"Just as the affection had suddenly developed to its full height at
the onset of the disease, and much more swiftly than, for example,
is the case in phlegmon of the external walls, so with extraordinary
rapidity did the clinical picture assume a new type. In this respect
we must consider the very great area of the peritoneal folds, their
numerous lymphstomata, and their intimate relation to the
circulation, and we are impressed with the fact that fluids and
solubles, as well as formed products, are rapidly absorbed by the
peritoneum.

"Somewhat less rapidly than this, but nevertheless in the course of
a few hours, another change took place, a favorable turn following
the rupture of pus into the intestine. Here we were dealing with a
well known and familiar phenomenon; if this occurs in the peritoneum
the effects are particularly well marked; similarly as in the case
of a phlegmon which rapidly disappears with the discharge of pus
even although the inflammation extend beyond the pus focus, the
symptoms of diffuse peritonitis promptly disappeared after the
rupture. Very likely, as has already been stated, the symptoms of
diffuse peritonitis in the first stages of the disease are to be
referred to a chemical inflammation of the serosa, i. e., one due to
toxins and without the ingress of bacteria; and it must be
remembered that the clinical picture of this chemical peritonitis
cannot be differentiated from that of the severe bacterial form.
With the rupture of the abscess, the entrance of poisons into the
free peritoneal cavity, and their resorption by the extensive
peritoneal surfaces, as well as the vomiting and the intestinal
paralysis, ceased. The taking of nourishment again be came possible.