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Chapter 4 sepsis (sepsis)

Sepsis is translated from Greek as decomposition. Sepsis due to pyogenic pathogens is called a systemic purulent infection, or generalized purulent infection, which develops from the primary purulent focus against the background of prior or acute weakening of the protective mechanisms (reactivity) and takes place as inhibition (insufficiency) of the functions of a number of vital organs and systems.

The term «sepsis» was introduced by Aristotle in the IV century BC and used in the meaning of «poisoning of the body by the products of decay of its own tissues». Sepsis was also called «rotten blood». Hippocrates described its symptoms and differentiated them from those of rabies. In the XVI-XVII centuries Paracelsus considered the reason for the «rotten blood» to be poisoning of the body by chemical substances. A French physician Gaspard in the XIX century showed in the experiment that small doses of pus in the vessels of animals are neutralized, and their repeated administration leads to death. A great contribution to the study of sepsis was made by N.I. Pirogov who suggested that sepsis develops if contagious miasma forms in wounds of patients (at that time the role of microbes was unknown). Miasms can accumulate in the hospital environment and affect even healthy people. Therefore, it is N.I. Pirogov who determined the significance of the primary focus and general condition of the body in the pathogenesis of wound sepsis. He also described clinical symptoms, compiled a classification and determined the principles of treatment.

Theories of sepsis emergence. With development of microbiology, the microbial concept of sepsis appeared. Sepsis develops following bacteremia from the primary septic focus. It is the purulent focus that causes sepsis. However, the importance of the general condition of the body, and its reactivity, were not taken into account in this theory.

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