Vol. 60, 1909 - University of North Carolina at Chapel Hill

ORIGINAL COMMUNICATIONS. 225
i
the back of the neck is responsible for their he lives. If, in this operation, you do not
being- found there most commonly. get all of each division, you are likely to
One of the first symptoms of a carbuncle, have further trouble and a spread of the
is a slight redness and swelling of the part, infectious process. Now, I do not propose
accompanied, usually, by pains radiating to criticise these modes of treatment and
from the point in various directions. If it stop there, but 1 hope to be able to present
happens to be on the back of the neck there something that will materially help the
is a stiffness of the muscles and pain runhing
up into the head more noticably than
doctor in dealing with these painful affec-
tions. To be brief, the plan I have found
^Isewhere.
Tha patient thinks little of it—thinks he
best is to treat them with a high power in-
candescent electric light. This plan of
has a little boil on his neck and very likely treatment softens the mass around the imbqueezes
it or gels some friend to squeeze it mediate infection, stops the infectious protor
him. This usually does more harm cess, and almost entirely relieves the pain,
than good for it bruises the underlying and They will almost invariably get well in a
adjacent tissues, making infection of them much shorter time under this than any
much more easy. This state of affairs may other plan of treatment I have ever tried.
Continue for a few days with pain and
bwelling gradually getting worse. He then
buts a poultice on it—thinking thus to soften
The light has a decided influence on the
spread of the infection, rendering it more
circumscribed. The most wonderful part
the core and get rid of it. In this he is usu- of the whole thing to me, is that the parts
ally mistaken, for instead of getting better are so nearly anesthetized that you can do
[t continues to grow worse and larger. By what little cutting is necessary or what
he time he consults a jjhysician it has gotten squeezing is necessary to force the pus out
ucli a firm hold thatnothing can prevent it. with very little pain to the patient. I use
The physician then finds a large circumscri- a 500 candle power incandescent light with
)ed mass with two or more openings in it, a parabolic reflector over it, focussing the
vith pus oozing from tliem and an infiltra- light rays on the desired spot; at the same
ion of the surrounding tissues, so much so, time drawing down the lamp as near the
hat the hardness sometimes extends several patient as he can stand. It gets hot alright,
nches on all sides of the openings, Those
)n the back of the neck p oduce such inolerable
pain in the head that nothing
but the relief from pain is so great that they
are willing for you to make it hot for them,
I have treated a number of cases in this
hort of Morphine hypodermically will way, the number of treatments varying
elieveit. This infiltrated skin has a dusky from one to twelve— giving one treatment
ed ajjpearance and is very hard to the each day. I will not go into details with
ouch. 'JMie temperature ranges from 99 these cases, but will only say that witli
i5 degrees. The bowels are constipa- about an equal number treated in the old
ed, the urine high-colored, and in many way with poultices, lancing, cjkc, and those
>atients some sugar is found, as it is gen- with the light—that the ftirmer took about
rally known that a man who has many as long again to recover and suffered three
arbuncles is in a pretty good road to be: or four times as much as the latter. One
ome a Diabetic. thing I wish to mention is this—that the
However this paper has nothing to do time reciuired to complete the cure after the
t'ith that, only dealing with the carbuncle cores have been removed is also very matelone,
Now as to treatment: Almost everything
rially shortened.
In conclusion, I only wish to say that I
u the medical alphabet has been used and think the advantages of the light treatment
)raised by some one. However there are a
w things that all agree are among the
are briefly these:
1. Less danger to the patient,
lest things to be done. Many advise mak- 2. The pain is much less,
iig two deep cross incisions through it and 3. Recovery much more rapid,
uretting out the contents. Some advocate 4. Much smaller scar.
lie injection of carbolic acid into them to I am sure that if you will give it a thortop
the infectious process. I suijpose the ough trial on even one patient, that you will
tost common practice in all cases is to never go back to the old way of treating
nesthetize the patient and cut out the them again.
rhole infected area. This usually relieves peripheral Operation lor Tic-Doulourex;
le pain, but it is very seldom that you will Report ol Case.
nd a patient who is willing to undergo the By Dr. A. IC. DakL-r, Cliarleston.S. C, Gynecologist,
nesthetic until he finds there is absolutely l'"!"-''' Hospital Polyclinic Medical School
o other way out of his trouble. This also Of all diseases that are not fatal, probably
as the disadvantage of making a large facial neuralgia is one of the most distresscar,
that stays with the patient as Igng as iug and one of the most difficult to cure.