BOIL, a superficial or deep localized in flammatory process of the skin leading to the destruction of tissue and the formation of pus. In practically all instances some form of in fection by a micro-organism, usually the Staphylococcus pyogenes aureus or albus, is present in boils. In the superficial varieties, the bacteria enter the hair follicles or the sebaceous glands and travel down beneath the skin and here either set up a process of destruction or continue one already begun by a wound. There results a local swelling, with exquisite tender ness, and later a pointing and discharge of the purulent detritus from the boil. In the deep seated varieties similar processes are in action, but the heading and discharge of the boil is de layed. The marked tenderness is due to the involvement of the nerve fibres in the tissues immediately surrounding the inflammatory centre. The predisposition to the formation of boils varies widely, some people being particu larly prone to them. They are apparently more liable in those who are "run or in those whose tissues are non-resistant and appear in many disorders of depressing character. Their presence is due, however, to infection rather than to a state of the blood or other individual condition, which only offers favorable soil for their development. For this reason they are
most common in boys and young men who are exposed to infection from barbers' fingers and implements, sweaters and other garments worn in athletic training, etc. It is probable that a favorable soil due to run down or other patho genic condition favors the reinoculation which is the actual cause of the successive recurrence or "crop of known as furunculosis. An occasional apparent epidemic is also due to re peated infection in the same family or group. A tonic and general hygienic treatment may be helpful but particular stress should be laid upon scrupulous cleanliness of the skin and all that comes into contact with it. In direct treat ment of the boil the aim should be to prevent or at least to limit suppuration. If suppuration has already begun applications may be made which will hasten it, but they should be strictly aseptic to prevent further infection. Surgical evacuation of the cavity followed by surgical aseptic measures are advisable.