TRAUMATIC FEVER. 171 
When an important vein is enclosed in a traumatic center or included 
in its walls, and by this fact exposed to thrombosis; and when the 
latter is already realized, one must insure the immobilization of the re- 
gion, avoid explorations and useless pressures, attend to the correct ap- 
plication of the dressings or necessary bandaging, and prevent the 
phlogogenous action of the secretions of the wound and of the pus 
upon the venous walls. Such are the general requirements. With pu- 
ruient thrombosis of some superficial veins, immediate ligature, made 
aseptically at some distance from the morbid center, is the surest way 
to prevent infectious complications. 
Vv. 
TRAUMATIC FEVER. 
The febrile reaction which occurs in subjects wounded and operated 
upon is due sometimes to absorption, from the traumatic center, of 
pyrogenous or septic substances (traumatic fever proper), at others, to 
a secondary local affection or a diathetic determination, both provoked 
by the wound (epitraumatic fever). 
Ordinary traumatic fever appears, generally, the second or third day, 
reaches a variable degree of intensity, according as it is aseptic or septic, 
remains stationary for two or three days, then gradually subsides, to 
‘disappear from the fifth to the eighth day. After accidental wounds or 
those from operations made in infected tissues, it often manifests itself 
in twenty-four hours, the pyrogenous substances of the wound being 
immediately absorbed. Although the fever is slight with traumas which 
cicatrize by first intention, it is sometimes severe when the wounds are 
extensive, deep and suppurating, and when violent inflammatory pheno- 
mena occur, due to the presence of a body foreign to the wound, toa 
necrosis, or a local gangrene. Any complication which occurs in a 
trauma is, in general, indicated by asudden ascension of the thermic 
curve and an increase of the other phenomena of reaction. The theory 
which explains traumatic fever by the absorption of the inflammatory 
or septic products, to-day universally adopted, is based upon the fol- 
lowing data: the pullulation on the wound of various microbes, in par- 
ticular of the agents of suppuration, brings on the elaboration of pyro- 
genous leucomaines absorbed by the tissues ;—with antisepsis, there is 
no traumatic fever, or it is very weak; when it is observed in wounded 
animals whose wounds cicatrize by first intention, protected by antiseptic 
dressings, or after subcutaneous lesions, it is almost always slight ;—in 
animals, septic traumatic fever is indicated by a hyperthermia of two or 
three degrees; in aseptic febrile reactions, the mercurial column does 
not rise much above 39°. Notwithstanding the results obtained by the 
well-known expcriment of Claude Bernard from the deep puncture by a 
