Lethal Factors in Bile Peritonitis

The mechanism of death in bile peritonitis has puzzled investigators for a number of years. Although the condition is rare clinically, its theoretical implications warrant a thorough consideration. In the present paper certain findings are reported that indicate that one of the lethal factors in bile peritonitis is a disturbance of fluid balance in the body resembling the so-called condition of surgical shock. RÉSUMÉ OF LITERATURE ON SURGICAL SHOCK Various Theories of Secondary Shock. —During the first three decades of the present century the question of the mechanisms active in the production of surgical or traumatic shock centered chiefly around the theories of nervous¹and of toxic origin. In Cannon's book²on the subject, published in 1923, he concluded: "The theory of secondary shock which has the strongest support both in clinical observations and in laboratory experiments is that of a toxic factor operating to cause an increased