252 DISEASES OF THE PERITONEUM 



the ordinary form, in the early stages, there is marked 

 congestion of the serous membrane, later the serous surface 

 becomes dull, lusterless, and the contiguous surfaces become 

 slightly adherent through the depositing of yellowish-white 

 flakes of fibrin (peritonitis fibrinosa). In some instances 

 there is but little effusion of fluid, but in most cases there is a 

 copious effusion of exudation, somewhat turbid containing floc- 

 culent masses of a yellowish color (peritonitis serofibrinosa). 

 The quantity of fluid varies considerably from a few cubic 

 centimeters to several liters. In other cases the exudation 

 is more turbid and contains purulent material (peritonitis 

 purulenta). The peritonitis following rupture of the bowels 

 is "very virulent, the exudation is purulent and contains 

 bowel contents. In the abdominal cavity a quantity of dirty, 

 brown, turbid fluid of offensive odor is found. In all cases 

 of peritonitis with effusion more or less blood is always 

 present (peritonitis hemorrhagica). When the peritonitis 

 results from rupture of the bladder, urine will be present in 

 the abdominal cavity, and the odor will be detected in the 

 abdominal contents. 



Symptoms.— Acute, diffuse peritonitis, when due to inju- 

 ries, rupture of the bowels, abscesses, etc., usually develops 

 rapidly under symptoms of marked general disturbance. 

 In the most severe infections the symptoms are principally 

 those of a septicemia or toxemia. In the beginning there 

 is abdominal pain, restlessness, stiff unnatural gait, and 

 "tucked up" abdomen. Palpation over the abdomen reveals 

 intense contraction of the abdominal muscles, and con- 

 siderable sensitiveness. When the peritonitis is diffuse the 

 sensitiveness is noted over the entire abdomen; when cir- 

 cumscribed only local areas of tenderness are evinced. The 

 pain is often severe enough in small patients (dog and cat) 

 to cause them to groan and cry. Pain is a prominent 

 symptom, and is usually continuous, except in cases where a 

 general toxemia exists. The respirations are of the costal 

 type. In most cases they are diminished, but if fluid is 

 present there is severe dyspnea. 



Vomiting is an early and characteristic symptom of peri- 

 tonitis in the dog and cat. It is usually one of the first 



