Tincture of steel—tincture perchloride of iron—should be administered to the patient throughout the illness, 15 drops in a wine glassful of water every two hours from 8 a.m.
to 8 p.m. For a long time after the attack the patient should protect the part that has been affected from cold and damp and wind.
Boil (Furunculus) is an inflammation of a small part of the true skin, usually beginning in the glands of a hair sac. The inflammatory material poured out causes a hard swelling, which is red, painful, and throbbing. Matter forms and appears at the top of the swelling as a yellow point. The matter bursts through and continues to be discharged through a minute opening for some time. Through the opening there may be seen, deep in the part, a yellow centre or "core." By the time this is loosened and discharged, the swelling and redness are greatly lessened, and the cavity fills up. When all tenderness and swelling have passed away a scar remains to mark the spot. In a " blind boil" the process is the same, but the boil is deeper and slower in reaching the surface.
A . boil may be produced by some irritation applied to the part at which it appears. It is due to the operation of a microscopic organism, a staphylococcus (see p. 496) acting on a de pressed state of general health.
Treatment.--One may be successful in check ing the development of a boil in its early stage, when it is felt as a hard painful spot in the skin, by the application of sonic soothing substance, such as a paint wade of equal parts of glycerine and extracts of opium and belladonna. When the boil is hard and stinging, hot applications ' are most soothing. To the water there should be added lysol, 15 drops to each tumbler of warm water used.
The most effective remedy is the injection under the skin of a vaccine—anti-staphylococcic. Yeast by the mouth is also very helpful ; a tea spoonful of dry brewer's yeast stirred into a tumbler of water and taken in four doses each day. Yeast may also be obtained from the drug gist in 5-grain tablets. It often hastens cure, and aids in the removal of pain, to have a sur geon freely open the boil with a lancet. Beside such local treatment the patient's bowels should be relieved by seidlitz-powder or similar medi cine, and nourishing food, quinine and iron tonic, &c., should be administered.
Carbuncle (Anthrax) is an inflammation of the true skin and tissue beneath it akin to that occurring in boils. It is more extensive than the latter, and instead of one has several cores.
Considerable portions of the skin are apt to be destroyed and to separate as sloughs. It is associated with a bad state of general health, from which condition its danger arises, for it may threaten life by exhaustion. It begins as a painful bard swelling, increasing in size and deepening in colour, situated most commonly on the back of the neck. The pain is severe and throbbing, and fever is marked. In a few days several openings are formed on the surface, from which discharge escapes, and through the openings yellow "cores" are seen. The skin becomes undermined, and the openings unite to form a large one, revealing an ashy-gray slough in the deeper parts. As this is dis charged a cavity is formed extending some distance under the skin. Often pieces of the skin die and are thrown off, so that a large ragged wound is formed, from whose surface shreddy matter separates. The exhaustion is often great, and extensive parts of the skin are more liable to die because of the general weakness.
Treatment. — Nourishing and stimulating diet is of the utmost consequence. Quinine and acid tonics (see Pitzscitierioafs) are to be given. The local treatment is similar to that prescribed for boil, specially the lysol fomentations. Car buncle is frequently fatal from exhaustion or blood-poisoning, and from the first a competent surgeon should have charge of the' case.
Ulcers of the skin are common. An ulcer implies that the skin is broken, and that there is loss of substance. Owing to softening and breaking down of the skin an open sore exists. Various circumstances may encourage the for mation of an ulcer. Thus some persons may be in such a depressed condition of health that the slightest scratch or bruise will lead to breach of the surface and the formation of an ulcer. Again, while the general health may be of a fair average, some particular part may be sub ject to influences that readily provoke ulcera tion. Thus persons who suffer from enlarged (varicose) veins are liable to have ulcers form ing on the legs on slight provocation. Owing to the dilated veins the circulation is so sluggish that the nourishment of the skin is impaired, and a scratch or knock or bruise gives rise to a sore difficult to heal. Such ulcers occur often in persons who have to stand most of the day, laundresses, cooks, &c., specially if they are stout of build; and the ulcers are on the legs because these are the lowest parts, from which the return of blood is most impeded.