Diseases of the Bowels. 83 
a short time the herald of death approaches, all pain ceases 
—mortification is the boon he grants before life leaves the 
suffering frame. The extremities become cold, the patient 
is comatose, and so passes quietly away ; or, occasionally 
delirium closes the scene. 
Post-mortem Appeavances.—Intense inflammation of the 
‘peritoneal membrane, often extending through its whole 
thickness, and portions of it are not unfrequently found to 
be gangrenous. The membrane covering the intestines is 
frequently involved ; livid patches are also to be observed 
on that portion of it covering the stomach and _ liver. 
The abdominal cavity contains more or less serous fluid ; 
if the disease has existed long the quantity is considerable, 
of a bloody hue, and smells very offensive. 
Treatment.—In the early stage of acute peritonitis, the 
bowels may be moved by an oleaginous aperient ; but in 
the later stages—when, in all probability, the membrane 
covering the intestines is involved, together with the in- 
ability of the system to withstand depletion—purgatives 
are attended with great danger, and simple enemas alone 
should be relied on. 
Hot fomentations, linseed-meal poultices, or bags of hot 
salt should constitute local treatment. At the onset leeches 
may be applied to the abdomen ; but they are not admis- 
sible at a later period. 
With regard to internal remedies, anodyne agents are 
indicated, and either of the following medicines may be 
given :— 
Fleming’s Tinct. of Aconite ... I to 3 minims, 
in a teaspoonful of water every two hours ; 
or, 
Opium .. ........ y sdgeisaeseespenstaaeees w. I grain 
Chloroform. iss ccies suas sores viassenesescin 5 minims, 
in a teaspoonful or two of water every four hours ; 
Sedative enemas may also be used, and are attended for 
a time with much relief. 
