PY^MIA. 11 



in these capillaries, they pass on through the hepatic veins to 

 the right side of the heart. 



When pyogenic bacteria enter the lymph stream, they are 

 carried to the lymph glands, there to be filtered off and killed in 

 a large proportion of cases, with or without evident inflammation 

 of the glands and their surroundings. If the cocci escape the 

 meshes of the filter, they may pass by the efferent vessels to the 

 larger lymphatic channels, and so on into the general venous 

 circulation at the entrance of the thoracic duct into the junction 

 of the left subclavian and left internal jugular veins, or that of 

 the right lymphatic duct into the junction of the right subclavian 

 and the right internal jugular veins. 



Although pyaemia may ensue from infection in any region of 

 the body, it is perhaps peculiarly prone to follow infection in 

 certain definite spots. Thus in the head, the middle ear is a 

 common seat of origin. Further the skin of the cheek and the 

 red surface of the lip are dangerous positions should inoculation 

 occur. The facial vein communicates by its radicles with those 

 of the ophthalmic vein, particularly about the inner canthus, 

 and through it with the cavernous sinus, and further the deep 

 facial vein has connections with the pterygoid plexus, which 

 again communicates with the same intra-cranial sinus by small 

 venous channels traversing the foramen ovale and foramen 

 lacerum medius. Moreover, the facial vein tends to remain 

 patent when incised, and has no valves, so that septic material 

 may easily pass from it to the internal jugular. 



The uterine veins are a frequent source of septic emboli. So 

 also are the veins of the periosteum of bone, and particularly 

 those bones which are much exposed to injury, such as the tibia. 



WOUND INFECTIONS. 



Cellulitis and Erysipelas. These two acute inflammatory 

 conditions are probably both of them dependent upon one and 

 the same specific virus a streptococcus, the species of which 

 may slightly differ in the two infections, so as to cause some 

 modification of the signs and symptoms. 



