Acute generalized peritonitis is so rapidly fatal that dietetic treatment cannot be said to form a part of its management. Vomiting usually prevents the taking of food by the mouth. If food is forced upon a patient, it produces peristalsis and pain and soon renewed vomiting. Small quantities of water or bits of ice may be given frequently when the symptoms are least urgent. One or two spoonfuls of predigested milk may be administered occasionally, so that from six to twelve ounces may be consumed during the day. Albumen-water or very thin gruels of barley or arrow-root may be substituted for predigested milk, but under the circumstances they are not so suitable as the latter. The accumulation of an undigested residue in the bowel should be avoided.

Strength must be maintained mainly by nutritive enemata. Intestinal flatus may be removed partly by purgative enemata of water and by the passage of a long rectal tube. Farinaceous foods are apt to increase meteorism, wherefore their use is not advisable. Turpentine stupes and turpentine in enemata afford some relief of this symptom.

The malady is so uniformly fatal that treatment is of little avail. It must be aimed to palliate suffering and to preserve strength. Stimulants are often given in these cases. Dry champagne will sometimes be retained by an irritable stomach when other substances are vomited. It should be taken in sips. Dilute brandy and whiskey are also used, especially when symptoms of collapse appear.

Localized acute peritonitis from any cause whatsoever, must be treated, so far as diet is concerned, as has already been advised for appendicitis.

Chronic peritonitis requires the use of foods that will leave little residue in the intestines and that are least likely to ferment there. The fermentation of starches and sugars is especially likely to distend the bowel with flatus, thereby causing increased discomfort. The intestines should be kept clean. Enemata may be needed. Sometimes mild purgatives may also be required.

Water should be given freely, both to promote the formation of intestinal secretions and thus to make soft stools, and to promote free elimination by the kidneys.

Simply prepared animal foods are the best. Milk, tender lean meats, finely divided and completely chewed, fish, oysters, and eggs must be the staples. Stale breads may be used sparingly; Zwieback, pulled bread, and toast are the best. The simplest vegetables and purees may be eaten. Cereals, soft-boiled rice, tapioca, and similar foods may be used providing fermentation does not counterindicate them.

Food should be eaten in very moderate amounts at a time, and every precaution should be taken to prevent intestinal indigestion.