This is really inflammation of the membrane (peritoneum) which forms the outer coat of the bowels and lines the abdominal cavity, and it is called in medical language peritonitis. This is a painful and dangerous disease. The symptoms are burning and tearing pains in some part of the abdomen, and great tenderness on pressure and on every motion.
The body is sometimes tense and swollen. In the early stages there is rigidity of the abdominal wall over the part where the inflammation is. There is often vomiting and much constipation. There is fever, sometimes to a high degree, but sometimes the temperature is little above the normal. The face is sunken, anxious-looking, and grey. See also APPENDICITIS.
Diagnosis.-Inflammation of the bowels may be acute or chronic. The chief diseases which may be mistaken for acute inflammation are an attack of colic, the passing of gall stones, pains connected with the womb, and typhoid fever. The history of the case will help to decide. As in most inflammations, there is generally a chill or a wetting to account for the symptoms; colic can mostly be traced to indigestible food, and there is no fever; also the symptoms in colic are generally relieved by pressure, whereas in inflammation there is great sensitiveness to touch or pressure. The passing of gall stones is attended with excessive pain, usually confined to a small area; the symptoms comes suddenly without warning, and are attended with no previous symptoms. Pains connected with the womb generally come on about the monthly periods. It is often difficult at first to distinguish inflammation from typhoid fever, but the progress of the case will soon show. In typhoid there is less pain than in inflammation, more fever, more head symptoms.
The worst forms of peritonitis are those arising from infection of the abdominal cavity following surgical operation, or consequent on the escape of matter from an abscess, or infection by tubercle. In many of these cases opening the abdomen and washing out the cavity gives the patient the best chance of recovery.
Chronic inflammation of the bowls is usually a consequence of an acute attack, and with this history is not likely to be confounded with any other disease.
General Treatment.-The patient must be kept perfectly quiet; no emetics or purgatives must on any account be given. The constipation will right itself when the inflammation is gone. All solid food must be interdicted. Milk, beef-tea, gruel, and farinaceous foods only must be given. Locally, light linseed poultices should be applied, and if the body is distended with gas a few drops of turpentine should be sprinkled on them.
Medicines.-(Every half-hour or every hour until there is a decided relief.)
Aconit. 3.-
Restlessness, anxiety, pain, fear of death.
Arsen. 3 – Thirst restlessness, terrible anxiety burning pains, diarrhoea, bloody stools without relief to pain; pain in region of right groin.
Bryon. 3.-
If the pains persist or increase in spite of Aconite and are worse by every movement; much fever.
Mercurius cor. 3.-
Griping, cutting pains, swelling, much tenderness.
Arsen. 3.-
Thirst, restlessness, terrible anxiety, burning pains, diarrhoea, bloody stools without relief to pain; pain in region of right groin.
