In sapremia the blood contains the toxins and dead saprophytic organisms. In septicemia the blood contains both pyogenic toxins and multiplying pyogenic organisms. In sapremia the causative condition is putrid material lodged like a foreign body in the tissues. In septic infection the tissues themselves are suppurating, and both bacteria and toxins are absorbed by the lymphatics. Of course, septic infection may be associated with septic intoxication or may follow it. The symptoms of sapremia depend upon the amount of intoxication. In septic infection, or septicemia, only a small number of organisms may get into the blood, but they multiply rapidly. A drop of blood from a man with septic infection will reproduce the disease when injected into the blood of an animal; hence it is a true infective disease. The wound in such a case is often small, and is commonly punctured or lacerated. +Pyemia+ may be defined as a condition in which metastatic abscesses arise as a result of the existence of pyogenic bacteria in the circulating blood, either free or contained in pus cells or thrombi. +Symptoms.+ The symptoms of pyemia are a febrile movement with a severe chill and a sudden marked rise in the temperature which lasts for a few hours and passes off with profuse sweating. The chills recur every other day, every day, or oftener. The general symptoms of vomiting, wasting, etc., resemble those of septicemia. The lodgment of emboli produces symptoms whose nature depends upon the organ involved. If in the lungs, there is shortness of breath and cough, with slight physical signs. In a suspected case of pyemia, always look for a wound, and if this does not exist, remember that the infection may arise from an osteomyelitis. Chronic pyemia may last for months; acute pyemia may prove fatal in a few days. +Treatment.+ The treatment is the usual supporting one that should be employed in septic affections, and all suppurating focci must be opened and drained as soon as detected. Every branch of the irregular cavities must be opened and drained at the most dependent part, and the sinuses must be treated to prevent pocketing. Serum therapy is also indicated. CHAPTER VI +HEMORRHAGE+ +Definition.+ The escape of blood from the blood vessels in great or small quantities, is called hemorrhage, and may occur either spontaneously or because of injury. +Spontaneous hemorrhage+ occurs in the organs and cavities of the body as a result of constitutional diseases, such as tuberculosis, syphilis, cancer, etc., in which erosion of tissue extends into vessels. It is also a result of a constitutional tendency. Persons with this, so called hemorrhagic diathesis, are known as hemophiliacs. In hemophilia, uncontrollable bleeding may occur from trifling injuries. +Hemorrhage due to Injury+ may be classified as follows: a—arterial b—venous c—capillary