PERITONITIS 255 



the quantity subcutaneously) are employed to combat symp- 

 toms of general weakness and coma. Alcoholic stimulants 

 or camphor may also be used for the same purpose. 



Surgical.— When severe infection is present, and in the 

 early stages, it is advisable to irrigate the abdominal cavity 

 in the following manner: Laparotomy should be performed 

 (see Laparotomy) and a sufficient amount of sterile, normal 

 salt solution introduced at the body temperature to 

 thoroughly irrigate all parts of the cavity. This should be 

 followed by a boric acid (2 per cent.) or a salicylic acid solu- 

 tion (2 per cent.). The value of this method will depend 

 largely upon the thoroughness of the application. Before 

 irrigating a thorough examination of the organs and tissues 

 in the cavity should be made for ruptures, etc., and if found, 

 proper treatment should be applied. When an excessive 

 amount of effusion is present it should be removed. (See 

 Treatment for Ascites.) 



Chronic Peritonitis.— Definition.— A chronic inflammation 

 of the peritoneum which may be either diffuse or circum- 

 scribed. As a rule chronic peritonitis is rarely found equally 

 well marked over the entire abdominal cavity. From a 

 clinical standpoint it is difficult to separate the two condi- 

 tions, therefore, they will be described as one. 



Etiology. — Chronic peritonitis may be due to a number of 

 different causes, the most important of which are: Intra- 

 abdominal lesions, such as diseases of the liver (hepatitis, 

 abscesses), the kidneys, spleen, etc., which may reduce the 

 resistance of the peritoneum; or from gastric or duodenal 

 ulceration providing a focus for peritoneal infection. In 

 these cases a general chronic peritonitis results instead of a 

 local inflammation, owing to the reduced resistance of the 

 membrane, or the low virulency of the infection. Chronic 

 venous engorgement from defective heart action would 

 produce much the same effect. Chronic peritonitis may 

 result from the acute fibrinous form when complete resolution 

 does not take place, or the infection is mild. 



In some cases it may result from disease of the pleura by 

 spreading through the diaphragm. Chronic peritonitis may 

 also result from disturbances of the intestinal tract. 



