Pneumococcus peritonitis : paper read in the Section of Pathology, at the Annual Meeting of the British Medical Association, Cheltenham, July-August, 1901 / by J.H. Bryant.

  • Bryant, John Henry.
Date:
[1901]
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Credit: Pneumococcus peritonitis : paper read in the Section of Pathology, at the Annual Meeting of the British Medical Association, Cheltenham, July-August, 1901 / by J.H. Bryant. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    of the diaphragm, as the bases of the lungs were the parts most involved. To sum up, then, it appears that when the peritoneum is infected through the lymphatics it is nearly always secondary to pneumonia or pleurisy, and the part of the peritoneum most involved is that covering the upper part of the liver and spleen. In some of the cases of local pelvic peritonitis also the organisms may be conveyed from the uterine cavity to the peritoneum, by the lymphatics, and not by the Fallopian tubes; in fact I consider that when the infection is carried by means of the lymphatics, the peritonitis is much more likely to be local than general. 5. The Skin. The skin is another possible channel by means of which the pneumococcus can reach the peritoneum; but there have been no cases, as far as I know, published which point to this manner of infection. An umbilical fistula, abscess, or other lesion of this part of the abdominal wall, or old adhesions binding the intestines to the parietal peritoneum lining the anterior abdominal wall, might predispose to such a mode of infection. Taking into consideration the symptoms, the physical signs, and the pathological changes found in my cases and in those reported by others, I am inclined to the view that in primary diffuse pneumococcus peritonitis, the pneumococcus reaches the peritoneum either through the alimentary canal, or uterine organs. I consider that undoubtedly some of the cases are manifestations of a general pneumococcus blood in- fection, and that others start as a peritonitis, and die from a subsequent pneumococcus septicaunia. BlBLIOOEAPHY. Bezan^on and Griffon. Philadelphia Medical Journal, 1898, No. 21. Blackburn. Thise de Paris, 1900. Boulay. Dos affections k pneumocoques indopeudantes de la pneumonie tranche, Thisc de Paris, 1891. Boulay et Courtois-Suffit. SociCtd Medicale des HOpitaux, May 16th, 1890. Brun. J.a Prcssc Medicate, February 27th 1897; ana Amcr. Journal of the Medical Pc.ie.nces, vol. cxiii, 620. Cassaet, Archives Cliniques de Bordeaux, Nos. 3, 4, 5, 1S9G. Cornil. Journal des Connaiss. Med., 1886. Dieulafoy. Clinique de I'Hotel Dieu, vol. 1. Fisher. Jjxncet, November 10th, 1900, p. 1384. Galliard. Soc. Med. des HOp, 1890. Guido Banti. Pneumococco o diplo- coceo capsulato, Bo Sperimentale, February, 1889, p. 143 et seq. llagenbach- Burckhardt. Correspondenz-blatt filr Scliweizer Acrzte, October 1st, 1898, xxviii, Jahrg. Jjincet, November 3rd, 1900, p. 1290. MenCtrier etLegroux. Bulletin dc la Soc. Medicate des Uopilaux, July 13th, 1900, p. 882; and Med. Review, vol. iii, 601. Michaut. Qaz. des II6p., May 30th, 361; and Med. Rev. vol. iv, 337. Netter. These de Mdnetrier, Grippe et Pneumonie, Paris, 1886. Quehaut, vide Michant. Tdmine, Thf.se de Paris, 1898. Weichelsbaum. Wien. klin. Woch., Nos. 29, 30, 31; and Ccutralbl. filr Bakleriol., January, 1894.
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