580 Peritonitis. 



out or at any rate for a considerable time and loud intestinal 

 murmurs, but rectal examination reveals no roughness of the 

 peritoneum nor is it painful. Other kinds of colic can be differ- 

 entiated by the facts that in them there is no rise of tempera- 

 ture for some time at least, and that the animals are restless, 

 and rectal examination aifords in many cases much valuable in- 

 formation. All forms of colic may lead to peritonitis in the 

 later stages, and especially those due to thrombosis and to dis- 

 placement of organs. In the dog cases of volvulus of the stom- 

 ach may be confounded with peritonitis (see page 317). As a 

 rule chronic peritonitis can only be diagnosed when the pres- 

 ence of fluid can be recognized in the peritoneum, or there is 

 known to have been an antecedent acute attack. At most, 

 limited areas of inflammation of the peritoneum will be found 

 where there have been some adhesions formed (see stenosis of 

 the intestine) . The differential diagnosis of chronic serous peri- 

 tonitis and ascites has already been dealt with (see page 568). 



Prognosis. Acute diffuse peritonitis must be considered as 

 a very dangerous condition and the prognosis is very unfavor- 

 able when the inflammation is due to perforation of the stomach 

 or intestine, or to the escape of pus into the peritoneum. Less 

 extensive localized fibrinous inflammation is commonly unasso- 

 ciated with any danger, and is in many cases not recognized dur- 

 ing life. Prognosis is more favorable in cases due to injury 

 from the outside, because with suitable treatment the disease 

 may be kept localized and a cure effected. Extensive chronic in- 

 flammation leads to adhesions between the abdominal wall and 

 some of the viscera, especially intestine, and consequently di- 

 gestive disorders of a permanent nature are produced. 



Treatment. In cases where the peritonitis is due to some 

 wound, such as castration, antiseptic treatment immediately 

 after the first sjanptoms make their appearance will frequently 

 arrest the extension of the disease and limit it to the immediate 

 neighborhood of the wound. Surgical intervention may be fol- 

 lowed by good results in cases due to encapsuled abscesses, such 

 as are produced in cattle by foreign bodies. Finally the good re- 

 sults obtained in human surgery indicate that in certain cases, 

 especially in carnivora, cures might be effected by surgical in- 

 tervention, such as laparotomy, suturing of the wound in the 

 intestine, resection of the intestine, washing out the peritoneum 

 with sterile salt solution at body temperature, or with weak 

 solutions of salicylic or boric acid. Baldoni cured a dog in 

 seven days by flushing the peritoneum. To decrease the absorp- 

 tive power of the peritoneum Wilms advises in human surgery 

 the intraperitoneal injection of 130 cc. of oil of camphor. Atten- 

 tion should next be paid to decreasing the movements of the 

 intestine to avoid as far as possible the dissemination of the in- 

 fective material by the peristaltic action. This object is best 



