Symptoms. Course. Diagnosis. 579 



digestive disorders with jx'rsisteiit diarrhea suggest chronic 

 intestinal catarrh, while in the horse occasional attacks of colic 

 which last only for a brief time have no diagnostic importance. 

 Diagnosis is generally possible only if in addition to the above 

 mentioned symptoms there is localized sensibility to pressure 

 of the abdominal wall, if there is an accumulation of fluid within 

 a short time, Avliich proves to be an exudate on test puncture. 

 In cases of chronic peritonitis with effusion there is sometimes 

 subcutaneous edema of the abdominal wall. 



Localized chronic peritonitis frequently causes disturbance 

 of other organs (loss of tone of the rumen in cattle, stenosis of 

 the intestine). The exact nature of these derangements can be 

 determined in rare cases only by rectal examination or palpa- 

 tion of the abdomen. 



Course. Acute peritonitis is sometimes very rapid in its de- 

 velopment and may cause death in the iirst stage of the disease 

 and even within a few hours. This is particularly the case 

 where there is an escape of stomach or intestinal contents or of 

 pus into the peritoneal cavity. It is seen only exceptionally in 

 cases of puerperal infection. In such cases the local symptoms 

 are less pronounced and the symptoms shown are those of gen- 

 eral sepsis associated w^ith high fever, rigors, occasionally a 

 subnormal temperature, weak and rapid pulse and great pros- 

 tration, or of a putrid intoxication. In the great majority of 

 cases the symptoms develop slowdy, death taking place from the 

 fourth to fourteenth day. Sometimes there is a marked fall 

 in temperature before death and there is usually diarrhea. In 

 other cases the disease becomes chronic and may last for months 

 or even years. The same is true for cases that are chronic from 

 the outset. 



Diagnosis. The moderately rapid development of the dis- 

 ease, fever, tenderness of the abdomen to pressure, constipa- 

 tion and tympanites, acceleration of the pulse from the com- 

 mencement and gradual weakening of the heart beat form a 

 fairly characteristic picture. Diagnosis is more certain in cases 

 where, owing to a previous examination of the animal or a re- 

 liable history, a primary disease is known to be in existence. 

 Otherwise it can only be based on the discovery of a roughened 

 condition of the peritoneum, adhesions between various organs 

 or the presence of a fluid exudate in the peritoneal cavity. 



In cases of peritonitis due to displacement of stomach or intestine the exudate 

 obtained by tapping is at first generally clear and reddish in color, but as the 

 amount of liquid increases, owing to disturbance of the circulation, and the peri- 

 tonitis becomes more severe the liquid becomes turbid. 



In the horse the disease is likely to be confounded with gas- 

 tric and intestinal colic in which the pulse is rapid and weak 

 from the outset, or the animals are inclined to be persistently 

 restless. In gastro-enteritis there is diarrhea either through- 



