ACUTE PERITONITIS. 105 
however, it has exceptions, and now and then cases of peritonitis are met with 
in which the pain is evidently very intense, and greatly aggravated by pressure. 
over the abdomen. 
In severe attacks of this malady the victims are usually restless at first, and 
change their positions frequently, walking with a stiff and awkward gait; but 
after a day or two they become quiet, seemingly resigned, and even require some 
urging before they will move about. 
The abdomen is shrunken at first, its walls being contracted and rigid, but 
soon they relax and there is considerable distention. Deep inspiration is pain- 
ful, consequently avoided, and the breathing is quickened. There is fever; the 
pulse is rapid, thin, and small; the expression anxious, and the eyes reddened 
and sunken. Vomiting may occur in the early stages, yet if so it is only occa- 
sional. Later, however, it is generally frequent and persistent. ‘Thirst, loss of 
appetite, and obstinate constipation complete the list of important symptoms. 
The latter is not constant, and diarrhcea may exist from the first; but the rule is 
that the lower bowel is powerless to unload itself until a marked change for the 
better has occurred or the discharges become involuntary as death approaches. 
In a well-defined case of peritonitis caused by perforation, the chances are 
nearly all against recovery. It may, however, occur if the disease is an exten- 
sion of an inflammation in the womb or intestines ; but even then the outlook is 
exceedingly grave, for the patient’s strength fails rapidly, and is almost always 
wasted before the affection has run its course. 
It may be assumed from this that treatment does not promise well, but of 
course it should always be instituted. If applied early and faithfully, cloths fre- 
quently wrung from very cold water not only afford some relief, but tend to 
retard the inflammation. After the disease is well fixed, however, and the in- 
flammation has spread and become intense, a stimulating application is indicated, 
and the following should be resorted to: Tincture of aconite root, chloroform, 
and aqua ammonia, of each three drachms ; compound soap liniment, six ounces. 
This should be freely and quickly rubbed into the hair over the abdomen, 
and at once covered with several thicknesses of cotton batting. 
The need of opium in this disease is urgent, not only to subdue pain but to 
lessen the tendency of the inflammation to spread and grow in intensity ; and 
its convenient form, laudanum, should be given in doses adjusted as in colic; 
while they should be repeated as often as every hour until the sufferer is clearly 
under its effects and dosing most of the time; in which state, if possible, he 
should be kept continuously by this means. 
There appears to be a disposition on the part of many practitioners in canine 
diseases to treat fever always, no matter what its association or cause; but in this 
instance it certainly would not be wise, for the remedies usually employed are 
sure to do more harm than the high temperature. 
An injection of warm sweet oil or soapsuds, once daily, would, perhaps, be 
