affection is termed peritonitis, and may be divided into the
_acute_ and _chronic_ forms.

ACUTE PERITONITIS. This form may be circumscribed; that is, confined to
one spot, or it may extend over the entire surface of the peritoneum,
when it is known as _general_.

SYMPTOMS. There is headache, quick pulse, tongue coated white,
countenance pallid, features pinched, respiration difficult, nausea and
vomiting, severe pain in the abdomen, which is extremely sensitive to
pressure and becomes very much distended. There is also pain in the
limbs, the bowels are constipated, and, in exceptional cases, diarrhea
is a prominent symptom. The urine is deficient in quantity, and there is
sleeplessness, chilliness, and great general prostration. Vomiting and
coughing or sneezing increase the pain. An erect position occasions
intense suffering. The patient is compelled to assume a recumbent
posture and is inclined to lie on the back, for in that position the
sufferer experiences the least pressure of the vital organs against the
peritoneum. There is also an inclination to draw up the lower limbs and
retain them in a flexed position.

CAUSES. Prominent among these are injuries which have been inflicted
upon the intestines, compression of the colon, or rectum, perforation of
the stomach or bowels, either by violence or some pre-existing disease,
thus allowing the discharge of blood, urine, bile, or fecal matter into
the abdominal cavity; also abortion, over-exertion, and exposure to wet
or cold. As acute peritonitis is always a grave disease, involving more
or less danger to life, it is the wisest course to employ a physician
and trust the case to his management. The same remark is equally
applicable to the chronic form of the disease.

CHRONIC PERITONITIS. Like the acute, it may be either _circumscribed_ or
_general_. This form is sometimes, though rarely, a sequel of the acute.
When it appears independently of the acute, it is generally associated
with some cutaneous affection pertaining to the abdominal cavity, and
the inflammation is induced by the tumor. If chronic peritonitis be
connected with the _tubercular_ diathesis, tubercles may be discovered
upon the surface of the stomach and alimentary canal, and may also be
found in the lungs and brain.

When the affection is not tubercular there will appear in the abdominal
cavity an effusion of serous fluid of greater or less quantity, mingled
with blood and pus. When such an effusi