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Updated: June 22, 2025
It is well to remember that there is nothing in the peritoneal cavity except a little serum.
The diagnosis has to be made from solid or cystic tumours overlying the artery; from a "pulsating aorta"; and from spinal caries; much help is obtained by the use of the X-rays. The condition usually proves fatal, either by the aneurysm bursting into the peritoneal cavity, or by slow leakage into the retro-peritoneal tissue.
Blows on the abdomen are prone to cause death from cardiac inhibition. 12. =Of the Liver.= May divide the large vessels. Venous blood flows profusely from a punctured wound of the liver. Wounds of the gall-bladder cause effusion of bile and peritoneal inflammation. Laceration of the liver may result from external violence without leaving any outward sign of the injury; it is commonly fatal.
The arteries, as was anticipated, were found to have undergone calcareous degeneration. There was an hepatic connection through the band, and also some interlacing diaphragmatic fibers therein. There was slight vascular intercommunication of the livers and independence of the two peritoneal cavities and the intestines.
There is a record of a woman of twenty-eight who was suddenly surprised by some one entering her chamber at the moment she was introducing a cedar pencil into her vagina. With the purpose of covering up her act and dissembling the woman sat down, and the shank of the wood was pushed through the posterior wall of the vagina into the peritoneal cavity.
"There could be no doubt that the perityph abscess had ruptured into the intestine, and that in consequence of this the diffuse peritonitis had at once been relieved." The peritoneal cavity, or the peritoneum as an organ, was not involved in this disease; hence it is an error to say that there was diffuse peritonitis which was at once relieved by the rupturing of the abscess into the intestine.
The layman will say that the bowels are in this cavity, but they are not; they project into the cavity, and their outside covering is the lining membrane of the peritoneal cavity, but they are truly on the outside of the cavity, and to enable the layman to understand the anatomy so that he can apply it when reading of the disease, I shall describe the course of an ulcer: If an ulcer starts in the bowel it first eats through the mucous coat which is the lining membrane of the bowel then through the submucous coat, which is the second layer or coat of the bowel, then through the muscular coat, which is the third layer of the bowel; this brings the ulcer to the serous coat or peritoneum.
An artificial vagina was created, but the patient died from extravasation of blood into the peritoneal cavity. Carter, Polaillon, Martin, Curtis, Worthington, Hall, Hicks, Moliere, Patry, Dolbeau, Desormeaux, and Gratigny also record instances of absence of the vagina. There are some cases reported in extramedical literature which might be cited.
"Among these signs pain, either spontaneous or upon touch, a rise in temperature, increased frequency of the pulse and, in general, the signs of severe illness, are to be looked upon as the local and general symptoms of a severe septic inflammation; vomiting, at least in the first stages of peritonitis, was due to decided reflex irritation of the numerous branches of the peritoneal nerves; the fecal discharges at the onset may be explained, but by no means invariably, as due to peristalsis acting reflexively.
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