Hot fomentations have long been in use but require persistent application and this is often difficult to secure. Recently cold applications to the abdomen in the form of ice or snow, or in the absence of these of cold water applied on a light rug, kept against the abdominal walls by elastic circingles, have been found of great service. This can be persistently applied, as all that is requisite is to keep the rug constantly wet.
When pus forms in the peritoneum or when extensive effusion has taken place, it should certainly be evacuated, as it is but a centre for the development of the deadly bacteria. It can be drawn off through the already existing traumatic orifice, or, if necessary, a new opening can be made by cannula and trochar, or by direct incision under suitable antiseptic precautions. The opening having been made, and the liquid having escaped, the peritoneum may be profitably washed out with a normal salt solution which has been recently boiled and which is used at near the body temperature (80° to 90°).
Blisters are sometimes of use in the advanced stages of the disease, in stimulating resolution and reabsorption, but hot or cold applications are preferable in the early acute stages.
Laparotomy in cases due to rupture of stomach or bowel, or of extensive perforation, has not been attempted in solipeds, and it could hardly be expected to succeed, yet in such cases, which are otherwise inevitably fatal, any measure giving even a remote hope of success is allowable.
When tympany sets in it may be met by using a fine cannula and trochar, and as soon as the gas has escaped, antiseptics like chloral hydrate, salicylate of soda, salicylic acid, or glycerine, can be injected into the fermenting mass by attaching a caouchouc tube and funnel to the cannula.
CHRONIC PERITONITIS IN SOLIPEDS.
Secondary: after acute, or with disease of liver, spleen, kidney, rheumatism, melanosis, lymphadenoma, epithelioma, carcinoma, or sarcoma. Gastric ulcer, infected punctures. Symptoms: poor health, tender abdomen, irregular bowels, slight colic, tense, fluctuating belly, pallid mucosæ, dropsy of sheath, limbs, etc., slight fever. Treatment: remove primary disease: saline laxatives, diuretics, drainage, antiseptic irrigation (boric acid, etc.), abdominal bandage, tonics, derivatives.
Causes. Chronic peritonitis is always a secondary disease, succeeding the acute, or dependent on some other affection of the abdominal organs, as chronic congestion of the liver, or spleen, Bright’s disease, rheumatism, melanosis, lymphadenoma, epithelioma, carcinoma, or sarcoma. Tuberculosis and actinomycosis, so common in cattle, are rare in solipeds. Chronic ulcers of stomach or bowels and injuries and infections from punctures are exceptional causes.
Symptoms. The manifestations of the disease are indefinite, the acute form may have subsided so that the patient is supposed to have completely recovered, a moderate appetite and a certain capacity for work may be present, yet he is easily fatigued, there is some tenderness of the abdomen to pressure, some irregularity of the bowels—constipation and diarrhœa alternating—and occasional slight colics. Some weeks later may be noticed abdominal tension and tympany, with perhaps fluctuation in the lower parts, increasing pallor of the mucosæ, and œdematous swelling of the sheath, mammæ, abdominal walls or hind limbs. To detect fluctuation it is sometimes necessary to introduce one hand into the rectum. When present hyperthermia is slight, but assists in diagnosis from ascites.
Treatment should be directed to the primary disease. As that is too often irremediable the peritonitis will resist all other treatment.