The practice of surgery : a treatise on surgery for the use of practitioners and students / by Henry R. Wharton ... and B. Farquhar Curtis.

  • Wharton, Henry R. (Henry Redwood), 1853-1925
Date:
1902
Catalogue details

Licence: Public Domain Mark

Credit: The practice of surgery : a treatise on surgery for the use of practitioners and students / by Henry R. Wharton ... and B. Farquhar Curtis. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

    45/1268 (page 31)
    sapriemia, septicjemia, py^imia. By B. Fabquhar Cuktis, M.D. Under the general term septicfemia we include certain conditions wliich are not to be considered as independent diseases, but as advanced states or sequelfB of a local bacterial invasion. Se^pticmmia may be defined as a morbid condition of the system caused by the presence of bacteria or their toxic products in the blood. Practically, we limit the term septicfemia to the effects of those bacteria which cause the acute surgical infectious diseases, although there is no pathological difference between the condition of general infection seen in typhoid fever and that of erysipelas, the constitutional symptoms in both cases being due to entrance into the circulation of germs or the toxic products of germs growing in the local lesions of the skin in the latter case, and of the intestine in the former. Sapraemia.—We distinguish between the poisoning of the system due to the absorption of the toxic products of the germs of decay and those of disease, calling the first saprsemia, the second septicaemia, because of the important clinical difference between the two. As the ordinary saprophytes cannot exist in living tissues or in the blood, the only manner in which they can affect the body is by the introduction of their toxic products into the circulation, x^roducing saprsemia. If these bacteria are implanted in dead matter in the body upon which they can grow, such as a clot of blood or necrotic tissue, decomposition sets in, ptomaines are produced, and gas is often generated. If no ]3yogenio or other special bacteria are implanted with the saprophytes, there is no inflammation, but the surrounding tissues absorb these chemical substances, and the whole body is poisoned by their presence in the blood. Symptoms.—There will be an elevation of temperature, with chilly sensations, although a true chill may not occur, a flushed skin, rapid pulse, dry, coated tongue, loaded urine, and constipation, followed by diarrhoea. This intoxication is rare in its pure form, but may develop from a putrid placenta or clots retained in the uterus after labor, or from a large imper- fectly drained abscess, the prompt recovery of the patient after removal of the cause of intoxication proving that pyogenic or pathogenic bacteria ai-e absent or so scanty as to be of no moment. An intoxication of this kind is never found until two or three days, or even longer, after the bacterial infec- tion. It begins gradually, for the putrefactive germs must grow to a cer- tain extent before they can produce enough ptomaines to poison the system. A complete removal of the decomijosing material, moreover, cuts the process short, just as evacuation of the stomach will cause the symptoms of mineral poisoning to cease as soon as the poison which has already been absorbed and entered the system is eliminated. These two facts enable us to make