DISEASES OF THE PERITONEUM. 



319 



reabsorption of the exudate is incomplete and if the leucocytes con- 

 tinue to emigrate, the liquid takes a purulent or muco-purulent 

 aspect. In rare cases, when partial adhesions and formations of 

 walls are established, more or less considerable portions of the exu- 

 date may become enclosed, they are gradually condensed, caseated, 

 and ultimately undergo calcareous infiltration. 



In peritonitis of long duration the intestine participates in the 

 morbid process ; its walls become œdematous, thickened, and very 

 friable; they are struck by paralysis; this produces an obstinate 

 constipation, with an accumulation of gas in the intestines, and 

 disorders which are the consequence of it. With time catarrhal 

 inflammation develops in the intestinal mucous membrane. 



Finally, the peritoneal exudate may, through its abundance, 

 cause disturbances, either by acting mechanically by a pressure 

 upon the diaphragm and the abdominal viscera, or by producing 

 infiltration and softening of these organs. The serous infiltration 

 of the diaphragm causes paralysis of this muscle and thus leads to 

 dyspnœa. 



Acute circumscribed peritonitis is accompanied by the same special 

 alterations, but they are confinod to certain regions of the peritoneal 

 membrane (intestine, liver, uterus, ovaries). Local peritonitis is 

 developed as a result of narrow wounds which intersect the serous 

 membrane (puncture), and in inflammation of the organs which are 

 covered by this membrane (perimetritis, perihepatitis, etc.). Phleg- 

 masia remains circumscribed when the irritating products are iso- 

 lated soon enough, either by a union of the inflamed folds or by 

 encysting. These mild forms of circumscribed fibrinous peritonitis 

 are somewhat frequent in our animals, mainly in the horse ; in fact, 

 it is not rare to find remains of old exudates at the autopsies. 



Symptoms of acute diffused, peritonitis, particularly in 

 the horse. The clinical picture of peritonitis does not possess 

 anything expressive, and above all nothing typical ; the numerous 

 variations which are observed in it are due to its frequent secondary 

 nature ; the symptoms of the pre-existing morbid condition are 

 dominant. In cases where peritonitis follows closely the develop- 

 ment of a primary lesion, it is very difficult to distinguish the 

 manifestations belonging to this, from inflammation of the abdom- 

 inal serous membrane; as a rule, the primitive disease (intestinal 

 changes of relation, for example) produce troubles of great inten- 

 sity, which obscure the symptoms of peritoneal phlegmasia to a great 



