Skin Disorders - Carbuncles
( Originally Published 1936 )
A carbuncle, like a furuncle, is due to an invasion of the lower layers of the skin by pus-producing germs which are normally present on the surface of the skin. They gain entrance to the lower layers of the skin, as they do in the case of boils, through a hair follicle or a sweat gland, or something of that kind.
Carbuncles are, however, far more serious than simple boils. A boil or furuncle is an accumulation of pus in a single place. In a carbuncle the infection gets into much deeper layers than in the case of a furuncle. And instead of stopping as a single accumulation of pus, it begins to burrow until there is a system of underground channels like a cave, all infected.
The amount of discomfort caused by a carbuncle, or danger resulting, is far greater than that caused by a boil or a crop of boils. In fact, it is not very unusual for a carbuncle to cause death. And under any circumstances it makes the patient very sick and leaves him very debilitated.
The usual site of a carbuncle, like a boil, is on the back of the neck. Any infection in this region which does not fairly rapidly come to a head and discharge pus and disappear should be considered as suspicious for a carbuncle. This is especially true if there is considerable thickening and infiltration of the tissues around the infected spot. If there is any suspicion of a carbuncle the patient should certainly be placed in the hands of a physician. It cannot be too strongly emphasized that a carbuncle is not a minor matter, but one that requires a great deal of skill in its treatment, and which should be in the most competent hands possible.
One important thing about treatment of either carbuncles or furuncles is not to attempt to massage the part or rub the disease away. In fact, just the opposite procedure is demanded—the part should be kept quiet, free from irritation of all kinds, and protected from movements or rough handling.
Most surgeons agree that the best treatment of a carbuncle is early excision. This means complete removal of the skin and deeper tissues with the entire area of infection. It usually demands a general anesthetic.
As a famous surgeon said, "Don't coquet with a carbuncle. Cut it out as you would a cancer, and you will never regret it."