are owing to the exhausted vitality of the skin, which is so inordinately taxed to relieve the blood of the immense quantity of water with which it is deluged."

Treatment

The patient may take the Cathartic pills No 4 at bedtime for three or four nights, and may afterwards take one pill every night for a week or two. As long as any fever lasts he may take the Fever Mixture No 9 every three or four hours. After the fever has abated he may take the following mixture:

Bicarbonate of Soda.............................Three Drams.

Tincture of Gentian............................One Ounce.

Tincture of Cascarilla.........................One Ounce.

Tincture of Orange Peel......................One Ounce.

Water, sufficient to make.....................Half a Pint.

A tablespoonful three times a day, in a glass of water.

If the patient is restless at night, he may take Sedative Pills, No. 6, or ten grains of the Bromide of Potash, at bedtime. If the discharge should be great, and the patient debilitated, his strength must be supported with beef tea, boiled mutton, boiled poultry, etc., and wine or even brandy may be necessary.

It has been the common practice in the treatment of Carbuncle to cut the tumour across, but Dr. J. Murray, of Wickham, Hants, has lately published an account of some cases treated by scoring the tumour across with a stick of Caustic Potash (Potassa fusa); and then applying a poultice. These cases all terminated satisfactorily. Mr. Pater, of the Hants County Lunatic Asylum, says: "During the last four years, all the cases of Carbuncle occurring in this Asylum, about 20 in number, have been treated by forming superficial eschars by means of Potassa fusa, and with uniformly satisfactory results. In cases where sloughing has not already set in, resolution takes place without suppuration; and in more advanced cases healthy suppuration is rapidly established, and speedy separation of sloughs takes place."

The abscess may be dressed with the Resin Ointment (commonly called Yellow Basilicon), and a poultice over that.