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The very varied pathology which underlies peritonitis caused by colonic diverticular disease makes the comparison of various methods of treatment very difficult. The best results are probably achieved by removal of the affected part of the colon from the abdomen as soon as possible. Really aggressive medical treatment is an essential accompaniment to any form of surgery. A two-stoma or Hartmann procedure is generally the safest form of resection. Immediate anastomosis has no particular advantage since it should always be accompanied by a proximal diverting colostomy, making a second operation necessary in any case. In desperate cases proximal colostomy may be the only possible procedure and can be life-saving. The advantage of a skin-bridge colostomy is stressed.In cases of haemorrhage the source of bleeding is usually impossible to locate. Conservative treatment is successful in most cases, but if there is no alternative to surgery subtotal colectomy with ileorectal anastomosis is the treatment of choice.

Over a period of 33 months a total of 2,146 peritoneal dialyses were carried out by means of indwelling Tenckhoff catheters in 65 patients suffering from terminal renal failure. The patients were maintained on peritoneal dialysis for periods varying from two weeks to 13 months. Treatment over long periods was possible in only a few cases. Infection and clotting, which tended to limit the functional life of the catheters, was reduced by rigid asepsis and by adding heparin to the dialysate. The Tenckhoff catheter was found to be valuable for peritoneal dialysis as a short-term measure, especially in patients in whom haemodialysis was not immediately feasible, in borderline cases when kidney function was not too seriously impaired, and as an alternative to haemodialysis when that was interrupted by complications.

The occurrence of endotoxaemia in 46 surgical patients has been investigated using a sensitive preparation of limulus lysate. Altogether 23 patients with local and systemic Gram-negative infections were shown to have endotoxaemia. An overt infection is not a prerequisite for a positive limulus test result, since endotoxin can be absorbed via the peritoneal cavity in patients with "chemical" peritonitis. Over 70% of the tests performed during episodes of Gram-negative infection or peritonitis gave positive results. In 23 patients without clinical evidence of infection or peritonitis only 15% of the limulus test results were positive. The implications of these findings and the use of the test in clinical practice are discussed.