Evening star. [volume] (Washington, D.C.) 1854-1972, 1881-09-20
PyR mia.
rye ml8s
u Pathology by DIR. Theodore Bilroth,


From Surgical Pathology by Dr. Theodore Broth. 8
Professor of Surgery III Vienna,
Py2mia (the name was formed by PiOrry
from puOn, Pus. an Anne, blood is disease
which we suppose to be due to the absorption
OF pus or its constituents into the blood: it Is
characterized by intermittent attacks of fever;
by the frequency of metastatic assesses and
metastatic diffuse inflammatiOns
The following is a description of a typical
case of the disease After the dressing of the
wound the patient feels very WE'LL he has but
little fever until about the third or fourth day;
thent the wound becomes more inflamed. secreteS
relatively little pus the surrounding skin be-
comes 9dematOus and red; the patient grows
very feyersh, especially towards evening; the
swelling about the wound increases and slowly
spreads: on pressure a badly-smelling pus flows
slowly from the wound; there is no trouble of
the mind no sign of intense, acute septicamia;
the patient is exceedingly sensitive to every
dressing: he is restless and discouraged: there
Is continued remittent fever, with high evening
temperature, and frequent, full, tense pulse:
the appetite is lost, and the tongue heavily
coated. this would be about the twelfth day
after the lnjury;) quantities OF pus flow from
different parts OF the wound; in the neigh
borhood of the wound fluctuatiOn is distinct,
this collection of pus may be evacuated
through the wound by careful pressure
but tine escapeis greatly impeded, and an lncison
must be made at the above pOnt); this being
done moderate quantity of pus is evacuated; a
then dry, burning fever, and lastly. profuse
sweating; the appearance of the wOundimproves
somewhat, but this does not last lOng we soon
notice new abscess near the wound; there is
another chill; more counter openings are re-
Qured at different points to give exit to pJls
which forms in quantities. The nights are sleep
less, the patient eats very little, drinks great
deal, and becomes much debitated; he enact
ates. especially in the face the color of the sln
changes to yellOwish: the chs recur the patic..t
70 tlinfvx
he coughs some, but raises little sPutum. On
examining the chest you find q moderate
peuritic emulation on one both sides, from
which, however. the patient does not suffer
much. Finally. there is deeubitus, but the pa
tient does not complain much of this; he lies
quietly. half insersible, muttering to himself.
This would be abOlt the twentieth day after the
injury The wound is dry. the patient looks
miserable: the face. and especially the neck, is
einaciated; the SKIN is very jaIlndiced. the eyes
uuii the trembling tongue Is perfectly dry, the
SKIN cool the temperature low, and only ele-
valeu ar evening; the pulse small and frequent
the respiration slow, the breath of a peculiarly
cauaseric odor; the patient becomes entirely
unconscious, and may PERTAINS remain SO for
twenty-four hours before death
TO sum up, you have an extensiys steadily
| increasing suppuration of wound with in
tense, continued fever. which has eyacerbatiOns.
| 10 TINS are added circumscribed infiammations.
/ ending In formation OF assesses In the Inngs
and other organs. These multiple points of in
fammation keep up the fever and ihev disturb
the functions OF tine affected organs, and the pa
tient dies OF exhaustion. The peculiar and
essential feature is the appearance of yarious
points of Inflammation after the suppuration
has attained certin grade.
There isOne symptom of py9mia that requires
special mention. viz, chills. They occur irregu-
| larry, and their duration and intensity vary ex-
ceedingly. Although we cannot consider cbills
characteristic of py9mia, still their frequent
occurrence. as well as the generally intermittent
| type CT the fever, is peculiar to this disease
Intermittent fever is the only disease In which
We see anything similar There We have inter
n:ittent attacks of fever with regular intervals.
The usual method of measuring the tempera-