Recovery, Prognosis, etc.--The action of the heart becomes weak and
irregular, respiration is shallow, the temperature taken in the rectum is
high, the skin is cold, pale and livid, death occurs sometimes suddenly,
usually in three to five days; less often thirty-six to forty-eight hours;
or even after ten days. The results depend mainly upon the cause of the
inflammation, and the nature of the infection, infectious disease that
produces it, being usually very bad after puerperal sepsis (after
confinement), induced abortion, perforation of the bowel or stomach, or
rupture of an abscess.

LOCAL PERITONITIS.--This may come from local injury, but it is usually
secondary to empyema, tuberculosis, or cancer, abscess, perforation of the
stomach or bowel, ulcer, etc.

Symptoms.--Onset is usually sudden. There is sudden local pain, increased
by any movements; tenderness, and vomiting; then chills, irregular fever,
sweating, difficult breathing, emaciation.

TREATMENT OF THE ACUTE PERITONITIS.--There must be absolute rest, morphine
by hypodermic method, one-fourth to one-half grain to relieve the pain.
Ice cold and hot fomentations with some herb remedy like hops, smartweed,
etc.; or cloths wrung out of hot water with five to ten drops of
turpentine sprinkled on them. This is very good when there is much
bloating from gas.

The turpentine should be stopped when the skin shows red from it. The
cloths should not be heavy or they will cause pain by their weight. Ice
water can be used when cold cloths are needed.

For vomiting.--Stop all food and drink for the time and give cracked ice.

Diet.--Should be hot or cold milk with lime water or peptonized milk if
necessary. If the feeding causes vomiting, you must give food by the
rectum. For the severe bloating enemas containing turpentine should be
given, one to two to six ounces of water used with ten to thirty drops of
turpentine in it; sometimes it is necessary to resort to surgery.

TUBERCULAR PERITONITIS.--This may occur as a primary trouble or secondary
to tuberculosis of the bowels, lungs, and Fallopian tube. It is most
frequent in males between twenty and forty.

[ DIGESTIVE ORGANS 135]

Symptoms.--These are variable. It may occur like acute peritonitis with
sudden onset of high fever, pain, tenderness, bloating, vomiting and
constipation; these symptoms passing into those of chronic peritonitis.
Often there are gradual loss of strength and flesh, low and irregular