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This condition is well defined by Bollinger as quoted by Hoare, when he calls it a purulent omphalophlebitis due to local infection of the umbilicus and umbilical vessels, by pyogenic organisms, causing a metastatic pyemia.
He also quotes a case of pyemia in a boy of seven, whose temperature rose to 107.6 degrees F. He also speaks of Wunderlich's case of remittent fever, in which the temperature reached 107.8 degrees F. Wilson Fox, in mentioning a case of rheumatic fever, says the temperature reached 110 degrees F.
The statistics of this major operation show a surprisingly small mortality. Fayrer operated on 28 patients with 22 recoveries and six deaths, one from shock and five from pyemia The same surgeon collected 193 cases, and found the general mortality to be 18 per cent.
Cases that may be diagnosed with certainty are usually advanced affections wherein dependable history is obtainable and the symptoms are well marked. Rheumatism may be thought of, with respect to arthritic inflammation caused thereby, as a sort of pyemia. Undoubtedly, exposure to wet and cold weather is an active factor, but probably a predisposing one only.
The third interesting feature of the case is its progress and treatment. At the time of the aspiration the patient was in a critical condition; temp. 105.4, pulse 120; the tongue and chill denoting danger of pyemia. This danger was avoided by drawing off the decomposing blood, and giving the patient a new lease of life.
The ball, he said, had passed on and out, and he went into particulars with me, while I wondered if Kendall knew, as I did, what parts of the body the pleura, the thorax, the clavicle and the pyemia were.
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