Farinaceous—Oatmeal, hominy, tapioca, sago, arrowroot (well cooked), whole wheat bread, graham bread, dry toast, crackers.
Vegetables—Mashed potato, almost all fresh vegetables (well boiled), plain salad of lettuce, water-cress, dandelions.
Desserts—Plain milk pudding of tapioca, sago, arrowroot or stewed fresh fruit (all without sugar or cream), raw ripe fruits.
Drinks—Weak tea or coffee (without sugar or cream), hot water, pure, plain or aerated water.
Must Not Take—
Strong soups, rich made dishes of any kind, hot bread or biscuits, preserved fish or meats, curries, red meats, eggs, fats, butter, sugar, herrings, eels, salmon, mackerel, sweets, creams, cheese, dried fruits, nuts, pies, pastry, cakes, malt liquors, sweet wines, champagne.
ACUTE GENERAL PERITONITIS. (Inflammation of the Peritoneum, Lining of the Abdominal Cavity).—Causes. Primary; Occurs without any known preceding disease, and is rare. Secondary; Occurs from injuries, extension from inflamed nearby organs, such as appendicitis or infection from bacteria, without any apparent lesion (disease of the bowel). Perforation causes most of the attacks of peritonitis. Peritonitis may accompany acute infections or accompany chronic nephritis, rheumatism, pleurisy, tuberculosis and septicemia. Peritonitis occurs from perforation of the bowel in typhoid fever also, and it frequently occurs after appendicitis and sometimes after confinement.
Symptoms.—This is often the history of one of the causes mentioned above, followed in cases with perforation or septic disease by a chill or chilly feeling and pain, varying at first, with the place where the inflammation begins. The patient lies on his back, with the knees drawn up, and the body bent so as to relax the muscles of the abdomen, which are often rigidly contracted,—stiff at first on the side where the pain starts. The pain may be absent. The abdomen becomes distended, tympanitic (caused by gas). An early symptom is vomiting and it is often repeated. There is constipation; occasionally diarrhea occurs. The temperature may rise rapidly to 104 or 105 and then become lower; it is sometimes normal. The pulse is frequent, small, wiry and beats 100 to 150 per minute; the breathing is frequent and shallow. The tongue becomes red and dry and cracked. Passing the urine frequently causes pain; sometimes there is retention of urine. The face looks pinched, the eyes are sunken, the expression is anxious, and the skin of the face is lead colored or livid. Hiccoughs, muttering, delirium or stupor may be present.
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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.