Symptoms. 577 



contraction of the muscles. Increased distension may best be 

 appreciated by palpation, and fibrillar muscular tremblings chu 

 frequently be felt. 



Friction sounds, due to tlie movement of rougliened layers 

 of peritoneum on each other, can be heard only rarely. This 

 is most frequently observed in cattle and in the left hypochon- 

 driac region if the inflammation involves the diaphragm (for- 

 eign body), and in the right flank in cases of metro-peritonitis 

 (Detroye). The roughness and painfulness of the peritoneum 

 can easily be discovered by rectal examination, and in many 

 cases of rupture of the stomach or intestine, particles of food 

 can be found in the peritoneum. 



Where large quantities of fluid are present the flanks are 

 depressed and the al)domen gradually becomes Avider in its lower 

 part. In such cases an area of dulness limited above by a hori- 

 zontal line can be made out. 



Neighboring organs are frequently affected in sjmipathy. 

 In carnivora and swine there is often vomiting and intestinal 

 contents may be found in the vomit. This s^nnptom results 

 from irritation of the peritoneum, especially over the stomach 

 wall and has been observed in exceptional cases in the horse 

 (Roll). On the other hand, extension of the inflammation to the 

 diaphragmatic layer is sometimes followed by persistent sob- 

 bing (Anacker). In cattle Otto noticed peculiar rolling sounds 

 following every movement of the rumen. 



In the early stages of the disease there is diarrhea, and act- 

 ive intestinal murmurs can be heard, provided the primary dis- 

 ease is not one in which peristalsis is suppressed. Very soon 

 and in some cases from the outset, constipation sets in which is 

 of a very persistent character. In the later stages there is 

 general meteorism in all animals, and in cattle distension of 

 the rumen is a prominent symptom. Animals strain frequently 

 and while doing so, groan with pain and show other signs of 

 pain in the intervals. 



Frequent urination with pressure of urine and tenesmus of 

 the bladder are sometimes observed. Exceptionally there is 

 retention of the urine which may be due to paralysis of the 

 muscular tissue of the bladder following on edematous infiltra- 

 tion, or to reflex contraction of the sphincter. 



Respiration is costal and accelerated, all movement of the 

 diaphragm and the abdominal organs being avoided as far as 

 possible. With the outpouring of the exudate and the meteor- 

 ism the difficulty of respiration becomes more pronounced. 



In acute peritonitis in cattle Cuny observed a bilateral flow 

 of tears which soon became converted into a purulent discharge, 

 associated with redness and swelling of the conjunctiva and 

 opacity of the cornea. He also noticed a watery nasal discharge 

 which in the later stages became mucoid. 



In all cases there are symptoms of general disturbance. 



Fever is very rarely absent and is, as a rule, high. The 



