ustules
and boils on his own forearm by rubbing in a culture of the
staphylococcus aureus.
A #boil# results when the infection is located in a hair follicle or
sebaceous gland. A hard, painful, conical swelling develops, to which,
so long as the skin retains its normal appearance, the term "blind
boil" is applied. Usually, however, the skin becomes red, and after a
time breaks, giving exit to a drop or two of thick pus. After an
interval of from six to ten days a soft white slough is discharged; this
is known as the "core," and consists of the necrosed hair follicle or
sebaceous gland. After the separation of the core the boil heals
rapidly, leaving a small depressed scar.
Boils are most frequently met with on the back of the neck and the
buttocks, and on other parts where the skin is coarse and thick and is
exposed to friction and pressure. The occurrence of a number or a
succession of boils is due to spread of the infection, the cocci from
the original boil obtaining access to adjacent hair follicles. The
spread of boils may be unwittingly promoted by the use of a domestic
poultice or the wearing of infected underclothing.
While boils are frequently met with in debilitated persons, and
particularly in those suffering from diabetes or Bright's disease, they
also occur in those who enjoy vigorous health. They seldom prove
dangerous to life except in diabetic subjects, but when they occur on
the face there is a risk of lymphatic and of general pyogenic infection.
Boils may be differentiated from syphilitic lesions of the skin by
their acute onset and progress, and by the absence of other evidence of
syphilis; and from the malignant or anthrax pustule by the absence of
the central black eschar and of the circumstances which attend upon
anthrax infection.
_Treatment._--The skin of the affected area should be painted with
iodine, and a Klapp's suction bell applied thrice daily. If pus forms,
the skin is frozen with ethyl-chloride and a small incision made, after
which the application of the suction bell is persevered with. The
further treatment consists in the use of diluted boracic or resin
ointment. In multiple boils on the trunk and limbs, lysol or boracic
baths are of service; the underclothing should be frequently changed,
and that which is discarded must be disinfected. In patients with
recurrence of boils about the neck, re-infection frequently takes place
from the scalp, to which therefore treatment should
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