78 INFLAMMATION. 



formed ptomaines, by their chemical actions, so alter the tissues 

 that the process of absorption is impaired, and suppurative perito- 

 nitis again results in consequence. The greatest clinical difference 

 between simple peritonitis produced by a trauma or chemical irri- 

 tants, and septic peritonitis, consists in the course and extent of 

 the inflammation. Simple inflammation produced by aseptic causes 

 remains limited to the seat of the trauma, and does not extend much 

 beyond the surface area to which the irritant is applied ; while 

 septic peritonitis is always characterized by its progressive charac- 

 ter, as the cause upon which it depends is multiplied within the 

 peritoneal cavity. The same can be said of the two kinds of 

 inflammation in any other tissue or part of the body. The same 

 conditions which were found to favor the development of septic 

 peritonitis, such as trauma and the presence of fluids, are equally 

 potent in determining localization of microbes in other parts of the 

 body, and intensify their pathogenic action by creating conditions 

 which prevent their absorption and destruction, and, on the other 

 hand, they furnish a nutrient medium in which the microbes find 

 a proper soil for their multiplication. 



Kinne ( u Der Eiteruugs process und seine Metastaseu," Archiv f. 

 klin. Chirurgie, B. xxxix p. 13) is of the opinion that on account 

 of the rapidity with which absorption takes place in the peritoneal 

 cavity that the peritoneum, when in a normal condition, is almost 

 immune to infection with pus-microbes. He injected from 30 to 35 

 c.c. of an aqueous suspension of a pure culture of pus-microbes into 

 the peritoneal cavity of healthy animals, and was never able in this 

 manner to produce a peritonitis. He had no better success with 

 injections of a mixture of a gelatin culture of staphylococcus aureus 

 and a turbid culture of the same coccus in bouillon. He also injected 

 from day to day a boiled putrid solution to which was added a 

 culture of the staphylococcus aureus without any inflammation fol- 

 lowing. The experiments, as a rule, were made on dogs, although 

 in several instances rabbits, guinea-pigs, and white rats were used. 

 He believes that the difference in the results obtained by him and 

 Grawitz, as compared with Pawlowski's, consist in the nature of 

 the abdominal wound. Pawlowski made an incision down to the 

 muscles and then perforated the abdominal wall with a blunt tro- 

 car, while he and Grawitz used a sharp, hollow needle for making 

 the injection. To prove that his injections entered the peritoneal 

 cavity he added coal-dust, which he found in the peritoneal cavity 

 in making, subsequently, the autopsy. 



