THE INFECTIOUS DISEASES. 



203 



The term pyaemia, as will be seen, indicates a clinical and anatomical 

 phase of septicaemia. 



The new foci of suppuration in pyaemia are called metastatic abscesses, 

 and in distribution these may bear an obvious relationship to the seat of 

 the primary lesion. Thus, in suppurative processes in the intestinal 

 tract, metastatic abscesses are liable to occur in the liver. From sup- 

 purations in the skin, bones, muscles, etc., infectious emboli maybe 

 transmitted to the lungs and lead to infarctions and abscess ; or, passing 

 these organs, the germs may induce multiple abscesses in the kidneys 

 and in other viscera. 



It should be remembered that the point of introduction into the body 

 of the offending germs may be wholly concealed and not associated with 



FIG. 94. MICROCOCCI IN MASSES IN THE FIBRINOUS EXUDATION OF PY^EMIC PLEURISY. 



any form of demonstrable external lesion. This is often called crypto- 

 genetic pyaemia or septico-pyaemia. 



After death from septicaemia and pyaemia there is a considerable 

 variety in the post-mortem appearances. 



There are cases in which there are no recognizable gross lesions. 



There are cases characterized by early post-mortem decomposition ; 

 post-mortem staining of the tissues ; congestion of the lungs, stomach, 

 intestines, and kidneys; extravasations of blood in the serous mem- 

 branes; swelling of the solitary and agminated lymph-nodules in the 

 small intestine ; swelling of the spleen and albuminous degeneration of 

 the liver and kidneys ; chromatolysis of the ganglion cells of the brain 

 and cord. 



There may be localized inflammations. The joints and the tissue 

 about them, the pleura, the pericardium, the endocardium, the peritoneum, 



the terms pyaemia, septicaemia, septico-pysemia, pyo-septicaemia, ichoraemia, inflamma- 

 tory fever, surgical fever, traumatic fever, suppurative fever, puerperal fever, and 

 purulent infection have been used. 



