in the
lighter cases lasts for the second week, or in more severe cases, even
until the third. The fever is constantly high, even 104 deg. and over. The
body is generally benumbed, the patient becomes delirious at night or
lies absolutely indifferent to all surroundings. The abdomen is now
inflated, the buttocks show small, light red spots,--the so-called
"roseola,"--which are characteristic of abdominal typhus. Furthermore,
in most cases, bronchial catarrh of a more or less severe nature
appears. Instead of obstruction of the bowels there is diarrhoea--about
two to six light yellow thin stools, occur within 24 hours. During this
second stage the complications appear.

At the end of the second or the third week respectively, the fever
slackens; in cases which take a favourable turn, the patient becomes
less benumbed and less indifferent, his sleep is quieter; appetite
gradually returns. The bronchial catarrh grows better, the stool once
more becomes normal; in short, the patient enters the stage of
convalescence.

This is a short sketch of the course the illness usually takes.

Of the deviations and complaints accompanying Abdominal Typhus, the
following are the most important details:--

The fever takes its course in strict accordance with the described
anatomical changes in the intestines. It increases gradually during the
first week, and at the end of that period it reaches its maximum of
about 104 deg.. It stays at that point during the second stage, gradually
sinking during the third stage.

In lighter cases the second stage may be extraordinarily short.

If perforation of the intestines, heavier bleeding or general collapse
should ensue, attention is directed thereto through sudden and
considerable decrease in the temperature of the body. Pneumonia,
inflammation of the inner ear and other accompanying complications also
cause sudden access of fever.

Effect upon the digestive organs: The tongue is generally coated while
the fever lasts; the lips are dry and chapped, and look brown from
bleeding. If the patient is not carefully attended to during the extreme
numbness, a fungus growth appears which forms a white coating over the
tongue, the cavity of the mouth and the pharynx, and may extend into the
oesophagus. Later on the tongue loses this coating and becomes red as
before. Few symptoms are shown by the stomach, except occasional
vomiting and lack of appetite. During convalescence there is great
desire f