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St. Louis Medical and Surgical Journal (1891)
St Louis Medical and Surgical Journal - 1891 Author:Unknown Author Purchase of this book includes free trial access to www.million-books.com where you can read more than a million books for free. This is an OCR edition with typos. Excerpt from book: buncle or its whole base sloughs. If not divided, they not infrequently suppurate only at their centers, and slough only in their central parts. In every case of... more » this kind you lessen greatly the amount of healing which has to be gone through. In some cases even carbuncles completely abort. Subcutaneous incisions have been supposed to have the same general effect as free incisions, and I think the same general conclusions may be drawn; that it is a measure unnecessary in the treatment of carbuncle, and that it retards rather than hastens the healing. As carbuncle usually occurs in persons broken down in health or exhausted by overwork, the loss of blood, although not usually great, would much retard the process of healing, and sometimes if the incision be perfectly carried out, the bleeding might be very profuse, and necessitate the distress and pain of plugging to arrest the flow. Agnew contends that the extent of the necrotic process is not affected by incisions, and that the loss of blood, which is often severe, is a positive injury to the patient. Duhring and Stelwagon do not advise incisions, but per contra, insist that weight of authority is against the practice. Crocker says this method is abandoned by general consent. Hyde states that crucial and deep incisions are certainly inferior in results to other methods. He advocates the plan of Taylor and Wood— the injection of a saturated solution of pure carbolic acid through the several apertures in every direction through the sloughing tissue by the aid of a hypodermic syringe. It is claimed that the pain is short-lived, the slough is readily separated, and the ulcer rapidly contracts, with the sequel of a small scar. The acid must be pure, in saturated solution to prevent its absorption and consequent toxic effects. F...« less