Diseases of the Bowels. 83 



a short time the herald of death approaches, all pain ceases 

 — mortification is the boon he grants before life leaves the 

 suffering frame. The extremities become cold, the patient 

 is comatose, and so passes quietly away ; or, occasionally 

 delirium closes the scene. 



Post-mortem Appearances.^lntense inflammation of the 

 peritoneal membrane, often extending through its whole 

 thickness, and portions of it are not unfrequently found to 

 be gangrenous. The membrane covering the intestines is 

 frequently involved ; livid patches are also to be observed 

 on that portion of it covering the stomach and liver. 

 The abdominal cavity contains more or less serous fluid ; 

 if the disease has existed long the quantity is considerable, 

 of a bloody hue, and smells very offensive. 



Treatment. — In the early stage of acute peritonitis, the 

 bowels may be moved by an oleaginous aperient ; but in 

 the later stages — when, in all probability, the membrane 

 covering the intestines is involvedj together with the in- 

 ability of the system to withstand depletion — purgatives 

 are attended with great danger, and simple enemas alone 

 should be relied on. 



Hot fomentations, linseed-meal poultices, or bags of hot 

 salt should constitute local treatment. At the onset leeches 

 may be applied to the abdomen ; but they are not admis- 

 sible at a later period. 



With regard to internal remedies, anodyne agents are 

 indicated, and either of the following medicines may be 

 given : — 



Fleming's Tinct. of Aconite ... 1 to 3 minims, 

 in a teaspoonful of water every two hours ; 



or, 



Opium I grain 



Chloroform 5 minims, 



in a teaspoonful or two of water every four hours ; 



Sedative enemas may also be used, and are attended for 

 a time with much relief, 



G— 2 



