Southern Medical and Surgical Journal - Georgia Regents University

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40 Acute Peritonitis in Infants. [January,Such are the most striking symptoms which we have observed.They differ in some respects, particularly in regardto the appearance of vomited matters and of the countenance,from those described by Billard, almost the only physician whohas carefully studied peritonitis in children at the breast, orgiven a description of it at all complete. This is astonishing,for since this author wrote, infantile pathology has been veryextensively explored, and several masterly treatises have beendevoted to it. In these, however, this redoubtable affectionreceives only a passing notice. Some persons may complainof our omission of the sigttS of peritonitis furnished by the generalsymptoms and particularly by the pulse. We have notmentioned them because they are identical with those observedin other febrile affections.Case I. Acute Peritonitis ; death.—A male child, forty-twodays old, entered the hospital on the 25th of May. 1850. The"lower limbs were covered by a papulous syphilitic eruption; asero-purulent, sometimes sanguinolent, discharge oozed from itsnostrils. In consequence of the obstruction of the nose, respirationwas laborious and lactation difficult.The child was placed upon mercurial preparations, and confidedto a healthy nurse, and soon became fat and hearty. Towardsthe end of June the eruptions had disappeared, but theozaena was not cured. The nurse baVing conceived aaffection for the child consented to take the hi-chloride of mercuryin order to cure it. The results of this treatment weresoon manifested; the child improved most rapidly.On November 8th, the child became obstinate all at once,uttered cries, refused to take the breast ; the face was flushed,the eyes fixed; vomiting of bilious matter occurred. The abdomenbecame enormously distended ;it was hot ; it could notbe touched without causing the child to cry and to shed tears.Constipation ; hurried thoracic respiration ; high fever. (Twoleeches near the umbilicus, emollient cataplasms ; laxative enema; diet)The child cried all night, lying motionless in its crib.On the 9th, more vomiting ; one consistent dejection. Theabdomen was very tense and painful.(Protracted warm bath;four leeches to abdomen ; emollients.)The child died in the conrse of the day.Autopsy twenty-four hours after death. Noemaciation. Theperitoneal cavity was filled with a flocculent sero-purulentliquid : there were various intestinal adhesions. The peritoneumwas highly injected; there was little or no redness of theintestines, the mucous membrane was healthy ; the liver was
;1854.] Acute Peritonitis in Infants. 41covered by a purulent layer ; the intestines were greatly distendedby gas. Xo other organs presented the slightest alteration,except the nasal bones, which were thickened fromperiostitis.redness.The umbilical cicatrix was complete, and withoutCase II. Acute Peritonitis : death.—A new-born child wasbrought to the hospital, Xov. 17th, 1852. It was a female, verysmall and feeble. The eyes were invaded by a grave purulentophthalmia. It was put under treatment for this affection, andfor a stomatitis (muguet) which supervened shortly after, and,at the commencement of January, all of its functions were wellperformed, it had gained flesh, and would have left the hospitalbut for the inclemency of the season.On the 14th of January, the child became cross, and criedwhen it was moved, and showed no inclination to nurse. Theleft lower extremity was oedematous, and was covered byerysipelatous patches. (Hygienic precautions.)Jan. 16th. The erysipelas disappeared from the left limb, butinvaded the opposite limb.Jan. 18th. The inflammation abandoned the inferior extremities,and attacked the left side of the trunk and thelower part of the arm. In the evening there was bilious vomiting.Jan. 19th. The abdomen became enormously distended ; thechild no longer vomited ;the belly was hot, and excessivelypainful. The slightest touch made the little patient cry. Therewas dullness at the inferior portion of the abdomen, but fluctuationcould not be perceived ; the face was flushed, the eyesfixed, the inferior extremities motionless, the respiration incomplete,thoracic ; one consistent dejection ; fever. The erysipelaswas still manifest on the arm. (Four leeches to the abdomenemollients ; laxatives ; diet.)The child died in the afternoon.Autopsy.—Liver enormous, fatty, yellow. Sero-purulentliquid in peritoneal cavity ;recent false membranes and adhesionsof the intestines ; a slight amount of purulent serosity inthe left pleural cavity. The lungs, spleen, and intestines presentedno pathological alteration. The cellular tissue of theleft leg and arm was infiltrated by serum. There was nothingabnormal in the articulations.In this case the peritonitis was discovered during life. Thecase which preceded it had taught us a useful lesson.We shall say nothing of the treatment of this disease,except that it is our intention, having derived so little bene-
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Page 4 and 5: we—' 'Wilson,on Female Medical Ed
Page 7 and 8: —1854.] -on, on Female Medical Ed
Page 9 and 10: —V^ ilson. on Female Medical Educ
Page 11 and 12: ——1854.] Wilson, on Female Medi
Page 13 and 14: ——1854.] Wilson, on Female Medi
Page 15 and 16: 1854.] Booth's Case of Delirium Tre
Page 17 and 18: —1854.] Carithers' Case of Mammar
Page 19 and 20: —1854.] RicorcTs Letters upon Syp
Page 21 and 22: 1854.] RicorcTs Letters upon Syphil
Page 23 and 24: 1854.] Chloroform. 25I allude to it
Page 25 and 26: ;1854.1 Chloroform. 27siderable thi
Page 27 and 28: —;1854.] Yellow Jessamine. 29ness
Page 29 and 30: ——1854.] Incipient Pulmonary PJ
Page 31 and 32: —1854.] Quinine in Acute Rheumati
Page 33 and 34: IS54.] Intermitting Diabetes,
Page 35 and 36: ——1854.] Case of Suffocation. 3
Page 37: ;1854.] Acute Peritonitis in Infant
Page 41 and 42: —1854.] Acute Peritonitis in Infa
Page 43 and 44: 1S54] Cancerous Growths. 45the prep
Page 45 and 46: —1854.] Modus Operandi of Fecunda
Page 47 and 48: 1854.] Modus Operandi of Fecundatio
Page 49 and 50: 1854.] Modus Operandi of Fecundatio
Page 51 and 52: ——1854.] Impalement upon a Pitc
Page 53 and 54: 1S54.] Extensive Laceration and Con
Page 55 and 56: 1854.] Diabetes Mellitus. 57conditi
Page 57 and 58: ;1S54.] Diabetes Mellitus. 59in the
Page 59 and 60: 1S54.] Editorial 61of theEDITORIAL
Page 61 and 62: 1854.] Editorial. G3muscles will gr
Page 63 and 64: 1854.] Miscellany. 65Ether and Chlo
Page 65 and 66: !1S54.] Miscellany. 67great fact th

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