Treatment of infective wound poison ing, and its resultant lymphangitis and lymphadenitis, by the prolonged use of local hot baths. Poisoned wounds arc generally on the extremities, and the in fective inflammation is worst in the im mediate neighborhood of the wound. The local hot-water baths almost immedi ately arrest the inflammation, soothe the pain, and cause speedy resolution, except where suppuration has begun, and limits the suppuration when it bas commenced. Fraser (Therapist, Mar. 15. 1900).
Method of rectal injection of salt solu tion recommended by kiegar, which is as follows: The eannula. introduced into the rectum is supplied by a receptacle filled with the llnid to be injected, and this fluid is allowed to flow into the bowel very slowly tinder very slight pressure until the patient is sensible of a certain amount of tension; the re ceptacle is then lowerea so as to cause part of the injected fluid to flow back into it; this process is repeated, the liquid being changed after a time if it is soiled by f•eal matter. As soon as the rectum has been sufficiently cleansed, absorption by the mucosa commences to the extent of 500 to 1000 cubic centi metres an hour; this is soon followed by more or less profuse diuresis, the re lief of the thirst and pa relied mucous membrane, and by abundant perspira tion, W hie'', unlike many critical sweats, is not aeeompanied by collapse or any distressing symptom, even though the temperature sinks to normal. Vernitz (Semaine Med.; Brit. Gynme. Jour., May, 1902).
Pymmia.
Definition. — An intermittent febrile disease characterized by the formation of multiple metastatic abscesses in various parts of the system, and due to the ab sorption of pyogenic organisms.
Symptoms.—Since antiseptic methods have been generally used in surgery, pyoemia has greatly decreased. The cases seen in practice are usually due to care less dressing of wounds, generally by the patient himself, who only applies for treatment after the symptoms of general infection are well marked.
The initial symptoms, a chill more or less marked, slight fever, increased sen sitiveness of the wound, usually come on a week or ten days after the injury was received: i.e., when suppuration has been fully established. After this first chill, a period of quiescence occurs of perhaps an entire day and, as a rule, an other chill occurs the second day, fol lowed by another on the third, and so on, until the chill is observed to be ir regularly periodical or intermittent: a characteristic manifestation of pymmia.
The same irregular intermittence is observable in the temperature-curve, which, after marked elevation,-104° F., —suddenly falls to the normal or even below, remaining there until the next exacerbation. The intermissions vary in length—sufficiently long sometimes to suggest recovery. Suddenly another oc curs, and another period of high tem perature supervenes. The pulse does not follow the temperature; though its rapidity is increased when there is py rexia, it is never normal as long as pyannic infection is present.
The second period is that during which metastatic abscesses are formed. The lungs, the spleen, the liver, and the kidneys are the sites of predilection for ' these abscesses, the first two organs espe cially. A sharp pain in the side with dyspnoea—the attending signs roughly suggesting pleurisy, htemoptysis, etc.— denotes that the lung has become the seat of the abscess, with perhaps septic effusion into the pleura. If the liver be invaded, jaundice, a common symptom in ppemia, becomes marked, and the physical signs indicate hepatic involve ment. Thematuria, the presence of many casts and much albumin in the urine, points to pyTmic nephritis. The brain may also be the seat of abscess, and show signs corresponding with the region involved. The joints are not in frequently the seat of abscesses, and the parotid gland also.
The general symptoms are character istic and unlike those of septicmia. The mental condition, unless a brain abscess develops, is totally different; in stead of apathy, there is usually clear perception of suffering, which may be come quite severe through the involve ment of nerves and joints in the inflam matory process. The skin is usually dark or yellowish and erythematous, and sometimes pustular eruptions may greatly increase the discomfort. The tongue is thickly furred. Marked weak ness, emaciation, and exhaustion are the rule, especially in cases of long duration. In the later stages delirium may appear, especially in acute cases; followed by coma.