Acute Peritonitis in Solipeds. 391 



(;;-)■ On the active depletion from the intestinal mucosa and 

 (through the common capillary plexus) from the congested 

 peritoneal coat, counteracting alike the effusion into the periton- 

 eum 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 may still be re.sOrted 

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

 as to lock up the poi.sons 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 

 tympanitis speaks forcibly for a judicious use of antiferments, 

 both by the mouth and anus. 



Hot fomentations have long been in u.se but require persistent 

 application and this is often difificult 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 

 requisite 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 precautious. 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 (80° to 90°). 



