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.

    230/976 (page 210)
    times cases of Pyaemia become chronic ; the evidence that such cases are pysemic being furnished chiefly by the occurrence of successive suppurations, in joints,* in the cellular tissue, in the eye (it may be) and in other parts. Cases of this kind are sometimes observed after parturition, and such are some of the cases following on enteric and other fevers. The frequent occurrence of pyamiic deposits in the lungs only has suggested the possibility of a local Pyaemia—a Pyaemia in which the poisoned condition of the blood is confined within certain limits, and effects its secondary changes within those limits only. By such a local condition of Pyaemia, confined within the ramifications of the portal system, Dr. George Buddf has endeavoured to explain the occurrence of hepatic abscesses in cases of dysentery. This explana- tion of the frequent concurrence of dysentery and abscess of the liver is probably erroneous ; j and, indeed, our knowledge of the progress of true Pyaemia does not justify us in admitting that the poison of Pyaemia can be limited in the manner suggested. (/) Origin of Pyaemia in Contagion.—Pyaemia, which probably only occurs in the classes of cases which have been enumerated—cases pre- senting the common feature of some unhealthy suppurating surface— may arise in them either spontaneously or as the result of some con- tagious influence. Cases of spontaneous origin are not unfrequent. Many of the cases in which (whether as the result of injury or not) acute suppuration rapidly involves some large portion of bone, are eases in which there has been no previous ill-health, no exposure to morbific influences. Many of the cases occurring after compound fractures or after operations arise under personal and surrounding conditions of good health. Other cases are induced by modes of dressing -wounds, which prevent union by first intention and promote suppuration and unhealthy discharges. Many of the deaths ascribed to puerperal fever, and occurring sporadically, arise under similar conditions, and, so far as we can see, wholly independently of contagion. There are many cases however, and these are in all respects the most important, where the occurrence of Pyaemia is distinctly due to the agency of some contagium. These cases are particularly met with in surgical practice and in obstetrical practice. As regards surgical practice, it is well known that Pysemia may be often absent from a hospital ward in which