1. THAT the Carbuncle does not spread too far, like a Gangrene, knowing no Bounds.
2. TO bring it as soon as possible to a Separation; and,
3. TO cure it as carefully as it can be done.
FOR the first Intention, such Remedies are suited which give a Restriction to the Part, so that the venomous Particles cannot spread; and such also as asswage the distempered Heat, and cherish and preserve that which is natural.
BUT the Cure of a Carbuncle is varied by its Nature, Progress, and Situation; and is accordingly to be treated sometimes with more, and at others with less Severity. In this Case Benefit is sometimes received from a Cataplasm with roasted Garlick, Soot, London Treacle, and Oil of Turpentine; Or,
[a]℞] Fermenti veteris [a]℥] [a][ss.] allii assati [a]℥] ij. stercoris columbini [a]℥] j. confec. Sinapi [a]ʒ] v. euphorbii [a]ʒ] ij. cum s. q. saponis nigri F. Cataplasma. But it is to be observed, that in the Application of these Cataplasms, which are very sharp, the utmost Caution must be used, that a Pain is not aggravated thereby beyond the Patient’s Power to bear; that the Humours be not colliquated, and thrown upon weaker Parts; and that an immoveable Eschar be not made thereby.
WHEN the Eschar does not fall off, nor any Signs of Separation appear, Unguents and Oils are not to be blamed; but if the Carbuncle spreads further, it will be necessary to have Recourse to more effectual Means; in which Case neither the Tenderness of Sex or Age is to be regarded. Sometimes the pestilential Venom is to be
drawn out by Cupping, or Scarrification, or Epispasticks: Sometimes also for the same Purpose is applied the bare Rump of a Fowl, repeated until these Creatures appear not to be hurt by it; for this natural Warmth sooths the vital Heat of the Part it is applied to, and entices away the morbifick Venom through the Pores; Pidgeons used alive, and warm Sheeps Lights, have likewise been observed thus to asswage the Acrimony of this pestilential Virulence.
THE Eschar is sometimes got off by burning, and sometimes by Incision; I never indeed found any thing more effectual than the actual Cautery; and in this Practice of ours we differ not from the celebrated Concoregius, who tells us, pag. 39. that in his Time they were wont to burn the Carbuncle with a red hot Iron. There are very convenient Instruments amongst the Surgeons for this Operation, which they call the Button, being so shaped; but they are of little Service, except the Burning extends to the Compass of the Eruption; and the Iron is by no means to be taken away, until the Patient is sensible of it; but to get off the Eschar, the middle Part must be burnt deepest.
AMONGST many other Advantages, I shall mention but a few that are received from the actual Cautery in these Cases; for from hence the Parts affected are rendred more firm and strong; hence the Vessels are more astringed; hence the subtil Miasmata are rarified and evaporated; hence the Poison is corrected and dried up; and lastly, hence the languishing Heat is quickned; and, not to use many Words, the pestilential Venom seems to be destroyed by Burning, no otherwise than the Bites of poisonous Creatures are cured after the same Manner.