On the subject of carbuncles, Dr. Patrick Russel observes, that “there are certainly varieties in them, but perhaps these varieties have been unnecessarily multiplied, from the same eruption having been viewed in different stages of its progress; for all of them sooner or later are covered with a black eschar.” Dr. Alexander Russel describes them as follows: “The carbuncles were commonly protruded the second day of the disease; and though the muscular and tendinous parts were more especially affected, no part whatever could be said to be free of them. The carbuncle at first resembled an angry confluent pock in its inflammatory stage, but was attended with intense, burning pain, and surrounded by a circle of a deep scarlet hue, which soon became livid. By a progress very rapid, it then spread circularly, from the size of a silver penny to an inch and an half, two inches, nay, even three inches, diameter; and the supervening gangrene often penetrated deep into the substance of the parts affected. In such of the sick as recovered, the gangrene usually ceased spreading on the third day; and, a day or two after, signs of suppuration were observed at the edge of the black crust, the separation of which, advancing gradually, was completed rather in less time than that of the eschar in issues made by caustic. In cases where the patient died, I was informed (for I saw none of those cases myself) that a quantity of ichorous matter oozed from beneath the eschar, which remained itself shrivelled and hard, without any favourable signs of separation or digestion.”[108]