PERITONITIS, 



585 



elevation of internal temperature. Manipulation of the abdomen, 

 or friction, usually well borne in simple colic, is both in in- 

 flammation of the bowels, and in peritonitis, provocative of 

 more distinct manifestations of pain. 



Course and Termination. — Unless the extent of the mem- 

 brane involved is small, and the diffusion of the morbid action 

 is early arrested, the course, although not so rapid as enteric 

 inflammation so-called, is generally steady, and ultimately fatal. 



Instances of patchy and circumscribed peritonitis do fre- 

 quently, judging from ■post-mortem evidence, terminate, after 

 moderate change of textural integrity, in a return to normal 

 functional activity. The amount of fluid effused, being small, 

 is removed without havmg given evidence of its existence, and 

 before producing further serious complications. 



Treatment. — In the majority of cases, and in every stage, 

 peritonitis is rationally treated upon the same lines which are 

 applicable to inflammatory action affectmg the bowels. In 

 particular instances of strong, previously healthy animals un- 

 affected by depressing influences in the early stages of the 

 disease, and where the cardiac action and character of the 

 pulse is favourable, blood may be abstracted with benefit. The 

 active and dominant symptom of pain must in all instances 

 attract the greatest share of attention, and is most surely miti- 

 gated by the administration of opium, or opium combined 

 with aconite. One or both may be exhibited in gruel, with 

 sahnes, as the solution of acetate of ammonia ; or more certainly, 

 in the case of the opium, by the subcutaneous injection of a 

 morphia solution. 



Even when the bowels are confined there is no necessity of 

 making attempts at once to incite their movement, but the 

 reverse. As thirst is often considerable, water or gruel may 

 be freely allowed containing salines in solution. 



With the employment of blood-letting and the exhibition 

 of opium internally, the early and steady application to the 

 abdomen of heat and moisture is to be recommended ; while, 

 when these applications are withdrawn, the use of soap lini- 

 ment combined with tincture of opium, or of turpentine 

 stupes, is deserving of a trial. 



In the second stage of the disease, whether the pain has 

 been removed or not, I have often believed that benefit has 



