. A practical treatise on medical diagnosis for students and physicians . less marked; the respi-rations are not interfered with, the pulse is not so rapid, and symptomsof collapse do not supervene. A rheumatic pharyngitis or inflammationof muscles in some other portion of the body may occur simultaneously. 1002 DISEASES OF THE PERITONEUM. Peritonitis is simulated by a condition to which the name hystericalperifoniths has been applied. It occurs in hysterical subjects, and everyfeature of the true form is imitated. The mode of onset, the decubitus,the difficulty in micturition, and the local d
. A practical treatise on medical diagnosis for students and physicians . less marked; the respi-rations are not interfered with, the pulse is not so rapid, and symptomsof collapse do not supervene. A rheumatic pharyngitis or inflammationof muscles in some other portion of the body may occur simultaneously. 1002 DISEASES OF THE PERITONEUM. Peritonitis is simulated by a condition to which the name hystericalperifoniths has been applied. It occurs in hysterical subjects, and everyfeature of the true form is imitated. The mode of onset, the decubitus,the difficulty in micturition, and the local distention and tenderness ofthe abdomen are characteristic of both. In a few cases that I have seenthe vomiting differed from that of true peritonitis, both in the mode ofejection and in the character of the fluid. It must not be forgotten thatthe temperature may even be elevated, and collapse may take place in thehysterical form. In the cases that I have seen, the abdominal facies didnot develop; on the contrary, the facies of hysteria, with the self-interest Fig. Bimanual palpation to determine if pus is localized in the retrocsecal region. exhibited by the patient, and the precision with Avhich symptoms werenarrated, coupled with emotional or other manifestations of hysteria, sug-gested the true nature of the affection. The case is judged by the historyof other manifestations of hysteria and the presence of permanent stig-mata of the disease; there is always a positive absence of cause and ofdisease in any of the abdominal viscera. Sometimes if the patientsattention is diverted, the tenderness on pressure may not be complainedof. I am not familiar with the results of examination of the urine inthis form of peritonitis; indican should not necessarily be increased, asit is found to be in acute sup])urative peritonitis. Local Circumscribed Peritonitis. The causes of localized peritonitisare those of general peritonitis—extension of inflammation from, or per-foration of n
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