ACUTE PERITONITIS. 479 



diseased condition of the mucous membrane and the uterine walls. 

 Ascendmg infections of this character and infections by contiguity of 

 tissue may only give rise to local peritonitis, though in too many 

 instances they become generalised. 



Acute peritonitis may follow infection from the stomach or bowel, 

 should a foreign body perforate the rumen or reticulum and pass 

 backwards towards the peritoneal cavity, or a serious intestinal inflam- 

 mation (enteritis, invagination, etc.) facihtate the passage of microbes 

 through the thickness of the intestinal wall. 



Abscess of the liver, suppurative echinococcosis, renal infection, 

 pyelo-nephritis, acute cystitis, rupture of the bladder, etc., may in a 

 similar way become complicated with acute peritonitis. 



Finally, abdominal wounds may cause interstitial ruptures and 

 lesions in the serous membrane, accompanied by local exudation 

 (kicks, horn-thrusts, blows from cart-poles, etc.), and if microbic 

 agents are brought within the region of the lesion by the general 

 circulation or otherwise, peritonitis may follow. 



Symptoms. At first the symptoms are vague and imperfectly 

 defined, and diagnosis is always very difficult during the i5rst few 

 days, except in cases where there exists a lesion or a condition pre- 

 viously recognised as likely to become complicated with peritonitis. 



The early symptoms comprise fever, loss of appetite, arrest of 

 rumination, rigors, constipation, etc., but these symptoms only at- 

 tain full significance when accompanied by what has been termed 

 " peritonism." 



The patient appears to be suffering from tympanites, as may really 

 be the case, but the tympanites of the rumen and gaseous distension 

 of the loops of bowel are not primary, and only result from the arrest 

 of peristalsis. The primary condition is peritonism, i.e., distension of 

 the peritoneal cavity, this being indicated by a symmetrical fulness 

 of the right and left flanks. 



The patients suffer from dull colic, and from this time always 

 assume an attitude indicating pain. They remain in one j^osition, 

 with the back arched, the limbs gathered together, and the lower 

 abdominal wall shortened. The face expresses suffering, the respira- 

 tion is short and rapid and of the costal type, movement is painful 

 and causes groaning, and the animals do not shrink when the lumbar 

 region is pressed upon. 



Palpation of the abdomen causes pain, and if practised at certain 

 points may be followed by groaning. This method of examination, 

 however, gives no further information, because the abdominal wall 

 is rigid, tense, and as though tonically contracted. 



Percussion is followed by tympanic resonance in the right and left 



