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Updated: June 8, 2025
"With a sharply circumscribed perityphlitic abscess there could be no doubt of the diagnosis of diffuse peritonitis nor of the indication for operation on account of the long continuance of the severe symptoms. But neither this proposition nor that of an exploratory laparotomy, the result of which might have induced the patient to yield, was accepted."
Three cases in confirmation of this statement, two of them fatal, have been reported to this Society within a few months. Of about fifty cases of injuries of this kind, of various degrees of severity, which I have collected from different sources, at least twelve were instances of infection from puerperal peritonitis.
The same bullet had apparently penetrated the left side of the abdomen of the elder young lady, midway between the umbilicus and the anterior superior spinous process of the ilium, and had become lost in the abdomen. This daughter suffered an attack of peritonitis, but recovered in two months under the treatment administered.
If the doctor ever had a patient presenting those symptoms and the patient lived after being subjected to the treatment he recommends, it is safe to say that he was dealing with an artificial collapse a drug collapse and he did not have perforation and diffuse peritonitis.
In most cases the joint affection makes its appearance a few days after the commencement of a pneumonia, but in a number of instances, especially among children, the lung is not specially involved, and the condition is an indication of a generalised pneumococcal infection, which may manifest itself by endocarditis, empyema, meningitis, or peritonitis, and frequently has a fatal termination.
Roberton says that in one instance within his knowledge a practitioner passed the catheter for a patient with puerperal fever late in the evening; the same night he attended a lady who had the symptoms of the disease on the second day. On the 16th of March, 1831, a medical practitioner examined the body of a woman who had died a few days after delivery, from puerperal peritonitis.
Slee mentions a case in which, after the death of a man from septic peritonitis following a bullet-wound of the intestines, he found postmortem a knife-blade 5/16 inch in width projecting into the brain to the depth of one inch. The blade was ensheathed in a strong fibrous capsule 1/2 inch thick, and the adjacent brain-structure was apparently normal.
The prognosis depends partly on the extent of the injury and the parts involved, but there is also risk from secondary hæmorrhage, and from such complications as pleurisy, pericarditis, and peritonitis. Death may result from shock, hæmorrhage, injury to brain or important nervous structures.
Under the above heading, we class the following troublesome complaints: Inflammation of the Breast, Milk Fever, Sore Nipples, Puerperal Swelled Leg, and Puerperal Fever, or Peritonitis, all of which complaints are practically unknown, under intelligent hygienic treatment.
Peritonitis in the thoracic cavity is a curious condition which may be brought about by a penetrating wound of the diaphragm. In 1872 Sargent communicated to the Boston Society for Medical Improvement an account of a postmortem examination of a woman of thirty-seven, in whom he had observed major injuries twenty years before.
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