Pyemia

“ Boils, carbuncles, cellulitis and gangrene are all apt to occur as life advances, though gangrene is much more frequent in men than in women. Diabetics are especially liable to phthisis and pneumonia, and gangrene of the lungs may set in if the patient survives the crisis in the latter disease. Digestive troubles of all kinds, kidney diseases and heart failure due to fatty heart are all of common occurrence. Also patients seem curiously susceptible to the poison of enteric fever, though the attack usually runs a mild course. The sugar temporarily disappears during the fever. ”

“ While these are most common in the chronic infections and contagions, they often occur in acute typhoid fever, scarlatina, diphtheria, whooping-cough, &c. Proper blood supply and utilisation of waste is thus prevented. Organs cannot perform their function, and are predisposed to disease from disuse and from weakness of the disease-fighting phagocytes and antitoxins. From this results irregularity of organ function, which is hereditarily transmissible. The weakened vessel walls yield to strain, and thus produce local stomach, bowel, liver, gland, and kidney disorders. ”

“ In cases of this kind, where the patient becomes enfeebled by long-continued fever and suppuration, there is always a low and impoverished state of the blood. It is, indeed, a sort of mild blood poisoning, but it is very different from pyæmia. Pyæmia is caused by absorption into the blood of the disunited elements of broken down pus. Small fragments of fibrine are carried into the circulation, and wherever such a fragment lodges in one of the minute blood-vessels it becomes a center of suppuration. ”

“ When possible, the primary focus of infection should be dealt with.
Pyaemia# is a form of blood-poisoning characterised by the development of secondary foci of suppuration in different parts of the body. Toxins are thus introduced into the blood, not only at the primary seat of infection, but also from each of these metastatic collections. Like septicaemia, this condition is due to pyogenic bacteria, the _streptococcus pyogenes_ being the commonest organism found. ”

“ I explained, however, to His Highness what was wrong.
To the hakims dropsy is a disease, and can be cured by the treatment set forth in their books. No attempt is made to discover the cause of the dropsy—whether it is due to kidney disease, heart, liver, [124] lung or blood disease—it is simply an accumulation of gas (bâd) in the tissues! In diseases of the chest, they do not, of course, employ auscultation with a stethoscope, nor percussion; and bronchitis, pneumonia, and phthisis are classed together under the name of sûrfa, or cough. ”

“ Some, he says, die from the violence of the pain, some from the conversion of the disease into suppuration, and some from blackening and mortification of the bowels. The symptoms are most accurately described. There is at first vomiting of phlegm and bile, but latterly of fæces; the pulse at first is rare and small, but before death it becomes very small, very dense, and intermittent. When inflammation is the cause of the disease, he approves of immediate venesection, so as to induce deliquium animi, which, he says, will, at all events, bring some respite to the patient’s sufferings. ”

“ I concluded that "piemia" was French for neglect, and that the antidote was warmth, nourishing food, stimulants, friction, fresh air and cheerfulness, and did not hesitate to say that if death wanted to get a man out of my hands, he must send some other agent than piemia. I do not believe in the medical theory concerning it; do not believe pus ever gets into the veins, or that there is any poison about it, except that of ignorance and indifference on the part of doctors and nurses. ”

“ Malarial Cachexia.—Although the malignant tertian infection has the greatest tendency to produce anaemia yet any type may, when untreated, bring about the more or less profound anaemia with earthy skin, enlarged spleen, dyspnoea on slight exertion, and oedema of the ankles characteristic of malarial cachexia.
Oroya Fever.—In this disease we have what might well be termed a fulminating pernicious anaemia. The rod-shaped protozoon which attacks the red cells seems to be peculiarly active in the bone marrow, excruciating bone pains being quite a feature of the disease. ”

“ Let us look at the facts. Nothing is easier: the two affections are under our daily observation side by side; in this climate and among working people few maladies are more common.
On the one hand we behold a constitutional disease with widespread manifestations—a special joint inflammation, which tends neither to the deposit of urate of soda nor to suppuration; a peculiar acid secretion from the skin; highly acid urine; a notable tendency to inflammatory heart complications; marked pyrexia. We observe also a marked disposition to recurrence and to the hereditary transmission of the diathesis. ”

