Volume 1

A system of medicine / edited by J. Russell Reynolds.

Date:
1866-1879
Catalogue details

Licence: Public Domain Mark

Credit: A system of medicine / edited by J. Russell Reynolds. Source: Wellcome Collection.

    218/976 (page 198)
    Pyaemia has not, so far as we know, been investigated. We must content ourselves therefore with the discussion of its physical pro- perties. With certain important exceptions, which will be presently fully considered, the blood in Pyaemia presents no important differences from the blood of health ; it retains its natural colour, the blood discs and the white corpuscles preserve their due numerical relation to each other and to the mass of the blood, and so far as can he recog- nised their normal characters. Sometimes the blood appears to he unusually fluid, to present in the cavities of the heart and in the larger vessels traces only of coagulum. More commonly it coagu- lates in the usual way ; and we find distinct clots in one or more or all of the cavities of the heart. Sometimes these are ordinary coloured post-mortem clots, sometimes they consist 'wholly or almost wholly of pure fibrine ; and in either case they may he prolonged in a cylindrical form into the large vessels. There is no special tendency for the right side of the heart to he occupied, far less to he occupied exclusively, hy these clots. They may he found there, it is time, and found there while the left cavities are contracted and empty. But in many cases, while the right side is empty the left is distended with them. In fact there is nothing in the situation or character of these clots to distinguish them from those which are found in many other forms of disease. The adherent rounded clots, which soften in their interior into a puriform pulp, have sometimes been supposed to cha- racterise Pyaemia. But this is clearly a mistake.* Such clots are far more commonly observed in other cases; indeed are altogether exceptional in Pyaemia; and when present are evidently accidental and probably trivial complications. The most important and characteristic changes of the blood in pysemic cases are manifested more particularly in the veins of the part at which infection is supposed to have occurred, and in the small arterial twigs leading to the spots in which secondary lesions have become developed. The veins leading from the seat of supposed infection have been examined over and over again with extreme care; and the general results of these examinations may be shortly sum- marized. In some cases the veins, though traced into suppurating and even sloughing regions, are found, both as regards their walls and