TREATMENT 95 



quels and accident" are: Acute septicemia, 

 chronic septicemia, pneumonia, pleurisy and 

 paralysis. 



1. Septicemia. As already mentioned under 

 the chapter on pathogenesis, there is a toxemia 

 associated with every case of fistula. The only 

 exception is during the saccular stage of the 

 typical form. After infection has entered, the 

 situation is only a question of how badly the 

 patient is affected by this complication. Some 

 patients resist this systemic complication bet- 

 ter than others, but after a fistula has become 

 chronic and has drained the patient's vitality 

 by copious discharges of pus for a long while, 

 impregation of the organism with toxic prod- 

 ucts and bacteria occurs to a greater or less 

 extent in every case. Death from acute sep- 

 ticemia, except after operations, is rare, but 

 clinical chronic septicemia is a very common 

 occurrence. It is this complication that most 

 undermines the health of all cases and which 

 causes the emaciation and general enfeeble- 

 ment already referred to. And while the com- 

 plication is an insidious one, deaths occur 

 therefrom quite often. We have found sec- 

 ondary abscess of the lungs and of tlie spleen 

 in animals that have died from fistula. As a 

 source of focal infection fistulse of the with- 



