Excerpt from To Clinical Surgery
Of all the inflammations to which the human frame is liable, there is not one of a more formidable character than that of the acute traumatic peritonitis, whether the result of perforation of an intestine from previous disease, or of rupture of one of the hollow viscera from external violence. In such a case the patient generally vomits immediately after the accident; the abdomen becomes rapidly tympanitic, and exquisitely tender to the touch; the patient is seized with a rigor, he lies in the supine position, with the knees drawn up, the thighs being semi-flexed, the pulse, although usually rapid, small, and compressible, is very variable, occasionally it is slow at the commencement, but, generally speaking, it sooner or later becomes small, weak, and faltering, gradually declining in strength; the respiration becomes hurried and thoracic; the extremities cold; the countenance pale and anxious. If at this stage you interrogate the patient as to his suffering, he will point with agony to the abdominal region.
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