SEPTICO-PY^MIA. 123 



days the patients became utterly prostrated. The symptoms which 

 pointed to local processes during life were referred most frequently 

 to the lungs, liver, spleen, pleura, heart, and the long bones. 

 Whether the primary infection occurred through the pharynx, 

 where the first symptoms were manifested, could not be definitely 

 ascertained. In the acute cases, the symptoms were grave from 

 the beginning and increased as the infection progressed, while in 

 chronic cases, infection is maintained from some suppurating focus, 

 and the disease may become prolonged for several years. Subcuta- 

 neous and retinal hemorrhagic extravasations were frequently 

 observed. The post-mortem examinations revealed suppuration in 

 some of the internal organs and vascular conditions which are 

 found in cases of sepsis. These cases may be compared with acute 

 suppurative osteomyelitis, where often the most careful inquiry 

 and the most scrutinizing examination fail in furnishing reliable 

 evidences for locating the primary source of infection. It is possi- 

 ble that the pus-microbes have gained entrance through an intact 

 mucous surface, or through the skin, and that they have remained 

 in a latent condition until a locus minoris resistentice is created 

 somewhere in the body, where they localize in a soil prepared for 

 their growth and multiplication, or, what is more likely the case, 

 they entered through an abrasion or slight lesion, which may have 

 been so insignificant that the patient himsejf failed to notice it, and 

 produced no symptoms until, by accident or disease, a proper soil 

 was prepared for the initiation of an acute attack in one or more of 

 the internal organs. 



