Online Encyclopedia

Search over 40,000 articles from the original, classic Encyclopedia Britannica, 11th Edition.

SEPSIS (Gr. Qi7,/iss, putrefaction), ...

Online Encyclopedia
Originally appearing in Volume V24, Page 653 of the 1911 Encyclopedia Britannica.
» Make a correction to this article.
» Add information or comments to this article.
Spread the word: del.icio.us del.icio.us it!

See also:

SEPSIS (Gr. Qi7,/iss, putrefaction), or SEPTIC INFECTION , a See also:term applied in See also:medicine and See also:surgery to indicate the resultant infection of a See also:wound or sore by micro-organisms or by their products. Under this See also:general heading come three See also:great constitutional diseases, differing radically from each other in their See also:aetiology and See also:pathology: sapraemia, septicaemia and pyaemia. Sapraemia (Gr. vasrpbs, rotten, a ,ua, See also:blood), or septic See also:intoxication, is the result of the absorption of a dose of the toxins produced by micro-organisms from some See also:area of infection without the entrance of the micro-organisms themselves into the blood. This See also:condition was for a See also:long See also:time confounded with septicaemia, but is distinguished from it in being a chemical intoxication. The blood in sapraemia if injected into an See also:animal is incapableof reproducing the disease as in septicaemia. Any condition in which there is a See also:mass of decomposing See also:tissue in the See also:neighbour-See also:hood of an unhealed wound may give rise to sapraemia. In surgical practice it may be met with in large, deep and badly-drained wounds where a quantity of putrifying material is pent up. When it arises in connexion with wounds accidentally received, it may be unavoidably due to the dirty See also:state of the skin or to See also:foreign bodies entering the wound. Absorption of toxins is notably frequent in portions of decomposing placental tissue which may accidentally have remained behind in the uterus after childbirth, and may give rise to puerperal sapraemia. Sapraemia is acute or subacute directly according to the amount of toxin absorbed. By some writers it is divided as follows: (I) Hectic See also:fever is a chronic blood poisoning with continual absorption of small doses of the toxins.

This variety usually arises in long-continued suppuration of bones and See also:

joints, and in decomposition occurring in a pulmonary cavity. The marked symptom is a See also:sharp rise of temperature in the evenings; the See also:face becomes flushed and the See also:pulse rapid. After profuse sweating the temperature drops. See also:Diarrhoea and wasting are a usual See also:accompaniment. (2) Septic traumatic fever is a slight See also:form which may follow See also:burns or See also:compound fractures and which tends to subside in a few days. (3) In acute septic intoxication large amounts of the See also:poison are absorbed. It generally starts with a severe rigor followed by a continuous high temperature, dry See also:tongue, rapid pulse and severe headache, together with See also:nausea and vomiting, and in the later stages diarrhoea. If the See also:case be a severe one rapid prostration speedily comes on with See also:low muttering See also:delirium, the temperature may fall to subnormal, and a gradually deepening See also:coma may end in See also:death; other cases pass into a typically " typhoid state," death occurring from exhaustion at the end of about a See also:week. (4) Amyloid (Gr. (tµukov, See also:starch, abets, form), or lardaceous disease, usually of the See also:liver, See also:spleen, kidneys or other See also:organs, is one of the results of long-continued septic intoxication. A substance derived from the breaking down of pus and tissue cells is carried in the blood and deposited in the connective tissue of the coats of the smaller See also:arteries, and the viscera become infiltrated with a material looking like See also:lard. The liver and spleen, being the organs most usually affected, become immensely enlarged.

No form of septic infection yields so easily to treatment as sapraemia. The prompt removal of the cause of septic absorption, the See also:

flushing out of the wound with weak antiseptic solutions, in See also:order to mechanically remove any decomposing masses, and the See also:establishment of proper drainage in deep wounds, is usually followed by a fall in temperature and an improvement in the general condition. A strong, preferably See also:mercurial, purgative should be given to aid in the elimination of toxic material. For the same purpose the injection into the See also:veins or into the cellular tissue of large quantities of normal saline See also:solution is useful. See also:Heart depression should be overcome by diffusible stimulants and hypodermic injections of See also:strychnine. When the wound has become " surgically clean " recovery is usually rapid. Septicaemia is an acute infective disease differing from sapraemia in that the micro-organisms themselves are absorbed, entering the general circulation, and may on examination be found in greater or lesser number in the blood-stream itself. The organism or organisms grow and reproduce themselves in the blood or tissues. A number of different organisms have been isolated from the blood-stream in cases of septicaemia. The most frequently found is the Streptococcus pyogenes, which is See also:present in 50% of the cases and is See also:common in puerperal septicaemia and in ulcerative endocarditis. The Staphylococcus pyogenes aureus et albus is also a frequent cause, but sometimes septicaemia may be due to other pathogenic microbes such as the Pneumococcus, the Bacillus coli communis, Bacillus pyocyaneus, Bacillus oedematis maligni and the Gonococcus. The micro-organisms are conveyed by the blood-stream to different parts of the See also:body, in which as in the See also:original wound itself they both multiply and set up factories for the See also:production of toxins.

