Malignant pustule ; Acute farcy or glanders in the human subject ; Cases of muscular anaesthesia? / by Alfred Carpenter.

  • Carpenter, Alfred, 1825-
Date:
[1874]
Catalogue details

Licence: Public Domain Mark

Credit: Malignant pustule ; Acute farcy or glanders in the human subject ; Cases of muscular anaesthesia? / by Alfred Carpenter. 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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    It was referred to by Sir James Paget in 18G9. He de- scribed it as an inflammation commencing in the lip, and spreading to the face; disease of the lymphatics then ensued, and pyaemia followed as the consequence. Sir James mentioned fifteen cases; all occurring in young persons; all fatal, with one exception only. He strongly objected to the term Carbuncular Inflammation of the lip, agreed to that of Malignant Pustule, but did not distinctly refer its origin to infection. In the nomenclature of diseases issued by the Royal College of Physicians, it is styled “ Malignant Pustule,” and defined as a “ spreading gangrenous inflammation, commencing as a vesicle on exposed skin; attended with peculiar hardness and foetor, and derived from cattle similarly diseased.” In the list of causes, it is again distinctly stated to originate from animals having infectious disease. It is not given as a cause of death in the Registrar General’s Report, but Dr. Farr has kindly furnished me with a return of the number of deaths which have been registered in England and Wales during the five years ending December, 1871, viz.,—in 1867, 6 ; 1868, 3 ; 1869, 4; 1870, 3; 1871, 5:—Total, 21. It may be that this return does not give a correct account, by reason of the possible registration of fatal cases under other names, such as Carbuncle and Erysipelas; but at any rate the fact is proved, that cases do frequently occur. Dr. Tanner says it is generally fatal within eight days* of attack, I have not found any detailed history of any case in which recovery has taken place. Sir James Paget incidentally mentions one only, but does not give details. It is stated on good statistical authority, that the mortality from Carbuncle, Phlegmon, and Boils, (diseases which probably belong to the same class,) is increasing. The Registrar Gene- ral for Scotland draws attention to the fact, and also infers that the increase of the mortality from these diseases is connected with the importation of foreign cattle ; and he suggests diseased meat as a cause for the malady. [Since reading the paper I have found that the subject is discussed in Holmes’ System of Surgery, by Mr. T. Smith. He is of opinion tliat facial Car- buncle exists as a disease, with a strong tendency to a fatal termination, as distinct from Malignant Pustule. The case 'described by liim appears to me to be a case of Malignant Pustule, but the writer refers to the absence of severe pain as diagnostic