Treatment is directed towards maintaining the patient's strength by food, fresh air, and tonics like quinine and iron, and phosphorus.
(Septiccemiu, from Greek, sego, to putrefy, and haima, the blood ; Py cemia , Greek, peon, pus, matter, and haima, the blood) is a disease due to the introduction into the blood of poisonous materials of a par ticular kind. The poison is produced by min ute living things always found in abundance in the matter of unhealthy sores. (See Cox rrAoloN, p. 493.) It is commonly in cases where such wounds or raw surfaces exist that the disease arises. Thus it is attendant on surgical operations; its occurrence is feared in cases of accident where injuries of any extent have resulted; it is frequently the cause of death in cases of dissection wounds, carbuncle, erysi pelas, and in suppurations involving bone, &c.; and it is one of the most terrible and fatal occur rences after childbirth. (See PUERPERA FEVER.) To take the last case, the separation of the after birth (placenta) leaves a large raw surface in the interior of the womb. If the after-birth has not been completely removed, and if a small piece remains attached, it begins to decompose and break down. This is nature's way of getting rid of it. But this decomposition is attended with the formation of unhealthy ma terial, which easily gains entrance to the blood, and produces the symptoms of the disease. The septic or poisonous matter seems to be formed at the wound and to be absorbed, and, as has been said, the septic material is the pro duct of certain minute living things (bacteria, p. 495) found in a womb in such a condition. The word pymmia, which literally means pus (matter) in the blood, is often used to signify the same condition. It means rather more. The poison of septicaemia is of a very subtle kind, not visible even with the highest micro. scopes, but in pyremia there is an actual trans ference along the blood-vessels throughout the body of minute pellets of poisonous material, which come from the place where the un healthy action is going on. These pellets, carried along in the current of the circulating blood, easily pass through the large arteries, but when they reach the very minute arteries they cannot pass along them. These arteries,
therefore, become blocked by the poisonous material, and abscesses form wherever this occurs. Now the pellets are distributed to every organ of the body, to lungs, liver, kid ney, brain, &c., in all which situations spots of inflammation and abscess arise. How serious such complications are may be imagined.
Symptoms.—The first occurrence usually is a fit of shivering, lasting for some time and followed by severe sweating, after which the person seems to get better ; but another pro longed shivering occurs, followed again by sweating, and so on. The fever runs very high, diminishes considerably after the sweating, but after a few days usually keeps high. The patient after a day or two begins to have a sallow look, and to be dull and heavy. The pulse is quick and weak, the tongue brown and dry, and the lips parched. Vomiting occurs, and perhaps looseness of bowels, and what is passed is dark and very badly smell ing. The breathing is quick and shallow, cough often arises, and pain and tenderness of the belly may be present. In severe cases of pytemia little patches of inflammation and sup puration may be seen on the fingers or toes or on various parts of the surface of the body. The occurrence of delirium of the muttering sort is a very grave sign. In the beginning of it the person's hands wander aimlessly about, picking at the bed-clothes, and it passes into unconsciousness as death approaches.
A chart showing the behaviour of the fever is shown in Plate XXVI.
Treatment is iu very many cases of little avail. The main thing is to keep up the per son's strength by nourishing food in fluid form, concentrated soups, beef-tea, milk, &c., and stimulants in small quantities repeated as often as seems desirable. At the beginning a good dose of saline medicine seems to relieve —seidlitz powder for example. To diminish, if possible, the fever, 5 to 10 grain doses of quinine should be given every six hours. Opium is often used to relieve pain and other symptoms, but it is a drug whose administra tion should be controlled by a medical man.