Tuberculosis of the peritoneum occurs in the various forms of which we gave a general sketch when treating of the tubercular disease of serous membranes, both as an acute and as a chronic affection.

It is very frequently found in the circumscribed form on those parts of the peritoneum which correspond with tubercular ulcers of the mucous membrane; and we here trace all the forms peculiar to peritoneal tuberculosis generally. It commonly does not appear until the secondary tubercular infiltrations have extended from the inner surface of the intestinal tube into the muscular coat, and thus involved the tissue of the peritoneum itself.

The tubercular exudations on the peritoneum likewise give rise to all the adhesions we have above spoken of, generally producing a more intimate agglutination between the viscera. Peritoneal tuberculosis occasionally appears as a primary affection, the peritoneum being the first tissue attacked by tubercular deposit; but it occurs more frequently after the cachexia has been evidenced by tuberculosis of another organ. Thus it allies itself to pulmonary, intestinal, and cerebral tubercle, and it very commonly terminates in tubercular affections of the abdominal lymphatic glands, and in the female sex more particularly in tuberculosis of the uterine and vaginal mucous membrane. The acute forms of peritoneal tuberculosis are, in most cases, complicated with a corresponding affection in the spleen, the liver, the kidneys.

The reflected action upon the adjacent muscular fibre, which occurs in peritoneal inflammation, is presented to us in a much higher degree in the tubercular exudative process. We find that the intestinal coats, in addition to being tumefied, become very friable; there is increased exhalation from the inner surface of the intestine, and liquefaction of its contents, the muscular coat becomes pale, is easily lacerated and broken up, and even the muscles of the abdominal parietes waste and lose color.

Peritoneal tubercle, and especially the granulated variety, rarely passes into the stage of softening; when it does so, it may cause tubercular suppuration or peritoneal phthisis, and consequently phthisis of other adjacent tissues; cretification is a still more unusual occurrence, but the tubercular disease frequently becomes stationary.