Evening star. [volume] (Washington, D.C.) 1854-1972, 1881-07-27
Symptoms and Progress Of Blood Poisoning
WHAT THE BOOKS SAY


WHAT THE BOOKS SAY.
DR.. Holmes work. entitled "a System of Sur
gerry" is recognized as a standard authority In
this work, under the head of Pyamia, is the fol-
lowing passage. which is of interest in connec-
ton with the consideration of the Presidents
present condition:
The secondary complications which may follow
the local disease (but are often dependent upon
conditions different from any of the preceding)
are marked by symptoms sufficiently character
istic. The patient. weak and enfeebed by
previous disease, or influenced by other
predispostions already described. complains
suddenly Of cold and is presently at
tackled with rigors. In nearly all surgical
instances. for example, in twenty -eight out of
thirty-three of Amottes reported cases. the pa
tient is described as going on well when the
symptoms first become declared. If wound is
suppurating at the time the discharge often
ceases, its surface becomes dry and the sur
rounding 1ntegument acquires a dusky hue.
The rigors of varying severity are repeated at
brief intervals, Or though this is the exception.
day or two may elapse before they recur no
symptoms arising in the interval. Perspiration
sometimes profuse and causing considerable eX-
haustiOn, sometimes scanty. succeed the rigors
The skin soon becomes dry and harsh. but
towards the close of the case. if it terminate
fatally, there breaks out clammy sweat. The
temperature fuctuateS. but rarely reaches above
1O4. The pulse, rising rapidly to 100 or $50
hitting. and. though jerking is easily COM
pressed The tongue, at first but little
altered from its condition prior to the attack.
soon grows dry on the dorsum, and is covered
with brownish fur At the same time there is
a remarkable sense of depression. The cOunte-
nance is anxious and oppressed. the eyes sunken
There is often pain about the head; the patient.
restless and irritable, fails to obtain accustomed
sleep, and becomes rapidly emaciated. With
these symptoms there exists tawny discOlOr-
alton OF the integument almost characteristic of
the disease. requiring, however, to be distin-
guished from the jaundice tinge with which it is
sometimes complicated. Without the intercur-
renee of other symptoms the patient may pass
quickly into typhoid state. and thus in a few
days. the disease may terminate fatally or. less
rapid in its progress, may tend to gradual sink
ing, the patient lingering for several weeks.
A foot note referring to the word ''lingering'
says: 'After operations the symptoms of
pyamia have commenced any time from the
second day to the third or fourth week." Dis
cussng the prOgnosis of pyamia, the author
says:
what is to be said of the prospect of re-
cOvery from the secondary complications? TAX
ing those cases in which no doubt has existed
of the nature of the disease. is it probable that
fatal result invariably ensues? 1t is true that
some cases are recorded in which patients have
recovered but in few of these is the existence of
py3mia certain. 1t is probable that fatal re-
suit must generally be anticipated. for all prac-
teal surgeons acknowledge that very little
chance remains for the patient, who. after an
operation, is attacked with the symptoms of
this disease"