424 DISEASES OF THE PERITONEUM. 



state of the patient will admit it, must be judiciously en- 

 forced. • 



ASCITES.^ 



Ascites, or dropsy of the abdomen, is what we have to 

 apprehend when peritonitis, assuming the chronic form, 

 continues long unchecked, or unsusceptible of arrest ; though 

 it is a disease, it must be understood, which may proceed 

 from other causes as well as inflammation. Consentaneous 

 sj^mpathy, a dropsical diathesis, and disease of certain im- 

 portant organs — the liver, kidneys, and in an especial 

 manner, the lungs — are all influential in the production of 

 ascites : all tending either to an augmentation of the natural 

 secretion of the membrane, or else to the efi'usioD of a fluid 

 w^hich, though* serous, possesses properties difi'erent from that 

 exhaled in health. 



The Symptoms denoting a collection of water in the belly 

 are — oedema, or dropsical eff'usions in other parts, i|i the 

 sheath and underneath the belly in particular : a symptom, 

 occurring under suspicious circumstances, worthy a good deal 

 of attention, especially when with entire absence of any filling 

 in the legs (see case, B 27, in ^ Record,^ p. 190) ; though the 

 legs are apt to swell as well, if not at first, towards the con- 

 clusion. There is dropping and actual enlargement of the 

 belly, fluctuation, and, on percussion, a dull obtuse sound, 

 diff'erent from a state of health ; shrinking, or sense of ten- 

 derness whenever the belly is pressed, or weight is imposed 

 upon the back ; perhaps something awkward to be perceived 

 in the gait of the hind legs in walking ; at one time dull and 

 dejected, at another roused into action by an attack of en- 

 teritic symptoms ; quickened respiration, which sometimes 

 comes on in fits ; lying down at full length, and looking up 

 or back at the belly, and sighing or groaning ; pulse small 

 and frequent ; bowels at one time costive, at another relaxed; 

 appetite, though at first not to be complained of, failing in 

 the latter stages. 



Causes. — Ascites is very apt to be associated with hydro- 

 ' See case of ascites, by Woodger, in ' The Vkterinarian ' for November, 1846, 



