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.

    239/976 (page 219)
    may be so sudden and so severe, and at the same time in many respects so like those of Pyaemia, that the supervention of the latter disease is very apt to pass unobserved. The diseases, which above all others Pyaemia resembles, are typhus and enteric fevers, internal acute inflammations (especially of the lungs), urethral and bladder affections in which the kidneys have become involved, and acute rheumatism. The resemblance to fever is proved by the fact that even surgeons of experience occasionally mistake Pyaemia for typhus or enteric fever. The general symptoms and the aspect of the pysemic patient are indeed almost identical with the general symptoms and aspect belonging to the fevers just named, and the frequent presence of diarrhoea approximates Pyaemia particularly to enteric fever. The liability to error is necessarily much increased when the Pyaemia depends on some deep-seated suppuration, which possibly escapes detection. The differences however are generally well pronounced; the severe rigors and perspirations of Pyaemia have scarcely any counterpart in either form of fever, in Much for the most part rigors are scarcely marked, and the skin is dry. Moreover, the eruptions characteristic of typhus and of enteric fever are absent in Pyaemia, and the jaundice which generally attends the latter disease is rarely present in either of the former. The morbid anatomy and the progress of the several diseases will suggest other marks of dis- tinction. In pneumonia, not only is the general aspect of the patient like that of a patient suffering from Pyaemia, but the rigors, the profuse perspirations, the jaundice, and even the diarrhoea, may all be present; while in Pyaemia more or less of the lung is mostly involved, and there may even be pneumonic expectoration. It is obvious, therefore, that there might be great difficulty, even impos- sibility, in distinguishing a case of pneumonia, secondary (say) to a compound fracture, from a case of Pyaemia, supervening on a similar injury. On the other hand, a case of Pyaemia, in which the source of pysemic affection is not obvious, might without much carelessness be taken for a case of pneumonia. Again, when inflammation and sup- puration of the kidney-structures come on as a result of vesical inflam- mation, or of any other disease obstructing the passage of urine, febrile disturbance with delirium follows, and the combined symptoms differ often but little from those of Pyaemia supervening on the same local