578 



Peritonitis. 



fever takes no typical course (Fig. 77); it is sometimes con- 

 tinuous and at others remittent or intermittent. In carnivora 

 and more rarely in other animals the temperature at the onpet 

 and even up to the end may be subnormal in cases of perforative 

 peritonitis. The pulse, which is quite independent of the tem- 

 perature, is without exception accelerated from the outset and 

 may be twice as rapid as normal or even faster. In the early 

 stages it may be rather tense, but soon becomes very weak and 

 may be nearly if not quite imperceptible, probably on account 

 of the serious fall in blood pressure. To this are due the sud- 

 den cooling of the extremities (especially 

 the ischial region and root of the tail 

 [Otto]), the cyanosis and pallor of the 

 mucous membranes, and also, at least to 

 some extent, the languor and prostration. 

 The animals are quite dull and take notice 

 of nothing, or they lie down and are very 

 difficult to move (cattle and small animals 

 in particular). There is, as a rule, a com- 

 plete absence of appetite. 



In severe septic conditions (septic 

 metritis, rupture of an abscess) peritonitis 

 develops rapidly with the symptoms of 

 pyemia or septicemia, there being high 

 fever and languor with the early onset of 

 diarrhea, but no symptoms of pain. 



In cases of rupture of the stomach 

 or intestine there is a sudden depression, 

 the extremities are very cold, the pulse 

 is thready and very rapid and the body 

 is bathed in cold sweat. In such cases 

 the excessive tenseness of the abdominal 

 wall, the suddenly developing distension 

 followed by a rise of temperature, the 

 rough condition of the peritoneum Avhich 

 is sometimes discoverable by rectal ex- 

 amination, and the complete collapse 

 indicate peritonitis. 



In cases of circumscribed acute peri- 

 tonitis the pain is generally less severe 

 and localized. The general symptoms 

 are less pronounced and the principal 

 symptoms observed are due to disease in neighboring organs. 

 Such localized peritonitis may lead to the formation of adhesions 

 and the encapsulation of the exudate, but there is always the 

 danger that under certain circumstances there may be a gen- 

 eral peritonitis spread from such places. 



The s^^nptoms of chronic peritonitis are, as a rule, so slight 

 and indefinite that it is very rare that a definite diagnosis can be 

 made. Gradual wasting associated with variable temperature, 



Fig. 77. Temperature chart 

 of a case of secondary dif- 

 fuse peritonitis in a liorse 

 due to injury of the inte- 

 rior of the intestine by a 

 calculus. 



