224 PYiEMIA — SEPTICEMIA. 



material of which the thrombus is composed, the material thus 

 distributed causing blocking of the capillaries, with the produc- 

 tion of secondary abscesses. This, however, is not absolutely 

 nor fully correct ; for although capillary thrombosis may be a 

 feature of pyaemia, it may also, we know, exist without the 

 specific changes attending this process, while the distribution 

 of the broken-down clot may be prevented by secondary 

 plugging from entering the blood-current. The existence of 

 micrococci on wounds, and otherwise gaining entrance into the 

 tissues of the animal body, where they find a suitable soil and 

 conditions favourable for their assuming certain activities and 

 potentialities, seem better able to explain the phenomena of 

 pytemia ; added to which, we know that certain fluids in which 

 bacteria exist are decidedly septic — these same fluids on 

 abstraction of the organisms being innocuous. That they may 

 not always be detected where expected to be found, is explain- 

 able on different hypotheses — they may be destroyed by 

 advanced processes occurring during the diseased action, or 

 they may be so altered that our ordinary means of recognition 

 fail; while that they should be present, and not produce pyemia, 

 may be accounted for because of the absence of material suit- 

 able for their growth and operative activities. They are 

 usually found where the blood-current is slowest ; and by their 

 presence produce irritation and vascular changes, the results 

 of which seem favourable for the operation of their powers of 

 septic production. It is not in the blood itself that the powers 

 of septic infection reside most powerfully — rather in serum and 

 serous fluid, the result of local irritation ; consequently, in the 

 cases of ordinary wounds, the serous material in the adjacent 

 tissues, the result of inflammatory action not yet taken posses- 

 sion of by the suppurative process, is the most powerful agent 

 of infective influence. This conveyed artificially, or naturally, to 

 distant parts is more certain than other fluids to induce 

 Abscesses and septic changes. 



Instead of restricting our ideas of this morbid state to par- 

 ticular local changes, whatever these may be, it seems certain 

 that we ought to regard it as contamination of the whole blood, 

 which is altered by the entrance of some poisonous material ; 

 that in this way the relation of the circulating blood to the 

 tissues is altered, so disposing to coagulation and obstruction 



