TREATMENT 95 
quels and accident” are: Acute septicemia, 
chronic septicemia, pneumonia, pleurisy and 
paralysis. 
1. Septicemia. As already mentioned under 
the chapter on pathogenesis, there is a toxemia 
associated with every case of fistula. The only 
exception is during the saccular stage of the 
typical form. After infection has entered, the 
situation is only a question of how badly the 
patient is affected by this complication. Some 
patients resist this systemic complication bet- 
ter than others, but after a fistula has become 
chronic and has drained the patient’s vitality 
by copious discharges of pus for a long while, 
impregation of the organism, with toxic prod- 
ucts and bacteria occurs to a greater or less 
extent in every case. Death from acute sep- 
ticemia, except after operations, is rare, but 
clinical chronic septicemia is a very common 
occurrence. It is this complication that most 
undermines the health of all cases and which 
causes the emaciation and general enfeeble- 
ment already referred tc. And while the com- 
plication is an insidious one, deaths occur 
therefrom quite often. We have found sec- 
ondary abscess of the Jungs and of the spleen 
in animals that have died from fistula. As a 
source of focal infection fistule of the with- 
