Thereafter the limb should be elevated and placed under some improvised irrigator from which a weak, warm antiseptic solution should continuously trickle over the now clean surface. If the phagedænic action recur the carbolic acid must be promptly reapplied as often as may be necessary. On healthy granulations springing up the nicer is to be treated on ordinary principles. Lloyd Patterson recommends a dressing of carbolic oil after the initial cauterization, and subsequently, when the sore is clean, a dressing of lead-foil such as is used for lining tea-chests. Patients with this disease should be regarded as infective, and, so far as possible, isolated.
Boils
The anatomical and clinical features of this painful affection are too familiar to require detailed description. Suffice it to say that a boil is produced by the proliferation of Staphylococcus pyogenes aureus and albus, Streptococcus pyogenes, or other pyogenic micro-organisms in the skin and subcutaneous tissue; that the organism gives rise to local and limited infiltration of the tissues with lymph which subsequently and rapidly dies, the necrotic core being surrounded by an areola of acute inflammation; that this core is separated by a process of sloughing and so got rid of, the resulting ulcer speedily healing and leaving a depressed scar, which, when occurring about the legs, may become pigmented. Though a self-limiting disease locally, it is nevertheless capable of being inoculated elsewhere in the same individual, both through a breach of surface and, also, by simple contact of the discharges with the skin, the micro-organism apparently entering by a hair follicle. This auto-inoculability of boils is apt to be overlooked.
Conditions of debility, presumably by lowering resistance, predispose to boils; the subjects of diabetes are specially prone to them, the saccharine state of the blood or secretions seeming to be particularly favourable to growth of the specific germ.
