METASTASES DUE TO INFECTANT MATTERS. 245 



metastatic deposits. But in my opinion, the history of 

 the processes which have been called pyaemia is not con- 

 fined to these conditions. When the process runs its 

 course free from all complication, so that from the origi- 

 nal seat of the disease (thrombosis in a vein, endocarditis, 

 etc.), only solid masses in an undecomposed state are de- 

 tached and cause obstructions, the real process is in 

 many cases brought to notice only in consequence of the 

 metastasis. There are cases which run their course so 

 latently that all the earlier stages of the affection are en- 

 tirely overlooked, and that the first rigors which declare 

 themselves announce that the development of the meta- 

 static processes has already set in. Usually, however, 

 another condition must be taken into consideration, 

 which is not directly accessible either to the coarser or 

 more delicate modes of anatomical investigation ; I mean 

 certain fluids, which in themselves bear no immediate and 

 necessary relation to pus as such, but manifestly differ 

 very much from one another in their nature and origin. 



Whilst I was engaged in the consideration of the 

 changes which lymph undergoes, I pointed out to you 

 (p. 220), that fluids which were taken up by lymphatic 

 vessels were not only freed in the filters of the lymphatic 

 glands from corpuscular elements, but were also in part 

 attracted and retained by the substance of the glands, so 

 as to display some activity within them. Similar effects 

 appear to take place also elsewhere than in the glands. 

 Where the reabsorption was primarily effected by the 

 veins, this must, of course, always be the case. There is 

 namely a series of peculiar phenomena which pervade all 

 infectious processes as a constant element. These are 

 on the one hand the changes which the lymphatic and 

 lymphoid glands may undergo not so much at the 

 seat of the primary affection as rather in the body gene- 

 rally, and on the other hand the changes which the 



