The doctrine of present surgical pathology is that suppuration will
not take place if pus-forming bacteria are kept out of the wound,
which will heal by first intention without inflammation and without
inflammatory fever.
In making this statement I am not unaware that there is a certain
amount of fever following various severe wounds within twenty-four
hours, even when no suppuration occurs. This wound fever, however, is
transitory; not high; and entirely different from the prolonged
condition of high temperature formerly observed nearly always after
operations and injuries. The occurrence of this "inflammatory,"
"traumatic," "surgical," or "symptomatic" fever, as it was formerly
called, means that the patient has been subjected to the poisonous
influence of putrefactive germs, the germs of suppuration, or both.
We now know why it is that certain cases of suppuration are not
circumscribed but diffuse, so that the pus dissects up the fascias and
muscles and destroys with great rapidity the cellular tissue. This
form of suppuration is due to a particular form of bacterium called
the pus-causing "chain coccus." Circumscribed abscesses, however, are
due to one or more of the other pus-causing micro-organisms.
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