.46 



blood, fluid or coagulated, haemoglobin, or even isolated 

 fibrin ferment can experimentally induce the same phe- 

 nomena. It is further conceivable, though not demon- 

 strated, that the products of a local inflammation, or the 

 modification of cell-activity through fatigue or emotion, 

 may also be directly responsible, through destruction of 

 leucocytes and liberation of fibrin ferment, for some of 

 those cases of spontaneous septicaemia which we ordi- 

 narily ascribe to unperceived entrance of bacteria or 

 putrid products into the body. 



Septicaemia is, then, a collective name for processes 

 more or less similar, but etiologically distinct at least, 

 in certain lower animals ; any one of several unorgan- 

 ized substances, any one of several bacteria (at least, 

 three in the case of the mouse) may induce character- 

 istic symptoms. It has been proposed to adopt the 

 term sapr&mia for putrid infection without bacteria, re- 

 taining the usual name to indicate the effect of organized 

 agents; yet the clinical distinction is probably rarely 

 possible. 



The clinical experience of all ages has unanimously 

 ascribed the second type of septic infection character- 

 ized by chills, a remittent or intermittent fever and the 

 formation of multiple abscesses to absorption from pus ; 

 and it has always been designated by a name pyaemia, 

 purulent infection indicative of this supposed origin. 

 The discussion of the relations of bacteria to pyaemia 

 begins, therefore, naturally with the consideration of their 

 relations to suppuration. That these organisms should 

 exist in pus exposed to the air, as in other albuminous 

 liquids under like conditions, was a priori probable and 

 long ago demonstrated ; that they exist also in the pus 

 of abscesses which have never been opened, has been 

 conclusively demonstrated by Klebs, Nepven, Rind- 

 fleisch, Waldeyer, Cheyne, Ehrlich, and especially by 

 Ogston, who found micrococci in every one of seventy 

 previously unopened acute abscesses, though rarely in 

 chronic, cold abscesses. 



The mere fact of association does not, of course, ne- 



