Columnae adiposae, a newly-described structure of the cutis vera : with its pathological significance in carbuncle and other affections / by J. Collins Warren.

  • Warren, John Collins, 1842-1927.
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: Columnae adiposae, a newly-described structure of the cutis vera : with its pathological significance in carbuncle and other affections / by J. Collins Warren. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    i It) OolumnoB Adiposce. Tlie English “carbuncle” is synonymous with “an- thrax : ” it is a term not employed by the French, who substitute “ anthrax ; ” by the Germans it is used to denote either disease. The current authority on surgical pathology ^ thus describes carbuncle : Anatomically it resembles a group of several furuncles lying close together. Its origin and first stage are the same as in furuncle; that is, the death of a small portion of the skin (perhaps a cutaneous gland) seems to be the starting-point and centre of the inflammation. “ Soon a number of white points form near each other, and the swelling, redness, and pain in the periphery increase in some cases so much that the carbuncle may attain the size of a soup-dish ; and while the detachment of the white plugs of skin goes on in the centre the process not unfrequently extends in the periphery. . . . After the loss of the plugs of cutis, the skiu appears perforated like a sieve. . . . But even when most intense, the process is almost always limited to the skin and subcutaneous cellular tissue. . . . You will have already noticed that the process of formation of furuncles and carbuncles differs from the inflammations with which you are already acquainted by the constant and peculiar death of portions of the skin. Of course, this must be induced by an early, perhaps primary, occlusion of small arteries; possibly of the vascular net-work around the sebaceous glands. . . . This limitation to the skin and subcutaneous cellular tissue is very characteristic of fibrinous (diphtheritic) in- flammations ; so that on this account, as well as from the hard infiltration and necrosis of the tissue once in- filtrated, I do not hesitate to consider carbuncle as a 1 Billroth, Lectures on Surgical Pathology, American edition, page 283.