A treatise on the principles and practice of medicine : designed for the use of practitioners and students of medicine / by Austin Flint.
- Austin Flint I
- Date:
- 1884
Licence: Public Domain Mark
Credit: A treatise on the principles and practice of medicine : designed for the use of practitioners and students of medicine / by Austin Flint. Source: Wellcome Collection.
Provider: This material has been provided by the University of Massachusetts Medical School, Lamar Soutter Library, through the Medical Heritage Library. The original may be consulted at the Lamar Soutter Library at the University of Massachusetts Medical School.
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![the action of bacteria, he does not regard the bacteria themselves as the ao-ents of infection. It is an interesting fact that the blood of septiciwmic animals is much moi-e virulent in its action than are putrid fluids. Septic blood, in fact, loses in virulence by decomposition. Davaine therefore distinguishes between septic material and putrid material. The septic blood of one animal may be innocuous Avhen injected into an animal of a different species, while an almost intinitesimal quantity may sutfice to infect an animal of the same species. Koch' has produced in animals forms of septicaemia invariably accom[)anied by characteristic bacteria in the blood. The sejitica^mia which he induced in mice was characterized by countless small rod-sliajted bacteria, that of rabbits was accompanied by the presence of oval bacteria. The inoculation in rab- bits of blood from septiciemic mice, did not produce the disease. It thus appears that the forms of septicaemia induced in animals are not, in all cases, the same. How far they are identical with septica^mic processes in man, is yet to be established. The results obtained by these experiments can not be used, at present, either for, or against, the doctrine that the agent of infection in septicaemia in man is a living contagion (Contagium vivum). Septicaemia is observed most frequently after wounds, especially those complicated by injuries of bone, and by contusion or laceration of the soft parts. Its first symptoms appear usually in two to four days after the in- fliction of the wound, and before suj)puration has been fairly established. The changes which render a wound a source of infection, are believed to be those of decomposition brought about by the agency of bacteria. The dis- charge from the wound is thin and ichorous, the surrounding parts are cede- matous and sometimes gangrenous. Septicaemia may be caused also by gan- grene, by ill-conditioned abscesses, and by inflammations in general. Usually, although not always, the focus of infection communicates with the open air. The hectic fever of phthisis, the sujjpurative fever of smallpox and certain other secondary fevers, are considered by some as due to septicemia. There is some reason to believe that the healthy respiratory and intestinal mucous membranes can absorb septic poison generated outside of the body. Tiie changes found after death from septicaemia, are mostly of a negative character. Decomposition sets in rapidly. The blood is dark-colored, and coagulates imperfectly. Ecchymoses may be found in the serous membranes and in other parts. The spleen is often swollen and soft. Parenchymatous degeneration of the liver, heart, and kidneys is present. Tlie solitary follicles and Peyei-'s patches may be swollen. Enteritis is less common in the septi- CEemia of man than in that induced in animals. Multiple abscesses are absent. There may be inflammation of the pleura or other serous membranes. Bacteria have been found in the blood of septicsemic patients during life. They are usually detected in the blood and organs after death. IMost im- portance is attached to the ])resence of micrococci; but these, when found, have no characters distinguishing them from similar forms in several other infectious diseases, and in putrefying fluids. Good observers have failed to detect bacteria in septic;>emic cases. Septicaemia may be ushered in by a chill, but this is not constant, and repeated chills do not occur. There is, as a rule, a continuous, usually high, fever without distinct type. The skin is dry and hot, or, at times, there may be profuse perspiration. There is usually a yellowish hue of the skin, but the icterus is not intense. The pulse is small and frequent. The tongue and lips are dry. Diarrhoea is inconstant. The urine is scanty and high-colored. It may contain albumen. From tlie onset, the patient is indifferent and ' Kocli, Uiitersuchungen uber die Aetiologie der Wundiafections-ki-niikheiten, Leip- zig, 1878.](https://iiif.wellcomecollection.org/image/b21198135_0094.jp2/full/800%2C/0/default.jpg)
