Septicemia is a form of blood-poisoning resulting from the absorption of poisonous (septic) products. According to Billroth, septicemia bears the same relationship to surgical or traumatic fever that pyemia does to suppurative fever, each being a malignant type of the corresponding milder affection, - in other words a malignant form of putrid infection. It frequently occurs as a complication of wounds, compound fractures, gangrenous conditions, and especially in wounds with abundant discharges, where micro-organisms have had free access and a process of putrefaction established.

It is characterized by such constitutional symptoms as high temperature, excessive prostration, disorders of the nervous systern, inflammation of internal organs, with typhoid symptoms, and more or less heart failure. The septic poisoning is due to the entrance into the blood of ptomaines, certain forms of microorganisms, or some ferment-like substance possessing the power of reproduction, and acting like the virus of diphtheria or tetanus. Septicemia is classified as septic intoxication, and septic infection; in the first class there is early absorption of the products of putrefaction; but in the second class the symptoms develop more slowly, and progressive changes occur which continue to a fatal termination notwithstanding all the efforts at antiseptic treatment, and is due to the invasions of micro-organisms into the blood. The prominent symptoms of septicemia are a chill, followed by a rise of temperature 101° to 1050, nausea, vomiting, and at times diarrhoea, followed by delirium and coma. The symptoms depend upon the character of the infecting organisms.

Treatment

Both local and constitutional. The prophylactic treatment consists in inducing an asceptic condition of the wound and surrounding parts and the employment of antiseptics. Irrigation with bichloride of mercury solution, 1 to 1000, or peroxide of hydrogen in moderate quantity, or carbolic acid solution, 1 to 20, is necessary, and in some cases curretting the surface of the wound to permit the remedy to reach deeper parts is also required. The wound is then packed with antiseptic gauze, or warm antiseptic fomentations may be applied to bring about free drainage.

Saline purgatives are employed to eliminate the organisms, and the strength of the patient maintained by quinine and stimulants until the secretory organs shall have eliminated the poison from the blood. Tincture of digitalis in from 5 to 10 drop doses is employed for the heart failure, or strychnia in doses of 1/40 to 1/30 of grain every two to six hours. The diarrhoea is to be controlled by opium, or bismuth and tannin.