The views i r. Traver.s and others would certainly seem to oppose adoption of such a step, but we have, on the tin- evident absorption of pus into the system by i id; and, besides, numerous cases are on record in which the liirature of the vein has not only not been l.y evil results, but has absolutely been the rent cause of preventing inflammation and pus ab: The non-appearance of symptoms of purulent poisoning till after the separation of the threads, makes it generally difficult to say which set of vessels those 1 or those not ligatured have been the carriers is. In the case referred to in the note death took place rapidly, before the ligatures were detached.
Ilennrn expresses himself thus on the danger of tying i: li When the irreat veins bleed I have hesitated about tying them also, and it is most particularly -sary in In that case thoee vessels which bad been dad ware freo i animation and pus, while those not included in ligatures were full of pus, and " much inflamed." Independently of all fortuitous circumstances, there can be little doubt but that some constitutions oppose themselves more to pus poisoning than others.
This, although a most unsatisfactory mode of explanation, yet seems the only way of answering the difficulty which is presented to us in the much greater susceptibility of some to purulent absorption than others. Most dir rapidly, while others, not apparently so well fitted to withstand the assaults of such an invader, though placed in precisely the same circumstances, only yield inch by inch, and others again escape altogether. The presence of typhus fever in an hospital has been supposed to favour the development of pyoemia, and, although it cannot be denied but that the diseases often co-exist, yet it seems more probable that they both proceed from a like source, a lowered vital energy in the patients, or vitiated hygienic arrangements.
The secondary deposits were with us, as usual, generally found in the lungs. Beck states, as the results of his observation in Holstein, that such was the seat of the deposition in seven cases out of ten in which patients died of pyoemia. This is not, I believe, an exaggerated average. Some of the French surgeons employed at Constantinople made the remark that they seldom found the pus collected in dep6ts, as they had been accustomed to see it in Africa; but that it commonly was disseminated through the organs, muscles, and bones. The visceral congestions which so often follow amputation/were more than commonly fatal in their results in the Crimea, from the presence in most cases of the seeds of disease in the lungs, kidneys, and intestines.
Aiii'i i Phthisis aii'l dteric attacks wen nut uiitrc(jurntly the immediate causes of death, and in at least two cases the symptoms of Blight's disease of the kidney were most rapidly developed after thigh ampu:i3.* For an outline of the statistics of the French army, see appendix II.