ltiply everywhere, but seem for some reason to
focalize chiefly in the alimentary canal, and especially the middle part
of it, the small intestines. After headache, backache, and loss of
appetite comes usually a mild diarrh[oe]a. This diarrh[oe]a is due to an
attack of the bacillus or its toxins upon certain clumps of lymphoid
tissue in the wall of the small intestine, known as the "patches of
Peyer." This produces inflammation, followed by ulceration, which in
severe cases may eat through the wall of a blood-vessel, causing profuse
hemorrhages, or even perforate the bowel wall and set up a fatal
peritonitis. The temperature begins to swing from two to five degrees
above the normal level, following the usual daily vibration, and ranging
from 100 degrees to 101 degrees in the morning up to 102 degrees to 105
degrees in the afternoon. The face becomes flushed.

There is usually comparatively little pain, and the patient lies in a
sort of mild stupor, paying little attention to his surroundings. He is
much enfeebled and seldom cares to lift his head from the pillow. A
slight rash appears upon the surface of the body, but this is so faint
that it would escape attention unless carefully looked for. Little
groups of vesicles, containing clear fluid, appear upon the chest and
abdomen. If one of these faint rose-colored spots be pricked with a
needle and a drop of blood be drawn, typhoid bacilli will often be found
in it, and they will also be present in the clear fluid of the tiny
sweat blisters.

This condition will last for from ten days to four weeks, the patient
gradually becoming weaker and more apathetic, and the temperature
maintaining an afternoon level of 102 to 104 degrees. Then, in the vast
majority of cases, a little decline of the temperature will be noticed.
The patient begins to take a slight interest in his surroundings. He
will perhaps ask for something to drink, or something to eat, instead of
apathetically swallowing what is offered to him. Next day the
temperature is a little lower still, and within a week, perhaps, will
have returned to the normal level. The patient has lost from twenty to
forty pounds, is weak as a kitten, and it may be ten days after the
fever has disappeared before he asks to sit up in bed.

Then follows the period of return to health. The patient becomes a
walking appetite, and, after weeks of liquid diet, will beg like a
spoiled child for cookies or hard apples or pie, or something