146 Surgical Diseases and Surgery of the Dog 



of a certain amount which can be eliminated within a limited period. 

 The actual cause of the disease is always a septic infection. It is 

 customary to speak of a plastic type of peritonitis but this is purely 

 a regenerative process produced by aseptic causes, such as trauma- 

 tism or the passage of an aseptic fetus from the uterus (Blanc). 

 It attends every healing of aseptic wounds. Certain cysticerci also 

 provoke inflammatory secretions, but this is very rare. Pathogenic 

 microbes gain access to the peritoneum through penetrating ab- 

 dominal wounds, including septic surgical wounds, perforation of 

 any part of the gastro-intestinal tract, the spontaneous opening of an 

 abscess into the cavity, the perforation of the uterine wall in cases 

 of pyometra, by migration from contiguous tissues in septic inflam- 

 mation of the latter or following a sudden lowering of vitality as 

 may take place when a chill is sustained, and even by localization of 

 circulating bacteria as occurs in tuberculosis. 



The disease may be acute or chronic, circumscribed or diffuse. 

 Contrasted with the other great serous sac of the body, the pleura, 

 the peritoneum offers opportunity for localization of infection by 

 reason of the coils of viscera forming pockets and recesses wherein 

 it m^y be and often is confined. The prognosis of the acute diffuse 

 fc«n is always grave. 



Symptoms and Diagnosis. In the acute form the disease is 

 ushered in by depression, coldness of the extremities, rapid pulse, 

 and tenderness of the abdomen to palpation. In the early stages the 

 temperature is elevated but later becomes subnormal. Soon retch- 

 ing or vomiting appear and death takes place by toxemia. In some 

 cases the symptoms closely resemble those of intestinal obstruction, 

 but the distinguishing feature of the latter diseases is the stercora- 

 ceous vomiting. The circumscribed form is often unrecognizable on 

 account of the absence of any indicative symptoms. 



Treatment. As this disease is caused by pyogenic microbes the 

 early removal of pathogenic foci which threaten to rupture into the 

 cavity is indicated. If septic material is already present or the con- 

 ditions are such that accumulation of putrescible material is likely 

 to ensue the cavity must be opened, flushed with warm sterilized 

 water, and free drainage established by means of folds or strands of 

 aseptic gauze introduced well within the cavity and the dependent 

 extremity carried outside the skin wound. These should be left in 

 place some four or five days. At the same time efforts must be di- 