“ The course of the disease is chronic, and in slight cases, provided fresh infections do not occur, is not unfavourable; in severe cases the cachexia caused by loss of blood, or intercurrent diseases to which the patients easily succumb—e.g., pyelitis, pyelonephritis, pyæmia, or uræmia—lead to a fatal issue. ”

“ LYDIA E. PINKHAM'S Blood Purifier Is far superior to any other known Remedy for the Cure of all Diseases arising from Impurities of the Blood, such as Scrofula, Cancerous Humor, Erysipelas, Rheumatism, Canker, Salt Rheum and Skin Diseases. IMPURE BLOOD CAN BE MADE RICH AND PURE.
There is no condition of the human system so uncertain or so deceptive as the condition of the blood. Other disease makes itself known by aches or appearance, but the blood courses on with no sign of vitiation, carrying its poison to every nerve and fibre of the body. ”

“ In ascites due to heart disease, the dropsy of the feet and legs precedes the ascites, and there will be a history of palpitation, shortness of breath, and perhaps cough. In the ascites of kidney troubles there will be a history of general oedema—puffiness of face and eyes on rising in the morning probably having attracted the attention of the patient or his friends previously. Other less common causes of ascites are chronic peritonitis, either tuberculous in the young, or due to cancer in the aged, and more rarely still pernicious anaemia. ”

“ IV. There are cases where nature is idle, as in the atonic stages of the gout, the cancer, the epilepsy, the mania, the venereal disease, the apoplexy, and the tetanus [13] .
V. There are cases in which nature does mischief. She wastes herself with an unnecessary fever, in a dropsy and consumption. She throws a plethora upon the brain and lungs in the apoplexy and peripneumonia notha. She ends a pleurisy and peripneumony in a vomica, or empyema. She creates an unnatural appetite for food in the hypochondriac disease. ”

“ The light that has lately been thrown on chronic sources of focal infection has cleared up many of the mysteries surrounding the causation of certain obscure affections—chronic rheumatism, arthritis deformans, certain forms of anemia, goitre, chronic heart and kidney troubles, diabetes, ulcer of the stomach, duodenum, etc., and other forms of chronic disease, especially those that have proved resistant to known methods of treatment. ”

“ In other cases the occurrence of pyæmic symptoms, consequent on parturition, metritis, omphalitis, bone-abscess or osteomyelitis, on suppurating internal inflammations, ulcerative endocarditis, or infective fevers like strangles, influenza, contagious pneumonia, cattle plague, distemper, rouget, hog cholera, etc., serves to identify the disease.
The prognosis of pyæmia is always grave, and death may be expected in six to fourteen days in acute cases. Chronic forms last much longer. ”

“ These infectious diseases are caused by several different species of bacteria that gain entrance to the tissues by way of wounds. The bacteria that cause pyaemia are transferred by the blood stream to different organs and produce multiple abscesses. In septicaemia, the bacteria may occur in immense numbers in the blood and produce a general infection of the tissues, causing a parboiled appearance of the liver, heart, voluntary muscles and kidneys, and enlargement of the spleen. ”

“ If the disease progress favourably the symptoms abate during the fourth week, the temperature gradually falls to normal, and the patient slowly recovers.
Complications.—Diarrhœa may be profuse and exhaust the patient. Bleeding from the nose may occur, but is not often a bad symptom; bleeding from the bowel is common and, if large in amount, is of serious import. Perforation of the bowel may occur from an error in diet; it is attended by collapse and is very dangerous. Inflammation of the peritoneum adds greatly to the danger. Bronchitis and pneumonia may supervene and increase the mischief. ”

