Microbic Diseases Individually Considered. 159 



multiply there ; in the case of others they may be 

 seen to penetrate into the circulatory fluids when the 

 disease is of rather long duration. It is evident that 

 this penetration can be followed by new troubles 

 localized in the different parts of the economy in 

 which these germs become arrested. But even in the 

 absence of microbes in the circulation, general symp- 

 toms of septicaemias are nearly always complicated 

 with local symptoms due to the irritant action of the 

 absorbed ptomaines. Such is the pathogeny of 

 parenchymatous nephritis with albuminuria, hepatitis, 

 enteritis with diarrhoea, pneumonia, pleurisy, peri- 

 carditis, myocarditis, endocarditis, meningo-enceph- 

 alitis, etc., which are seen to develop in the course 

 of septicaemias. 



Septicemic fever presents several varieties, the 

 clinical importance of which should not be disre- 

 garded. Traumatic fever is the mildest form, the first 

 degree of acute septiccemia ; the latter develops in sev- 

 eral days and determines a greater and more lasting 

 elevation of temperature; super-acute, fulmiiiating, or 

 gangrenous septiccemia kills the subject in a very short 

 time ; finally, chronic septiccemia, or hectic fever occa- 

 sions a slow pining away of the patient, and is of 

 much longer duration. 



Septicaemia may succeed to a large number of local 

 lesions : sanious wounds, abscesses, erysipelas, fu- 

 runcle, gaseous gangrene, etc. The microbes which 

 occasion it are very variable and the symptoms are 

 therefore not always alike. 



The pyogenic germs can also give rise to a pure 

 septicaemia; the streptococcus pyogenes is the cause 

 of puerperal fever; the staphylococcus pyogenes 



