Acute Peritonitis in Solipeds. 399 



(3). On the active depletion from the intestinal mucosa, and 

 (through the common capillary plexus) from the congested peri- 

 toneal coat, counteracting alike the effusion into the peritoneum 

 which forms the culture fluid for the invading bacteria, and the 

 infiltration of the serous and subserous tissues which beside 

 tearing apart the tissue elements, and robbing their leucocytes of 

 their power of phagocytosis, furnishes within the invaded tissue 

 itself the most favorable of culture media ; and (4) on preserving 

 a better tone of the nervous system, and, locally, of the tissues, 

 the cells of which can struggle more successfully against the small 

 body of invading bacteria advancing slowly along the surface of 

 the peritoneum, than with the countless myriads produced in and 

 washed everywhere by the abundant liquid exudate. 



Along with the soda sulphate may be given antiseptics, like 

 sodium salicylate, or chloral hydrate. The latter serves to miti- 

 gate the pain without checking the secretion or peristalsis. 



When the suffering is very acute, opium ma}- still be resorted 

 to, but preferably subcutem, in the form of morphia sulphate so 

 as to lock up the poisons as little as possible. 



Enemata are in order to facilitate the operation of the bowels, 

 and may be made laxative and antiseptic. The danger of tym- 

 panitis speaks forcibly for a judicious use of antiferments, both 

 by the mouth and anus. 



Hot fomentations have long been in use but require persistent 

 applications and this is often difficult to secure. Recently cold 

 applications to the abdomen in the form of ice or snow, or in the 

 absence of these of cold water applied on a light rug, kept against 

 the abdominal walls by elastic circingles, have been found of 

 great service. This can be persistently applied, as all that is re- 

 quisite is to keep the rug constantly wet. 



"When pus forms in the peritoneum or when extensive effusion 

 has taken place, it should certainly be evacuated, as it is but a 

 centre for the development of the deadly bacteria. It can be 

 drawn off through the already existing traumatic orifice, or, if 

 necessary, a new opening can be made by cannula and trochar, or 

 by direct incision under suitable antiseptic precautions. The 

 opening having been made, and the liquid having escaped, the 

 peritoneum may be profitably washed out with a normal salt solu- 

 tion which has been recently boiled and which is used at near the 

 body temperature (8o° to 90°). 