“ In the advanced or dangerous stage of the disease, the pulse is weak, soft, and irregular. Sometimes there is nausea of the stomach; and sometimes delirium.
The termination of pulmonick inflammation is by resolution, by suppuration, by gangrene, by fatal effusion of blood, or exudation of coagulable lymph into the cellular texture. Favourable symptoms are, as in anginous excreation, facility in expectoration, without much exertion or coughing, copious, of due consistence, a little yellow, white, thick, slightly streaked with blood ”

“ Peripneumonia is an inflammation of the lungs, supervening, for the most part, upon violent catarrhs, cynanche, asthma, pleurisies, or other complaints, but being sometimes the original affection. It is accompanied with difficulty of breathing, an acute fever of the ardent type, weight and tightness of the chest, a râle, a seizure of the face with great fulness, the morbific matter being determined upwards like fire. Wherefore the cheeks appear red, the eyes swelled, with falling down of the eyebrows, and the cornea appears somewhat glossy. ”

“ The affection of the stomach, often mentioned in vague terms, and occasionally as a vomiting of blood, was doubtless only a subordinate symptom, even if it be admitted that actual hematemesis did occur. For the difficulty of distinguishing a flow of blood from the stomach, from a pulmonic expectoration of that fluid, is, to non-medical men, even in common cases, not inconsiderable. How much greater then must it have been in so terrible a disease, where assistants could not venture to approach the sick without exposing themselves to certain death? ”

“ In pneumonia, pleurisy, and in all the affections about the lungs and trachea, the disease is held to be of a dry nature when there is no expectoration from the parts affected; and in any complaints about the liver, the mesentery, the stomach, the small or great intestines, or spleen, when the belly is either entirely constipated, or when the discharges brought away by artificial means are dry and scybalous; and diseases of the arteries and veins are known to be dry by the dryness of the tongue, and the parched appearance of the whole body. ”

“ Sometimes the virulent character of the disease can only be accounted for by an idiosyncrasy of the patient. Constitutional symptoms, particularly pyrexia and anaemia, are most often met with in young women. Patients over forty years of age have greater difficulty in overcoming the infection than younger adults. ”

“ For instance, a considerable number of different types of blood poisoning, septicaemia, pyaemia, gangrene, inflammation of wounds, or formation of pus from slight skin wounds—indeed, a host of miscellaneous troubles, ranging all the way from a slight pus formation to a violent and severe blood poisoning—all appear to be caused by bacteria, and it is impossible to make out any definite species associated with the different types of these troubles. ”

“ Fever, as probably disease in general, serves the ends of nature in the interest of our conservation. In addition to the thyroid, the other ductless glands protect us from infections and intoxications. Thus, the pituitary body which Casselli, [73] Guerrini, [74] Torri, and many others found, as a rule, altered through infectious diseases. Torri noticed a hyperplasia of the chromophile cells of the pituitary body, and disappearance of the colloid from the follicles in the majority of cases of pneumonia, typhoid fever, tuberculosis, diphtheria, and other infectious diseases. ”

“ In fact, the ordinary precursor of this disease, in all those cases in which the bones are involved, is an attack of osteo-myelitis; but in other cases the patient often complains of malaise, giddiness, headache, pain in the limbs, weakness, and loss of appetite, while the experienced surgeon will be deeply impressed with the patient's rapid emaciation and cadaverous face. These symptoms are soon followed by jaundiced skin, etc. The commencement of an attack of pyæmia is commonly manifested by a chill. ”

“ VII. All ordinary fever being seated in the blood-vessels, it follows, of course, that all those local affections we call pleurisy, angina, phrenitis, internal dropsy of the brain, pulmonary consumption, and inflammation of the liver, stomach, bowels, and limbs, are symptoms only of an original and primary disease in the sanguiferous system. ”

“ While the patient is yet able to go around, the disease manifests itself by occasional pain in the bowels, stomach, and chest. Often there is a hacking cough, nervousness, lassitude, and a generally enfeebled condition of the whole system. The patient is easily fatigued; there is apparent loss of vitality, impaired appetite, a feeling of tightness across the stomach and chest, gradually declining health, and loss of flesh and strength, torpidity of the liver, deficient secretions, constipation, and morbid excretions from the kidneys. ”