DISEASES OF THE PERITONEUM. 



331 



happens as a consequence of pulmonary or cardiac paralysis, or by 

 the progress of marasmus. 



Diagnosis. The diagnosis is shown by the information fur- 

 nished by the inspection, palpation, percussion, and auscultation of 

 the abdomen. In order to insure it in the dbg we may make an 

 exploratory puncture ; this is of advantage in cases where the liquid 

 is not abundant and where the trouble is not shown by any well- 

 marked symptom. The possibility of making a complete examina- 

 tion upon small animals renders tlie diagnosis much simpler in 

 them than upon those of our large domestic species. 



It is often very difficult to ascertain the cause of ascites, but it 

 is very important from the standpoint of prognosis. Hydremia 

 with a tendency to dropsy may be affirmed if cutaneous œdema 

 and transudations are found in serous membranes other than in the 

 peritoneum. Heart and lung diseases as well as interstitial chronic 

 hepatitis, which are frequent causes of ascites, often remain unde- 

 tected ; their diagnosis is quite delicate. When ascites is symp- 

 tomatic of atrophic cirrhosis there are usually two symptoms 

 wanting which belong to tliis : they are the impossibility of recog- 

 nizing the reduced size of the liver and the absence of icterus. In 

 affections of the liver accompanied by an increase in the size of this 

 organ or alterations concerning its surface, and which are appreci- 

 able by exploration (echinococcosis, tumors, etc.), ascites may be 

 related to its true cause. In hepatic ascites the urine generally 

 contains coloring matters of the bile ; but this symptom is of little 

 value. In the dog, a simple gastro-intestiual catarrh produces 

 this urinary anomaly, and cases of enormous hepatic lesion are 

 not rare (for instance, in distomiasis), w^ithout any appearance of 

 coloring matters of the bile in the urine. In this animal the eti- 

 ology of ascites is rendered still more embarrassing on account of 

 the frequency of dual factors in its causation ; indeed, it is not un- 

 usual to find the coexistence of valvular insufficiency and hepatic 

 cirrhosis. Concerning peritoneal tumors, it is exceptional to recog- 

 nize these through palpation. 



In those animals in which the peculiar condition of the organism 

 may be confounded with ascites we must specially mention : 



1. Peritonitis. This disease is accompanied by fever, profound 

 disturbance of the general condition, manifestations of pain, abnor- 

 mal sensibility to the touch ; the specific weight of the peritoneal 

 fluid obtained by the exploratory puncture is higher than in ascites. 



