122 SEPTICAEMIA. 



second form 2. Saprsemia, putrid intoxication, or, as Neelsen 

 terras it, toxic mycosis of the blood, in which few or DO microbes are 

 found in the blood, and in which death is due entirely to the pres- 

 ence of ptomaines. In the first variety it seems that the infection 

 is generally due to the presence of pus-microbes which either reach 

 the circulation directly by permeating the vessel wall, or enter 

 indirectly through the lymphatic channels. The latter mode of 

 infection gives rise to the most acute and fatal form of septicaemia. 

 Saprsemia, or putrid intoxication, represents that form of septicaemia 

 in animals in which a preformed toxic agent, as boiled putrid sub- 

 stances or a toxic alkaloid, is injected into the circulation, and in 

 which the maximum symptoms are reached as soon as the poison 

 has become mixed with the blood. This form of sepsis may be 

 caused by any microbes, otherwise harmless, or only with slight 

 pathogenic properties, as the bacilli of putrefaction, which cause 

 putrefaction in any dead tissue, as, for instance, a blood-clot or 

 contused tissue ; and the symptoms arise as the ptomaines are ab- 

 sorbed, and are proportionate to the amount absorbed, and subside 

 with the cessation of absorption and their elimination through some 

 of the excretory organs. 



Septico-pycemia. 



Septico-pysemia is a condition in which the symptoms indicate 

 the presence of both septicaemia and pyaemia, and in which the 

 post-mortem appearances point to septic and purulent infection. 

 Leube (" Zur Diagnose der spontaneu Septico-pysemie," Dcutsches 

 Archivf. Jdin. Medicin, B. xxii. S. 335) first described this affection 

 and called it spontaneous, because he was unable to trace the source 

 of infection from without in the cases which came under his obser- 

 vation. Litten (" Ueber septische Erkrankungen interner Art, 

 namentlich hamorrhagische Sepsis interna," Zeitschrift f. klin. Medi- 

 cin, B. ii.), on the other hand, was always able, in his cases, to locate 

 the infection-atrium, but the primary infection at the time acute 

 symptoms appeared had either disappeared or its location could 

 only be ascertained by a most careful examination. Jiirgensen 

 (Berliner klin. Wochenschrift, JS T o. 18, 1888) calls it '< Krypto- 

 genetic Septico-pysemia/ 7 as he was unable to find a tangible infec- 

 tion-atrium. He gave an account of one hundred cases which had 

 come under his own personal observation. The patients were 

 usually attacked first with an angina, and, as this stage was gener- 

 ally attended by a chill and a general feeling of malaise, the 

 patients usually attributed it to a cold. In most cases the general 

 infection was announced by a severe chill. Rapid loss of strength 

 was one of the most prominent symptoms, so that in a very few 



