THE PYOGENIC FOLLICULITES 



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deeper layers of the epidermis, and often surrounded by a hypersemic 

 halo. When these firmly fixed crusts are removed, shallow circular 

 ulcers with sharply defined edges are produced. 



General Symptoms. — Constitutional symptoms are of the shghtest, 

 but during the first few days of the eruption there may be shght 

 fever. 



Diagnosis. — -The definition indicates the principal characters of 

 the complaint. As regards the differential diagnosis, this must 

 be made from chicken-pox, in which the bright yellow, discoidal, 

 deeply attached crusts are absent. 



Treatment. — The treatment advised is i per cent, white precipitate 

 ointment. 



THE PYOGENIC EOLLICULITES. 



These are pyogenic affections of the hair follicles caused by cocci. 

 The following varieties may be differentiated: — 



A. Deep-seated in the hair follicle; occur anjrwhere — Tropical 



boils. 



B. Superficially situate in the hair follicle; found on the legs 



and thighs — Purulent folliculitis of the legs. 



Tropical Boils. 



Synonyms. — Tropical furunculosis, Nile boils. Mango boils. 



Definition* — A tropical boil is a deep-seated purulent inflammation 

 of a hair follicle due to pyococci. 



Remarks. — Furunculosis is very common in the tropics. It 

 does not differ from what one sees in Europe except that it is often 

 of much severer type, and has a great tendency to spread all over 

 the body. The individual boils are frequently of very large dimen- 

 sions and extremely painful. There may be fever. The condition 

 is very common in people who perspire much and suffer from prickly 

 heat. 



etiology. — It is due to staphylococci. Carbuncle, especially of 

 the neck and gluteal regions, with deep infiltration and multiple 

 openings, is not rarely associated in our experience with ordinary 

 boils. The so-called ' Nile boils ' have been examined bacteriologi- 

 cally by Chalmers and Marshall and by Archibald, and have been 

 shown to be generally caused by Aurococcus mollis (Dyar, 1895). 



E. Black describes under the term* f urunculus contagiosus ' a benign multiple 

 furunculosis observed by him in Brazil. 



Treatment.— The quickest and most rehable method of cure in 

 cases of multiple boils is, in our experience, Wright's vaccine 

 treatment, the vaccine being prepared from staphylococci isolated 

 from the patient, or being prepared from organisms known to occur 

 in a given district. When this treatment cannot be carried out, 

 the administration of fresh yeast, half a wine-glassful twice daily, or 

 of yeast preparations internally, will be found to be useful in some 



