491 



Septicemia may bavo occurred primarily, or as a complication of ana- 

 sarca. The diagnosis must be from the history, and the prognosis is 

 of little import. 



While this is not an excessively fatal di.^ease the prognosis must al- 

 ways be guarded. The majority of cases run a simple course and ter- 

 minate favorably at the end of eight or ten days, or possibly after one 

 to two relapses, requiring several weeks for complete recovery. Effu- 

 sion into the head renders the prognosis much more grave from the pos- 

 sible danger of mechanical asphyxia. Threatened mechanical asphyxia 

 is especially dangerous on account of the risk of blood-poisoning after 

 an operation of tracheotomy. 



Metastasis to the viscera, or from. the legs to the head, is a most seri- 

 ous complication, while metastasis from the head or other portions to 

 the belly and legs is ftivorable, as removing, for a moment at least, all 

 danger of immediate death. The prognosis is otherwise based on the 

 complications, their extent and their individual gravity, existing, as 

 they do here, in an already debilitated subject. 



Treatment. — The treatment of anasarca may have been as variable as 

 are the lesions. The indicatioue are at once shown by the alterations 

 and mechanism of the disease, which we have just studied. These are; 



(1) Eegulation of the disordered circulation of the blood and 

 strengtheniug of the vasomotor system. 



(2) Promotion of absorption of the colloid mass, which has infiltrated 

 the tissues. This, of course, is based upon oxidization in order to meta- 

 morphose the exudation into absorbable crystalloids. 



(3) Prevention of metastasis, which is the most frequent fatal termi- 

 nation of this trouble, if not directly by oedema of the lung or enteritis, 

 indirectly by further weakening the already debilitated system. 



(4) The immediate treatment of the complications, each, perse, as- 

 phyxia and gangrene, being the two which most frequently call for ac- 

 tive interference. 



These indications call for constitutional and local remedies. 



Blood-letting would at first seem totally contra-indicated, but in cer- 

 tain cases it acts like a charm. Debilitated, as an animal usually is 

 when attacked by anasarca, we have yet seen that one of the great pre- 

 disposing causes is the plethoric habit. The current of blood, like a 

 swollen river after a spring storm, can be thrown from its usual course 

 by the slightest side channel. The use of bleeding requires the acute 

 perception of the practitioner to be put upon the alert to regulate it. 

 Not only the present condition, but the previous state of health, and the 

 probable future hygienic and medical care must be taken into consider- 

 ation. Given a case that will admit of bleeding, the quantity to be 

 taken is always a minimum one, and it is to be regulatedby the effect 

 upon the pulse during the bleeding. 



With the weakened walls of the vessels but a little lessening of the 

 pressure will produce a vacuum, when compared with the condition 



