320 DISEASES OF THE DIGESTIVE APPARATUS. 



extent. The course of the different forms of peritonitis is far 

 from beiug uniform ; some develop slowly, whilst others are accom- 

 panied bj very alarming symptoms from the beginning; in certain 

 instances it will* lead to death within such a short time that it is 

 impossible to recognize the special symptoms. It is thus that in 

 peritonitis by perforation, the blood becoming very rapidly loaded 

 with infectious products, the manifestations ot the septic infection 

 masks absolutely those of peritoneal inflammation. 

 The most important symptoms of peritonitis are : 



1. Acute painSy which are marked by more or less intense colics. 

 They are often severe and continuous at the beginning of the 

 affection : later they are remittent or intermittent. We often see 

 traumatic peritonitis starting from the testicular cord (peritonitis 

 of castration) giving rise to colics which appear violent from the 

 onset, and are marked by grinding of the teeth, groans, convulsive 

 extensions of the extremities, and costo-dorsal decubitus ; the ani- 

 mals, which are much depressed, keep their heads in the litter, 

 without moving ; sweating spells are apparent upon various parts 

 or on the whole surface of the body, etc. If the disease runs 

 through these different phases, these manifestations of pain diminish 

 in intensity or present a series of passive remissions and exacer- 

 bations. In other cases the sufferings are particularly slight during 

 the whole course of the affection ; they produce only frequent 

 decubitus, complaints, and a certain agitation ; the animals scratch 

 the soil, look at the flank, sway the tail, etc. Finally, in some 

 instances the pain seems to be absolutely wanting. 



2. The/eyer is generally acute. In diffused peritonitis we have 

 almost constantly observed a temperature of 41° to 42° C. In 

 peritonitis by perforation, fever starts with chills, and it may 

 rapidly become intense. But, in general, the thermic curve of 

 peritonitis is very erratic ; the fever has an irregular course, it is 

 either intermittent or remittent. In septic peritonitis the tempera- 

 ture at times is nearly normal. 



The circulation is always much accelerated, and the number of 

 pulsations does not at all correspond to the temperature ; 60 to 130 

 per minute may be counted. From the onset the pulse is slow and 

 hard ; as the disease progresses it grows gradually weaker, and is 

 almost imperceptible in some patients ; the artery is filiform and 

 contracted ; parallel with the changes of the pulse, the contractions 

 of the heart become increasingly stronger and more tumultuous ; 



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