THE THORACIC AND ABDOMINAL WALLS 163 



to examine first for hernia, and to see tliat the knife does not 

 open the abdomen. 



Acute Suppurative Peritonitis. 



Vm in the abdomen, when floating about freely and not 

 encapsuled, of necessity sets up a peritonitis, and if not 

 removed is fatal. This condition may cause death within 

 three or four days, or the patient may hve for several weeks 

 after the operation or injury which has been its source of 

 origin. 



Symptoms. — In acute suppurative peritonitis the temperature 

 rises three or four degrees, respiration is accelerated, the pulse 

 is quick and wiry, the abdomen is tender on pressure, the eye 

 is abnormally bright, the mucous membranes are very hot 

 and feverish, and the animal vomits, refuses food, and is dull. 

 Death may take place within forty-eight hours, being preceded 

 by coldness of the surface and extremities and coma. In the 

 chronic form the disease may progress unsuspected until 

 near the finish, the patient eating food a little capricious^, 

 but appearing normal in other ways. The thermometer is 

 the best guide, but even that is uncertain in the dog and 

 cat, as the least excitement and exertion will cause variations 

 (see p. 5). 



In either condition the previous history is always worth 

 the most careful consideration. 



Operation. — The only chance of escape from death lies in 

 the removal of the purulent fluid, and the only prospect 

 of doing this effectually lies in surgery. When the peri- 

 toneum is invaded, laparotomy should be done without delay 

 (see p. 158), and the sooner it is done the better for the chance 

 of success, the abdomen being carefully irrigated (not swabbed, 

 as this removes the lining cells) with warm non-irritating 

 antiseptic solution (such as chinosol, a grain to the ounce). 

 Sterilized saline solution (a teaspoonful to a pint of distilled 

 water) employed at a slightly higher temperature than that 



II — 2 



