2 
PURGATIVES IN PERITONITIS. 
regarded as a wise provision of nature to avert that increase 
of extent and intensity of peritoneal inflammation which 
would assuredly occur, as a result of the friction between one 
or other of the free surfaces of the inflamed serous membrane, 
were the peristaltic movements of the intestines continued 
at the normal rate. 
On the same principle a joint becomes almost immovable 
if affected with synovial arthritis. If the inflammation 
within the articular cavity be very acute, the motive powers 
of the joint become, to a certain extent, paralysed. Although, 
in health, the movements of the articulation may be quite 
under the regulation of the will, under certain inflammatory 
conditions the joint becomes, during the continuance of such 
conditions, nearly a fixed one. It is an admirable provision 
that such should be the case, as, were the joint to be moved 
as if it were in a healthy state, the movements would but in- 
crease the inflammatory action of the opposed surfaces within 
the articular cavity. Although the principal movements of 
the intestinal canal within the abdominal cavity are caused by 
the involuntary muscular tissue, which, when the animal is in 
health, is in a state of almost continuous activity, it would 
appear that when the peritoneum becomes inflamed, the 
bowels become torpid. Is not this to prevent the inflam- 
mation of that membrane by increased continuance of the 
friction between the free surfaces, as a consequence of con- 
tinuous intestinal peristaltic motion? During a course of 
experiments which I performed some years ago on the in- 
testines and other abdominal viscera of animals, I almost 
invariably found that inflammation of the peritoneum was 
accompanied with a marked diminution of intestinal peristaltic 
actions, and diminished susceptibility to the action of pur- 
gatives ; also that purgatives almost invariably increased the 
inflammatory action of the peritoneum, and, in many in- 
stances, caused its rapid extension and a fatal termination. 
Even when previous to the action of the medicine the 
inflammation had been confined to the serous membrane 
in the immediate vicinity of the abdominal incession, 
I found that opium, by causing torpidity of the bowels, 
and thus diminishing the peristaltic action of the intestines, 
caused not alone a diminution of pain, but also a mitigation 
of the other symptoms. In practice I generally combined a 
preparation of mercury with the opium. In some excep- 
tional cases, where I had reason to believe there were im- 
pactions in the intestines, I tried to remove them by 
clysters and aperient medicine, but, under such circum- 
stances, I always avoided aloes, or medicine in a solid form. 
