250 LECTURE X. 



prehended under the term pyaemia. I see at least no other 

 possible way of explaining certain more diffuse processes, 

 which do not present themselves in the form of the ordi- 

 nary circumscribed metastatic deposits. To this class be- 

 longs that metastatic pleurisy which develops itself with- 

 out any metastatic abscesses in the lungs that seemingly 

 rheumatic articular affection, in which no distinct deposit 

 is found in the joints that diffuse gangrenous inflamma- 

 tion of the subcutaneous connective tissue which cannot 

 well be accounted for unless we suppose a more chemical 

 mode of infection. Here we have, as may be seen in 

 cases of variolous and cadaveric infection, to deal with a 

 transference of corrupted, ichorous juices into the body ; 

 and we must admit the existence of a dyscrasia (ichorous 

 infection) in which this ichorous substance which has 

 made its way into the body, displays its effects in an 

 acute form in the organs which have a special predi- 

 lection for such matters. 



Now it may possibly happen that in the course of the 

 same case of illness the three different changes which we 

 have considered may coexist. An increase in the num- 

 ber of the colourless corpuscles (leucocytosis) may take 

 place to such an extent as to tempt one to believe in the 

 presence of a morphological pyaemia. This will at all 

 events always be the case when the process has been con- 

 nected with extensive irritation of the lymphatic glands. 

 The formation of thrombi, moreover, and embolia with 

 metastatic deposits may occur. And finally there may 

 at the same time be taking place an absorption of icho- 

 rous or putrid juices (ichorrhaemia, septhsemia). These 

 three different conditions may present themselves as com- 

 plications one of the other, but do not necessarily coin- 

 cide. If it be wished therefore to retain the term pyae- 

 mia, let it be reserved for such complications as these, 

 only we must not seek for a common central point in a 



