24 SURGERY. 



usually gregarious, and depend upon derangement of the primoe vise, 

 and frequently succeed eruptive diseases. 



The swelling is of a conical shape, having a hard, red, and painful 

 base, and a yellow apex. If left to itself it bursts and discharges 

 pus, and a core, or slough of cellular tissue. When completely 

 emptied the heat and pain subside. 



Treatment. — Poultices and warm fomentations should be applied 

 early ; as soon as pus has formed a free incision must be made ; and 

 the granulating wound dressed in the ordinary way. 



ANTHRAX, OR CARBUNCLE. 



This is a serious disease ; it is a solitary inflammation of the cel- 

 lular tissue and skin, presenting a flat spongy swelling of a livid 

 hue, and attended with dull burning pain. It varies in size, and its 

 progress is slow. 



The constitutional symptoms are asthenic throughout, and the at- 

 tendant fever is apt to become typhoid ; prostration and delirium often 

 terminate the case. It most frequently attacks high livers of an ad- 

 vanced age. 



Treatmerit. — A free and early incision will evacuate sanious pus 

 and fetid sloughs ; this is to be followed by applications of caustic 

 potash, in order that the dying parts may be thoroughly removed. 

 Poultices and warm fomentations will clean the surface, and give 

 rise to healthy granulations. Tonics and stimuli, such as bark, 

 brandy, ammonia, are early required, particularly if the carbuncle 

 is large, and system debilitated. 



PERNIO, OR CHILBLAINS. 



This is an affection of the skin, produced by sudden alternations 

 of cold and heat, most commonly afi^ecting the toes, heels, ears, or 

 fingers. It is attended with itching, swelling, pain, and slight red- 

 ness at first ; it may afterwards become of a livid hue, with vesica- 

 tions and ulcerated fissures, which are difficult to heal. 



Treatment. — There is a great variety of applications in domestic 

 use for this disease, and some of them of the most opposite character. 

 The most serviceable remedy under all circumstances, but particu- 

 larly when there is ulceration, is the nitrate of silver. Temporary 

 and soothing relief is produced by cold applications. 



FROST BITE. 



Severe exposure, combined with exhaustion and fatigue, irresist- 

 ably induces sleepiness, which, if yielded to, is followed by coma and 

 death. When a part of the body is frost-bitten it becomes contract- 

 ed, pale and insensible. It may take place without the conscious- 

 ness of the patient ; without care it terminates in gangrene. 



^Treatment. — Produce moderate reaction, which will restore cir- 



