on.=--It is impossible for the layman to determine the
existence of typhoid fever in any given patient absolutely, but when
the symptoms follow the general course indicated above, a probability
becomes established. Unusual types are among the most difficult and
puzzling cases which a physician has to diagnose, and he can rarely be
absolutely sure of the nature of any case before the end of the first
week or ten days, when examination of the blood offers an exact
method of determining the presence of typhoid fever. Typhoid
fever--especially where there are chills--is often thought to be
malaria, when occurring in malarial regions, and may be improperly
called "typhoid malaria." There is no such disease. Rarely typhoid
fever and malaria coexist in the same person, and while this was not
uncommon in the soldiers returning from Cuba and Porto Rico, it is an
extremely unusual occurrence in the United States. Examination of the
blood will determine the presence or absence of both of these
diseases.

=Complications and Sequels.=--These are very numerous. Among the
former are diarrhea, delirium, mental and nervous diseases,
bronchitis, pleurisy, pneumonia, ear abscess, perforation of and
hemorrhage from the bowels, inflammation of the gall bladder, disease
of heart, kidney, and bladder, and many rarer conditions, depending
upon the organ which the germ invades. Among sequels are boils,
baldness, bone disease, painful spine, and, less commonly, insanity
and consumption. While convalescence requires weeks and months, the
patient often gains greatly in flesh and feels made over anew, as in
fact he has been to a great extent, through the destruction and repair
of his organs.

=Outlook.=--The death rate varies greatly in different epidemics and
under different conditions. During the Spanish-American War in the
enormous number of cases--over 20,000--the death rate was only about
seven per cent, which represents that in the best hospitals of this
country and in private practice. Osler states that the mortality
ranges from five to twelve per cent in private practice, and from
seven to twenty per cent in hospital practice, because hospital cases
are usually advanced before admission. The chances of recovery are
much greater in patients under fifteen years, and are also more
favorable between the twenty-second and fortieth years.

=Treatment.=--There is perhaps no disease in which the services of a
physician are more desirable or use