or food. The anatomical changes in the intestines have already
been mentioned.

While obstruction prevails during the first week, the second week is
characterized by diarrhoea of a pale and thin consistency.

When general improvement sets in, the stools gradually decrease in
number, they grow more solid and finally reach the normal. The abdomen
is not very sensitive to pressure and is usually intensely inflated with
gas.

In the region of the right groin a cooing sound is often heard, caused
by a liquid substance in the intestines, which can be felt under
pressure of the finger.

Bleeding from the intestines is not infrequent and happens during the
third week of the illness. It usually indicates a bad complication,
since the result may be fatal. The stool assumes a tar-like appearance
through the mixture of the coagulated blood with the faeces. Close
attention must be given to minor hemorrhages, since they often herald
others of a more intense nature.

In such extreme cases of serious complications, however, a cure has
nevertheless been sometimes effected. They are occasionally followed by
the immediate beginning of convalescence.

The perforation of the intestines, which is caused by an ulcer eating
its way through the wall of the intestines, is much more dangerous. It
happens most frequently during the third or the fourth week. The patient
feels a sudden, most intense pain in the abdomen; he collapses rapidly,
the cheeks become hollow, the nose pointed and cool. Vomiting follows,
the pulse becomes weak and extremely rapid. The abdomen is enormously
inflated and painful. In the severest cases death ensues, at latest,
within two or three days, the cause being purulent and ichorous (or
pus-laden) peritonitis.

Such extreme developments as these, however, are infrequent, since the
illness, by timely attention according to the methods herein prescribed,
will, as a rule, respond to the treatment and take a favourable turn.

_Respiratory Organs_:--

In the course of typhus, intense bleeding of the nose is not infrequent.
In the severer cases this is a sign of decomposition of the blood, but
in lighter cases it merely serves to alleviate the intense headache
which is a feature of the case. The throat is liable to be affected;
hoarseness and coughing occur; hardly any case of typhus catarrh. This
sometimes extends into the air-passes without a more or less intense
bronchial cells and causes catarrhal pneumonia, whic