tnt DOCTRINE OF CONTAGItJM VlVUM. 32l 



They may do so at the near approach of death, but scarcely 

 before that period. 



Inthecourseof traumatic septicaemia there sometimes occurs 

 an event of great importance which imparts a new feature to 

 the disease ; I mean hifectivetiess. How this arises is a matter 

 of speculation. To me it appears probable that, under a 

 certain concurrence of conditions in and about the wound, 

 a modification takes place in the vital endowments of the 

 septic organism, whereby it acquires a parasitic habit, which 

 enables it to breed in tissues of degraded vitality or even in 

 the healthy tissues, and in this way to produce the infective 

 endemic pyaemia which we sometimes witness in the wards 

 of our large hospitals.^ I shall develop this idea more fully 

 by and bye. 



Before leaving the subject of septicsemia, I may allude to 

 the possibility of wounds being infected with septic organ- 

 isms from within. As a rare occurrence, I am inclined to 

 think that this is possible, and that it may account for the 

 occasional alleged infection of protected wounds. From an 

 observation by Chauveau, it may be inferred that septic 

 organisms, when injected directly into the blood, are able to 

 survive for two or three days, although unable to breed 

 there. ^ It is conceivable that occasionally a septic germ enter- 

 ing the body in some of the ways which have been suggested 

 may escape destruction and pass into the blood and lurk 

 there awhile, and finding by chance some dead tissue or 

 liquid within its reach, may multiply therein and produce 

 septic effects. Such a contingency, if it ever occur, must be 

 very rare, and would not appreciably detract from the value 

 of the antiseptic mode of dressing wounds. 



E-ELAPSiNG Fever. — In 1872, Dr. Obermeier, of Berlin, 

 discovered minute spiral organisms (spirilla) in the blood of 

 patients suifering from relapsing fever. This discovery has 

 been fully confirmed by subsequent observations. The organ- 

 isms are found during the paroxysms ; they disappear at the 

 crisis ; and are absent during the apyrexial periods. 



These little parasites consist of spiral fibrils of the 

 most extreme tenuity, varying in length from two to six 

 times the breadth of a blood corpuscle. In the fresh state 

 they move about actively in the blood. They have not been 



' Such a modification or "variation" might be correlated with a modifi- 

 cation of the ferment action, whereby a more virulent septic poison is pro- 

 duced. Would not such a view explain the sudden intensificaliou of the 

 infecting virus which was found by Chauveau and Dr. Sanderson iu llieir 

 experiments on infective inflammations ? 



» ' Comptes Rendus; 1873, p. 1092. 



