The clinique médicale; or, reports of medical cases / Condensed and translated, with observations ... from ... medical authors: by D. Spillan.

  • Andral, G. (Gabriel), 1797-1876
Date:
1836
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Licence: Public Domain Mark

Credit: The clinique médicale; or, reports of medical cases / Condensed and translated, with observations ... from ... medical authors: by D. Spillan. Source: Wellcome Collection.

    1034/1050 (page 1002)
    must be distinguished ; some of them occur as mere complications during a paroxysm of fever ; they are the result of a local congestion more intense than ordinary, and produce symptoms more or less serious, which disappear with the paroxysm ; thence result those diseases jjernicious fevers. The disease now under consideration, Torti w^ould have called j)critoneal intermittent fever. Other inflammations also occur in an intermittent form, but isolated and separate, without being preceded or accompanied by shivering, or followed by sweating ; in a w^ord, w'ithout that group of symptoms which constitute a paroxysm of fever. SECTION II. CHRONIC PERITONITIS. It is only by collecting and carefully perusing cases that one can make himself acquainted wflth the infinitely varying forms which chronic inflammation of the peritoneum may assume. There are cases, no doubt, where nearly the same symptoms are observed as those which mark the existence of acute peritonitis ; but at other times these symptoms disappear : thus, there are cases of chronic peritonitis which are painful only at their onset ; there are others w'hich never occasion the slightest pain, resembling in this respect certain cases of pleuritis, already alluded to in a preceding part of this work, which commence, become developed, and terminate in the formation of vast purulent collections, without the patient’s having ever felt any pain. There are other cases of chronic peritonitis in which the abdomen retains its softness ; and if there be at the same time no pain, the inflammation of the peritoneum must be almost necessarily overlooked. In cer- tain cases the onset of the disease has been peritonitis ; but at a subsequent period nothing is found but mere ascites. Owing to the varying disposition of false membranes, the abdominal parietes may present strange anomalies in their form ; the fever may be continued, may exist only at intervals, or may not appear at all ; chronic peritonitis again is found very much modified in its progress and in its symptoms by the different diseases w'hich may complicate it, and which have their seat either in the abdomen, such as different affections of the digestive tube or liver, or outside this cavity, as diseases of the lungs or their appendages. In the peritoneum, affected with chronic inflammation, different accidental pro- ductions are frequently developed, and particularly tubercles ; in this organ, better than in any other, can w'e trace the formation of those bodies, ascend to their etiology, and discover theiff nature. The different forms of chronic peritonitis being determined, it still remains to be ascertained what treatment is most applicable to them, and how this treatment should be modified according to circumstances. CHAPTER I. CASES OF CHRONIC PERITONITIS ACUTE AT THEIR ONSET. Case 9='^. — Very acute abdominal'pain and frequent vomiting during the first ten days ; afterwards, a disappearanee of every sign of acute inflammation of the peritoneum—Collection of pus in the cavity of this membrane—Chronic cntero' colitis. A WOMAN, forty-four years of age, felt, on the 21st of March, an acute pain, * This case of chronic peritonitis, and the following, were acute at their commencement.