Diseases of the intestines and peritoneum / by Hermann Nothnagel ; edited, with additions by Humphrey D. Rolleston ; authorized translation from the German, under the editorial supervision of Alfred Stengel.

  • Nothnagel, Hermann, 1841-1905.
Date:
1904
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of the intestines and peritoneum / by Hermann Nothnagel ; edited, with additions by Humphrey D. Rolleston ; authorized translation from the German, under the editorial supervision of Alfred Stengel. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

    988/1106 (page 940)
    Local applications to the abdomen are recommended by many writers. Wliile it is difficult to prove to what extent they can do good, it cannot be denied that they are occasionally useful. The chief appli- cations used are Priessnitz compresses and poultices. Compresses that slightly irritate the skin (salt water or one of the artificial or natural mud-baths) are useful. With the same object the application of sapo kalinus viridis may be recommended. I am not, however, in favor of the use of gray ointment, for its so-called absorptive action is too uncer- tain and its effect on diuresis (H. Yierordt) too slight to justify its use, while the fact that it may have bad effects must be borne in mind. When it is necessary to irritate the skin, tincture of iodin (with tinc- tura gallarum aa) is better than blistering, which is not necessary. Diuretics, diaphoretics, and cathartics are useless. Ascites should be tapped when it becomes so marked that it does harm mechanically. CHRONIC INDURATIVE AND ADHESIVE PERITONITIS. One form of chronic peritonitis deserves separate description because it is of the greatest clinical importance—viz., that in which the anatomic changes are essentially or exclusively indurations and adhesions of inflammatory origin. It is important to emphasize the fact that the tuberculous or carcinomatous forms of adhesive peritonitis are not in- cluded in this description. This form of chronic peritonitis may be diffuse and involve a large part of the abdomen, or it may be localized and limited to circumscribed areas. The diffuse form, unless due to tuberculosis or carcinoma, is rare. The partial form is common and of great clinical interest. Virchow, who specially investigated, and after Eokitansky was the first to call attention to the disease, says : I consider this partial form of chronic peritonitis one of the most important morbid conditions, and cannot recommend it sufficiently to the attention of medical men. Since VirchoVs exhortation much attention has, in fact, been given to the disease, and its importance, particularly as bearing on displacements and interference with the permeability of the intestinal tract, has been recognized by all clinicians; and Treves, and more recently Riedel, have made many valuable contributions to our knowledge of the sub- ject. In the last decade medical men have recognized that this form of peritonitis may be the cause of a great number of internal distur- bances, and this knowledge is largely due to the surgeons, who, from the increased frequency of laparotomy in recent times, have gained an insight into the conditions existing during life. ETIOLOGY. Partial Indurative and Adhesive Peritonitis.—AU the three factors concerned in the causation of peritonitis in general may be active in this form—viz., bacterial, chemic, and mechanical irritants. By careful study of the general pathogenesis of peritonitis it is possible to determine approximately which of these three factors is at work in