PERITONITIS. 85 



lies on the floor of the abdominal cavity; but where the exudate 

 forms very rapidly the ■whole abdomen is filled up, causing great 

 dyspnoea. 



In the early stages of some cases the abdomen is tucked up, 

 the walls are tense, firm, and painful to the touch, and it is some 

 time before the abdomen begins to enlarge from the collection 

 of the exudate. . As a rule, the bowels are constipated, except 

 where there has been some diarrhoea present before the disease 

 started, which is seen in those cases where there is ulceration of 

 the mucous membranes. Vomiting is always present, the vom- 

 ited matter being greenish-yellow mucus. There is total loss of 

 appetite. The temperature rises to 40° C. or above. If the dis- 

 ease is not so severe as to cause death in a day or two, the tem- 

 perature fluctuates, being high at one part of the day, and then it 

 becomes subnormal, its character being remittent. The pulse is 

 fast, thin, or wiry, and finally imperceptible. 



The great majority of cases are fatal, the animals dying in from 

 one day to a week, according to the intensity of the disease. They 

 usually die in a condition of collapse ; in rare cases from heart- 

 failure or suffocation from the collection of the exudate. 



Oircumscribed or chronic peritonitis produces less marked symp- 

 toms and is harder to recognize, the symptoms of diffuse chronic 

 peritonitis being those of ascites. The best way to confirm a 

 diagnosis is to puncture the abdomen with a small trocar and see 

 the character of the fluid. 



Therapeutics. Acute diffuse peritonitis should be treated 

 with constant applications of cold-water compresses to the abdo- 

 men, and, if the irritation is very intense, the application of a 

 counter-irritant, such as mustard poultices or mustard oil; the latter 

 is the best. Take 30 to 50 grammes of a mixture composed of 

 mustard oil, 10 parts, and olive oil, 100, rubbing it well into the 

 abdomen. Opium is to be given internally in doses of 0.1 to 0.5 

 gramme, and when there is collapse give whiskey and spirits of 

 camphor. If there is any obstruction of the bowels, give injections 

 of warm water. The exudate can only be removed by puncture of 

 the abdomen, when the acute symptoms have subsided. It must 

 be always borne in mind (and this holds good in inflammation of 

 other serous membranes) that the production of a serous exudate 

 is a process that assists the existing conditions because the liquid 



