The Method used in the treating Carbuncles.
We have observed these sort of Tumours during the whole Course of the Sickness, in a very great number of diseased Persons in all the Classes, though less frequent than the Buboes; remarking also very often in the same Subjects, these two sorts of Emptions.
The Carbuncles present themselves in different Places on the Surface of the Body, especially in the Thighs, Legs, Arms, Breast, Back, but very rarely in the Face, Neck, or Belly.
They appear at first under the Form of a Pustle or Tumour, which is whitish, yellowish, or reddish, Pale in its middle, or inclining to an obscure Red, which becomes insensibly blackish, crustaceous, especially about the Edges; as also variegated with divers Colours; so that, according to that which is predominant, and the Excess or Defect of Sensibility and Elevation, we may give it the Name of a Phlegmonick, Erysipelatous, or gangrened Carbuncle.
We immediately attack all these sorts of Carbuncles by Scarification, making the Incision to the Right and to the Left, in the Middle, and on the Edges, to the Quick; and if the Escarr is Thick and Callous, we take away all the Thickness, and what is Callous, as much as the Situation of the Parts will permit.
We have not thought proper to use here the actual or potential Cauteries which are employed in our Province, in the case of common Carbuncles, because, having made Trial of them at the Beginning, we observed that they caused Inflammations so considerable, that a Gangrene presently ensued, and its Edges became Callous again: The Caustick Stone succeeded not but in small Carbuncles, which heal of themselves, almost without any Help.
After having scarified these Tumours, we applied Pledgets with good Digestives, as in the Case of Buboes, only with this Difference, that we have left out the suppurating Ingredients, using only the Treacle, Balsam of Arcæus, and Oil of Turpentine; and if there is much Corruption, we add the Tinctures of Aloes, of Myrrh and Camphire, &c.
We put over the Pledgets, emollient and anodine, or spirituous and dissolving Cataplasms, as over the Buboes, according to the diversity of Indications. In the Course of the Dressings, the Lotions and Injections are also employed the same as for the Buboes, according to the Exigence of the Case. And, if in the Process of Suppuration, the new Flesh be so sensible, that the Digestives applied cause a very great Pain, as we have seen it often happen, then we substitute in their room Pledgets with Unguentum Nutritum, with very good Success.
The Method relating to the Sick of the Fifth Class.
We believe it will be useless to give every particular of the Method that has been followed, and which is still actually used in the Cure of the diseased of the Fifth Class, wherewith the Hospitals are filled; because they being afflicted with no other Symptom besides the Buboes and Carbuncles ill looked after, or neglected, and by consequence, nothing here offers it self but the Abscesses, Ulcers, Fistula’s, Scirrhus’s, and Callus’s, which Negligence, or an ill Treatment have left behind them; so that there is here nothing farther required, but to put in Use the Method laid down above, or to employ the Means practised in the like Cases, according to the Rules of Art.