h--if not promptly
treated according to the instructions herein detailed--may become
extremely dangerous.

_Organs of Circulations_:--

With the exception of a strongly accelerated action, no change is
noticeable in the heart. It may, however, suddenly become paralyzed and
cease entirely, owing to the general weakness of the patient and the
intensity of the fever. Weakness of the heart and possible cessation
occur only during the climax or convalescence.

_Nervous System_:--

Disturbances of the nervous system are very frequent, hence the name
"nervous fever."

Consciousness is, in nearly all cases, more or less benumbed, and at
times completely lost. The patient is either lying absolutely
indifferent, or he is delirious, cries, rages, attempts to jump out of
bed and can only be subdued by the strongest efforts.

Patients lose control of urinary and faecal movements and require
feeding.

These disturbances disappear as soon as convalescence sets in and
consciousness returns.

As a rule the patient, on return to consciousness, knows nothing of what
he has gone through, and has no reminiscences of the immediate past.

Sometimes cramps in the masticatory muscles have been observed, which
explains the grinding of teeth apparent in some instances. Convulsions
in the limbs and facial muscles sometimes appear, but most of these
disturbances are of short duration.

_Urinary and Sexual Organs_:--

With high fever albumen appears in the urine. In some instances it may
lead to inflammation of the kidneys, the symptoms of which may at times
completely overshadow the symptoms of typhus. Fortunately this
complication is very rare. Catarrh of the bladder occurs, because the
patient retains the urine too long, while in a state of unconsciousness.
Inflammation of the testicles has been observed with male patients, and
pregnant women have miscarried or given birth prematurely.

_Bones and Joints_:--

Inflammation of the joints is infrequent and in a few cases only,
inflammation of the periosteum has been observed.

_Skin_:--

At the beginning of the second week small rose-like spots of a light
rose colour appear on the buttocks (roseola typhosa), which later on
are also found on the upper legs, upper arms and back. They soon
disappear, however, and leave no traces.

Pustular eczema is so rare in cases of typhus, that as a rule its
appearance is taken to indicate that the disease is not a case of
abdominal typhus. F