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Updated: June 8, 2025
A good many different forms of severe painful conditions, especially all those complicated by peritonitis, were included under the term, and the modern student of surgery is likely to wonder whether these old observers had not noted that the right iliac region was particularly prone to be the source of fatal conditions.
On 15th and 2Oth two who did well. On 25th I attended another. This was a severe labor, and followed by unequivocal puerperal fever, or peritonitis. She recovered. August 2nd and 3rd, in about twenty-four hours, I attended four persons.
Ovariotomy cannot be successfully performed by an untrained and inexperienced operator. The necessary precautions against the infection of the part must be observed, in order to promote the healing of the wound and prevent peritonitis. The seat of the operation should be carefully cleaned and disinfected. Following the operation the animal should be fed a spare diet for a few days.
The ball entered on the left side of the abdomen, its lower edge grazing the center of Poupart's ligament, and passing backward, inward, and slightly upward, emerged one inch to the left of the spinous process of the sacrum. On July 6th all the symptoms of peritonitis made their appearance. On July 11th there was free discharge of fecal matter from both anterior and posterior wounds.
Couper reports a fatal case of stab-wound of the buttocks, in which the knife passed through the lesser sacrosciatic notch and entered the bladder close to the trigone. The patient was a man of twenty-three, a seaman, and in a quarrel had been stabbed in the buttocks with a long sailor's knife, with resultant symptoms of peritonitis which proved fatal.
With a perfectly normal peritoneum a considerable quantity of a pure culture of colon bacilli may be injected into the abdominal cavity without causing any harmful effect, as has been shown by the experiments of Ziegler, but if there is any disturbance in the circulation or nutrition of the peritoneum, the same quantity taken from the same culture will give rise to a dangerous peritonitis."
At a meeting of the College of Physicians just mentioned Dr. Warrington stated that a few days after assisting at an autopsy of puerperal peritonitis, in which he laded out the contents of the abdominal cavity with his hands, he was called upon to deliver three women in rapid succession. All of these women were attacked with different forms of what is commonly called puerperal fever.
Puerperal peritonitis may produce such a poison, and puerperal women may be very sensible to its influences, conveyed by contact or exhalation. Whether this is so or not, facts alone can determine, and to facts we have had recourse to settle it. The following statement is made by Dr. Meigs in his 142d paragraph, and developed more at length, with rhetorical amplifications, in the 134th.
He had misunderstood her cruelly. The one thing Elizabeth Hunter was trying to do was not to show her affection for this man who was not her husband, but as she became worn and tired from duty at the sick-bed it became more and more evident that she could not accomplish it. Hugh had the daily fear of her peritonitis coming back upon her; Doctor Morgan had warned him while John was away.
Ice to the abdomen, calomel pushed to free purgation, a small fly-blister below the ensiform cartilage, nutritious enemata, with stimulants in the form of whiskey or champagne, and hypodermics of strychnine, give a more hopeful prospect than would operation. When the peritonitis has subsided and the constitutional condition warrants, operation may be performed with a much better prognosis."
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