Modern surgery, general and operative . utlet; it cannot spread easilyto the sides, so it slowly works its way to deeper tissue and from one to anotherinterspace and finds its way to the surface through other fatty columns (War-rens Surgical Pathology) (Fig. 73). When pus finds its way to the sur-face, an opening forms, hence the numerous foci of pointing; finally a largeopening forms (Fig. 74). Carbuncles are most common in the spring of theyear. In persons with diabetes and Brights disease carbuncles not unusuallyoccur. The local symptoms in the beginning resemble those of a boil, but thecon
Modern surgery, general and operative . utlet; it cannot spread easilyto the sides, so it slowly works its way to deeper tissue and from one to anotherinterspace and finds its way to the surface through other fatty columns (War-rens Surgical Pathology) (Fig. 73). When pus finds its way to the sur-face, an opening forms, hence the numerous foci of pointing; finally a largeopening forms (Fig. 74). Carbuncles are most common in the spring of theyear. In persons with diabetes and Brights disease carbuncles not unusuallyoccur. The local symptoms in the beginning resemble those of a boil, but theconstitution sympathizes from the very start (perhaps a chill and always aseptic fever) and the pain is usually severe. The inflammatory area beginsas a papule with an indurated base, it enlarges enormously, is boggy to thetouch, is dusky in color, is edematous, and the skin is not freely movableover the deeper parts. In a few days many pustules appear, each pustulemarking the site of a focus of necrosis. Large vesicles filled with bloody. Fig. 72.—Columna adiposa (Warren). Carbuncle 139 serum ver>^ frequently form. In some cases about the tenth day the pustulesrupture, the necrotic plugs are discharged, and the case slowly progressestoward cure; but in many cases the carbuncle spreads at the peripher}- whilepustules are rupturing near the center of inflammation, and pus forms in thedeeper tissues, reaching the surface through many small openings, each ofwhich is partly blocked by a plug of dead tissue. A carbuncle in this stage
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Keywords: ., bookcentury1900, bookdecade1910, bookpublishe, booksubjectsurgery