The disease commonly follows blows or wounds which have not been treated on surgical lines. Much laceration of the tissues at the time of the injury offers increased liability to infection. Septicaemia is frequent in spreading See also:

gangrene, in diseases of the periosteum, and in fevers such as scarlatina, See also:diphtheria or See also:plague, and in the puerperal state. The See also:period of See also:incubation may be from a few See also:hours to several days. The condition of the wound or site of injury shows marked changes. In severe cases following a prick received in conducting a See also:post-mortem the See also:finger in a few hours becomes greatly swollen and painful, the See also:pain spreading up the lymphatic vessels to the nearest lymphatic glands, which may become enlarged, and sloughing or gangrene of the parts involved may take See also:place. In milder cases the wound remains with reddened and oedematous margins in a more or less unhealthy state. In mild cases of septicaemia the See also:local condition of the wound, high temperature and feeling of illness are the distinguishing features. The treatment of septicaemia may be preventive or active. The preventive See also:side consists in the performance of operations with all due aseptic pre-cautions. Since the days when I. P.

See also:

Semmelweiss (q.v.) of See also:Vienna insisted on cleanliness in his maternity wards, the death-See also:rate of puerperal septicaemia has been enormously reduced. In the See also:British registrar-general's returns for 1868 it was stated that in twenty-two years no less than 23,689 See also:women in See also:England and See also:Wales had died of puerperal septic diseases. In the reports of the Rotunda See also:Hospital, See also:Dublin, the largest maternity hospital in the See also:United See also:Kingdom, we ascertain that of 30,023 women delivered during the ten years 1894–1903 there was only a mortality of 21 due to sepsis, a ratio of o•o66%, while the registrar-general's returns for England and See also:Ireland for the period have a ratio for sepsis of x.216%. When dealing with a wound that is already septic, See also:free incision and swabbing the See also:surface with pure carbolic See also:acid may have to be resorted to, and constitutional treatment must be under-taken at once. Should the infection be due to a Streptococcus, an antistreptococcic serum may be injected. There are, however, many strains of Streptococci, and a polyvalent serum may give See also:good results. Menzer's antistreptococcic serum has been successful in puerperal septicaemia not of gonococcic origin. Many cases have also now been recorded in which the systemic infection is combated by means of an autogenous vaccine. The first case was described by See also:Sir See also:James See also:Barr before the Liver-See also:pool Medical See also:Institute in May 1906. In urgent cases, where time will not allow of the manufacture of a vaccine, See also:quinine in large doses, stimulants and liquid nourishment must be given, and the temperature controlled by tepid sponging. Pyaemia (Gr. v6ov, pus, aiµa, blood), which got its name from an erroneous See also:idea that the pus passed into the blood, is now understood to mean an acute disease with the formation of metastatic abscesses. The first definite See also:account of the disease was published by See also:Boerhaave in 1720.

See also:

Virchow in 1846 pointed out that it was not pus in the veins, but altered blood-See also:clot. See also:Jean D'Arcet showed the See also:separate processes of poisoning by products of decomposition and the blocking of the veins with emboli. Any pyogenic organism may give rise to pyaemia, or it may follow any acute See also:abscess. The cause of pyaemia may be said to be any condition favouring the formation of emboli. An occasional cause of pyaemia is infective endocarditis, while puerperal pyaemia may arise from infection of the genital See also:tract. When the emboli See also:lodge in the See also:lung there is a breaking down of the tissue in front of the embolus, a haemorrhagic infarct being formed. The clinical symptoms of acute pyaemia generally start with a rigor repeated at periodic intervals; the skin becomes hot and the patient soon develops an earthy See also:colour, the pulse becomes frequent and weak and the tongue dry. In about a week secondary abscesses appear, most frequently in the region of joints. There may be little or no pain to See also:herald the formation of an abscess, but usually there is intense pain followed by suppuration. Unless See also:early treatment is undertaken the See also:joint may be rapidly destroyed. In acute cases multiple abscesses in the See also:kidney may give rise to pain and See also:albuminuria, abscesses in the lungs to dyspnoea, while acute See also:peritonitis may arise from rupture of a splenic abscess into the peritoneal cavity,and sudden See also:blindness be the result of the plugging of the arteria centralis retinae. The duration of a case of pyaemia depends on the severity of the infection.

Death may occur from the formation of abscesses in vital organs such as the See also:

brain and heart, or from exhaustion from continued suppuration, or chronic forms may after months pass on to See also:complete recovery. Unfortunately pyaemia cannot be recognized apart from other blood infections until abscesses begin to form. The local treatment is to endeavour to prevent the detachment of infected emboli and the infection of the general blood-stream thereby. An infected See also:limb may be dealt with by' amputation above the seat of the See also:lesion, or it may be feasible to dissect out the infected veins. When abscesses have formed they must be dealt with by opening and washing out the cavities. Antistreptococcic serum may be tried, as in septicaemia; and if there be time to prepare a vaccine it offers the best prospects, more particularly in the subacute and chronic forms of pyaemia. The usual See also:administration of nourishing See also:diet and stimulants when required should be undertaken, and every effort made to keep up the patient's strength.

End of Article: SEPSIS (Gr. Qi7,/iss, putrefaction), or SEPTIC INFECTION

Additional information and Comments

There are no comments yet for this article.
» Add information or comments to this article.
Please link directly to this article:
Highlight the code below, right click, and select "copy." Then paste it into your website, email, or other HTML.
Site content, images, and layout Copyright © 2006 - Net Industries, worldwide.
Do not copy, download, transfer, or otherwise replicate the site content in whole or in part.

Links to articles and home page are always encouraged.

[back]
SEPPINGS, SIR ROBERT (1767-1840) 		[next]
SEPT

Site © 2006 - Net Industries