This conception, at any rate, enables us to understand 

 much that is otherwise perplexing. Various have been 

 the attempts, for example, to explain the so-called asep- 

 tic wound fever, which occurs in the majority of severer 

 wounds, even under the most perfect Lister dressing. 

 Kiister and Sonnenburg ascribed it to absorption of car- 

 bolic acid ; but extensive experiments upon man, as well 

 as the lower animals, have proven that the acid does not 

 cause fever ; but .induces, on the contrary, after slight, 

 brief, and by no means constant elevation, a decided 

 depression of temperature. Others have referred the 

 phenomenon to absorption of chloroform a hypothesis 

 incompatible with the fact that wound fever follows op- 

 erations performed without anaesthesia (as is so often 

 done in Germany and Austria) as usually as those done 

 under chloroform. The more general opinion, that 

 aseptic wound fever differs from sepsis, i.e., putrid infec- 

 tion in degree rather than in kind, meets a serious ob- 

 fection, as Gussenbauer remarks, in the fact that the 

 jormer occurs within a few hours after the infliction of 

 the wound, before decomposition and consequent sepsis 

 can be reasonably presumed to have occurred. 



The clinical facts (i) that a large minority of wounds, 

 severe as well as slight, are followed by no fever under 

 the Lister dressing, as was the case in over three hun-' 

 dred of a thousand reported by Volkmann and Genz- 

 mer, and in nine of twenty-four most carefully observed 

 by Edelberg ; (2) that the course of subcutaneous frac- 

 tures without extravasation of blood is usually afebrile, 

 while similar fractures with extensive blood extravasa- 

 tion often induce fever ; (3) that the application of a 

 tight bandage to a wound or fracture, which must cause 

 some extravasation of blood, is often followed by fever 

 in a patient previously afebrile (Edelberg) ; (4) that the 

 blood of patients during simple surgical fever sometimes 

 contains free fibrin ferment in appreciable quantities 

 such facts indicate that aseptic wound fever is caused 

 by absorption from extravasated blood, especially since 

 it has been demonstrated, as already remarked, that 



