The Portland daily press. [volume] (Portland, Me.) 1862-1921, 1881-08-27
Septicaenia.
It's Origin, Dangers and Treatment.

The distinguished Rudolph Virchow of Ber-
lin, wrote, in 1885, an article on the subject OF
septicemia, based on his own investigations at
the bedside, in the dissecting room and in the
laboratory. This paper is still authority on
the subject. In it Prof. Virchow speaks very
briefly of the innocuous form of the disease
famillarly known as mumps, and treats exclu-
sively OF the grave form which supervenes in
the course of grave diseases, such as pneumo-
mia, puerperal fever, typhus, measles or CLAN
ders. He refers to another trea tise of his
C'Gesammette Abhandlungen zur Wissen-
chaftlichen Medcin," PIP. 4S0, 64O) in which
he has shown that the phenomena belonging
to so called pyamia may be classed under two
heads, one class comprising the phenomena
due to embolism-i. e., the transportation of a
solid corpuscle from one part of the body to an
other where it is arrested in narrow blood
vessel, and a second class due to infection
that is to say the absortion into the blood Of a
poisonous liquid. This latter it is which he
calls septic8mia. The inflammation OF the par
toris belongs commonly to this latter class.
Its origin may be understood If it is supposed
that some irritant is secreted from the blood
with the saliva and produces an irritation of
the surfaces with which it comes in contact,
exactly as cantharidin, the irritant agent in a
blister, when it is absorbed by the blood and
secreted with the urine, irritates the urinary
organs, producing catarrhal or croupous inha-
nation.
The inflammation of the parots may be divid-
ed into three groups: The primary, simple
catarrh or mumps, which is usually epidemic
and has no tendency to suppuration; the sec
ondary, purulent catarrh, which readily forms
assesses and is associated with catarrh Of the
mouth, sprue. etc., or sometimes with affect
tions of middle ear; and, finally the specific,
septicemic catarrh, which almost always
gives rise to sanious pus, and is very frequent
ly combined with other SO called metasrases-.
tnat is TO say, appearances in other localities
either OF a septicemic or an embolic character.
Ancient writers have laid much stress upon
the sautary effect of the formation of an abs
cess with laudable pus in the parotis. This is
only true In so far as opposed to cases in which
the suppuration produces thin, sanious pus.
1t may be that the suppuration has certain
favorable effect on the body, but it is certain
that it is much preferable if it can be avoided,
for the Inflammation of the parotis is both in
the beginning and the end disorder which
renders the case more complicated.
The dangers of suppurative Inflammation
of the parotid gland are very numerous. If it
complicates the latest stages of other diseases
the new disturbance suffices often to lead to
the death of the exhausted patients by a re-
newal or increase of the fever. II the swell
ling of the surrounding parts be very consider
able the Inflammation Of the parotis, by i'm
peding the circulation in the numerous veins
which lie In contact with it, may give rise to
edema OF the temporal region and around the
eye, headache, difficult breathing, etc. These
phenomena become still more violent if the
impediment to circulation is large enough to
cause coagulation of the blood in the veins.
The clots thus formed become much more dan
gerous as they extend far beyond the gland,
and later when they soften become the starting
point of embolism and infection. In several
cases the surrounding connective tissue is also
inhamed, and then the Inflammation extends
gradually over the neighboring parts, causing
assesses in the muscles, Inflammation of the
auditory canal, periostitis of the lower jawbone
and temporal bone, followed by necrosis.
Through the bones the Inflammation may ex-
tend to the membranes surrounding the brain
or attack this organ itself.
Another way in which the Inflammation
spreads is by following the course of the
nerves. The veins are apt to become obstruct-
ed, and clots extend down along the side Of
the neck or interior of the cranial cavity. In
such cases the Inflammation of the parotis may
blood poisoning and of embolism in the lungs
and other organs. The dangers connected
with the inflammation Of the parotis are part
ly due to the situation of the organ under a
dense fascia or tendinous membrane. This
circumstance is also of Importance in regard to
treatment. Ii suppuration cannot be avoided
it should be fastened and the pus emptied as
soon as possible. To attain this end it is often
necessary to make deep incisions, the swelling
of the superficial parts being so great that pus
is reached only at depth of half an inch.