428 DISEASES OF THE PERITONEUM. 



ascites — though evidently complicated with "farcy humours'' 

 — which waSj after great perseverance in small bloodlettings, 

 aperient and diuretic medicine, and counter-irritants, com- 

 pletely recovered. Scruple doses of cantharides were occa- 

 sionally given also with apparent advantage. 



The POST-MORTEM Appearances consist in the presence 

 of an aqueous fluid in the cavity of the belly, accompanied by 

 congestion in the peritoneum, or, more likely, with alterations 

 in its structure. In general, the effused fluid is of a bright 

 yellow colour, perfectly pellucid, and altogether similar in 

 its aspect to the serum of the blood ; though at times it is 

 almost as colourless as water : in fact, it is evidently of the 

 same description as that found in pleurisy. In one case, 

 where blood was found in the cavity, Mr. Cartwright saw it 

 looking like "pale port wine/' Its quantity will vary con- 

 siderably : sometimes its amount is but comparatively small ; 

 while in other cases it is very great. Mr. Hodgson met with 

 an instance in which the fluid amounted to "four stable-pail- 

 fuls — about sixteen gallons.^' I have seen the cellular 

 tissue of the mesentery and mesocolon loaded with the same 

 fluid. I have also met with a case in which the cellular tissue 

 connecting the muscular to the vascular coat, of the stomach 

 was filled to that degree, that one tunic was not only com- 

 pletely but widely separated from the other. Now and then 

 flocculi of coagnlable lymph are found in various places, ad- 

 hering to the surfaces of the intestines, while loose portions 

 are floating about in the water, giving the turbid whey- 

 like appearance. The peritoneum is either not perceptibly 

 altered in its aspect and texture, or exhibits a general and 

 more or less intense reddening ; or else is reddened in 

 patches. In inveterate cases, losing its shining character, 

 it turns opaque and white, and becomes more or less 

 thickened in substance. Of the abdominal viscera, the kid- 

 neys seem the most subject to morbid alteration in these 

 cases : I have occasionally found them pale, unusually tough 

 in their texture, with purulent matter in their pelves. Mr. 

 Brown (of Melton) met in one case with "purulent mucus'' 

 in the pelvis, with ulceration of its surface. 



