Pustula Maligna

Also called Carbunculus contagiosus, is characterized by the appearance of an angry-looking pustule, associated with gangrenous destruction of the surrounding parts which owes its origin either to a direct inoculation of the poison from an animal affected with the disease called Anthrax, or Charbon, or to a transmission by flies of the poison, or to inoculation of the poison from man to man, or to the eating of the flesh of diseased animals. It is therefore most frequently found among persons who have to do with diseased animals, or who work in manufacturing establishments, where the products of such animals (hides, horsehair, wool) are prepared for different uses. The infec­tion takes place principally on the uncovered parts of the body which are exposed to the entrance of the poison. The eating of diseased flesh first causes general malaise and intestinal troubles, after which, in about eight or ten days, anthrax carbuncles appear, by preference on the arm, forearm and head.

After an incubation of from a few hours to several days, there is at first felt on the spot where the poison took hold a slight burning and itching, as if from the bite of an insect, and one can see a little red speck with a black point in its centre. This soon becomes changed into an itching papule, capped with a small, generally reddish or bluish vesicle, which gradually enlarges. After bursting it discloses a dark red base, which becomes covered with a crust, while often, though not always, secondary vesicles spring up around it, which contain a yellowish, reddish or blackish fluid. At the same time the surrounding parts swell oedematously over a considerable area, the cellular tissue underneath also becomes infiltrated, and in many cases discolored lines mark the course of the veins, or red stripes the course of the lymphatic vessels in the oedematous region; the corresponding lymphatic glands also swell. The general symptoms correspond with the severity of the local affection; there is fever, great weakness, delirium, excitement, confusion; sweating, diarrhoea and pain in the extremities; in fatal cases collapse; in favorable cases after the dead masses have been removed by sloughing off, the wound gradually heals by healthy granulation.