( Originally Published 1927 )
Boils (Furuncles). Description.—A boil results from the entrance of pus germs into such natural openings in the skin as hair sacs, sweat glands, or oil sacs. Nature's defense is here very alert and thorough. True, the germs are contained within a closed bag, as it were, but in this particular condition they are apt to wander beyond the confines of the sac or gland. Here is witnessed an engorgement of the blood vessels, the onrush of the serum (the antiseptic part of the blood) and of the white defensive cells to the seat of trouble. At the same time, a wall of cells is built about the affected area so as to leave nothing undone to stop the progress of this condition. Therefore, the first inkling 'of a boil is the presence of a hard, reddened, painful swelling. When the defense has lagged and the germs have slipped into the deeper parts, a deep swelling results which can be felt rather than seen.
In this struggle there are casualties on both sides and as a result pus forms in the deeper parts, indicated by a redness and softening of the over-lying skin. The pus seeks an exit on the surface and as this urge becomes greater and greater, the skin in the center of the boil thins and finally breaks. The escaping material is thick and yellow and often mixed with blood. Very often the dead tissue (the core) is one mass and the full measure of relief is only obtained when this core is dislodged. The escape of the destroyed flesh and pus leaves an opening which fills up very rapidly with new healthy tissue, and a scar usually marks the site of the boil.
Boils usually appear on the back of the neck, the buttock, the face, the armpits, and about the privates and rectum.
Cause and Contagion.—Two essentials are necessary for the development of boils, pus germs and a soil favorable for their growth. The diseases and conditions which can foster such a favorable soil are numerous and include such diseases as diabetes, Bright's disease, anaemia (an impoverished state of the blood), and inflammation of the bowels, especially in children. Boils may appear as complications in smallpox, and other contagious diseases as scarlet fever, chickenpox, measles, etc.
Injury to the skin, such as may result from the rubbing of a frayed collar or from horseback riding, may favor the presence of boils. Persistent crops of boils have been known to result from abscessed teeth. Persons taking medicines containing iodides and those working in tar or paraffin may also develop boils.
Presence of a single boil is of no consequence, but when they appear in crops or extend over a long period of time, they should receive serious attention. Boils may be spread in a number of ways, through the nutrition channels of the skin and through infection of the surface by the pus. It is advised that boils be treated very early, as then it is possible to stop their progress, thus saving much suffering and inconvenience.
Suggestions for Prevention.—When boils keep on reappearing, it is most necessary that the patient receive a thorough examination, including a study of the urine and blood.
CIeanliness of the skin surrounding the boils is most important, for this removes one source through which new boils may develop.
Carbuncles. Description.—A carbuncle is nothing more than a number of closely grouped, deep boils. It begins as a flat, painful thickening, varying in size from a chestnut to an orange. The overlying skin is hard, boardlike and violaceous in color. At the end of a week or ten days, the skin breaks in numerous places and from each swollen area, bloody pus and a core escape. The openings fill up with healthy tissue, and healing takes place with the formation of scars. The usual sites for carbuncles are the neck, shoulders, buttock and thighs.
Chills, fever, marked weakness, and loss of appetite indicate the participation of the body as a whole in this disease.
Young persons suffering from carbuncles usually recover in a few weeks; elderly persons often succumb either from blood-poisoning or general weakness. Carbuncles of the scalp are more serious than in other situations because of the possibility of cutting off the blood supply to the brain.
Cause and Contagion.—The factors responsible for boils also cause carbuncles.
Suggestions for Treatment.—Those suffering from carbuncles should consult a doctor as soon as possible.
Abscess.—Description.—An abscess is another condition caused by pus germs. It may be defined as a walled-off cavity containing pus. The out-standing feature of an abscess is the formation of a definite limiting wall, within the confines of which the pus is formed as a result of the struggle between the germs and the defensive bodies.
At first the area of the abscess is hard, and as the pus forms, it softens. The overlying skin is red, and throbbing pain and a sense of pressure are experienced. When the pus becomes very abundant, the overlying skin thins because of the pressure, and to this phenomenon the term "pointing" is applied.
Suggestions for Treatment.—Abscesses require the services of a surgeon.