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April 11, 1903

REPORT OF A CASE OF TYPHOID PERFORATION WITH GENERAL PERITONEAL INFECTIONAND FIVE OTHER CONSECUTIVE CASES OF GENERAL SUPPURATIVE PERITONITIS; ALL RECOVERED.

JAMA. 1903;XL(15):977-981. doi:10.1001/jama.1903.92490150029002i

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Abstract

It is the prevalent opinion of the profession that practically all cases of general suppurative peritonitis should terminate fatally. That this is not true, however, is forcibly illustrated in the cases here reported. The questions arise, therefore: 1. What are the conditions which produce the fatal result? 2. Can these be overcome by medical or surgical treatment, and if so, when and how?

General suppurative peritonitis is not necessarily a fatal disease. The result of a general peritoneal infection depends on the following:

(a) The type of infection.  If it be a virulent streptococcus type, with little pus formation, the peritoneum is rapidly denuded of the epithelial covering and becomes a "blistered surface" through which absorption rapidly takes place. Death in these cases is caused by the large quantity of the products of infection rapidly absorbed. If the poison be diluted or the pressure under which the infective

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