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All forms of peritonitis, the inflammation of the membrane lining the inside of the abdominal cavity (peritoneum), are similar. The degree of inflammation was recorded in a group of patients with different underlying diseases by examination of the affected cells and blood, and by analysis of the capacity of the blood to inhibit such inflammation. Blood testing in these patients began at the time of hospital admission when acute abdominal pain led to emergency laparotomy, a surgical incision into the abdominal cavity. Depending upon the duration of the illness and the severity of the peritonitis, levels of fibrinopeptide A and of C3a, two substances produced during blood clotting, significantly increased within a few hours of admission. Subsequently there was an increase in the level of elastase alpha-1-proteinase inhibitor complex, a substance which inhibits an enzyme necessary for protein digestion. There was a strong correlation between levels of these three substances before surgery and the course of the patient's postoperative recovery. A significant increase in the ability of a toxin produced by the body to inhibit growth of certain cells of the peritoneum was identified in the blood of patients who died. This toxin was present in trace amounts before surgery in four patients with peritonitis.