oea must be resisted by means of diet and clysters (enemas) with
rice-water, if necessary; the enemas must be given _cautiously_. They
are dangerous on account of possible violations and consequently rupture
of the ulcerated intestines. These and other points, however, such as
threatening paralysis etc., are entirely in the hands of the physician.

The contest against all the complications of typhus must be directed by
absolutely skilled and experienced persons only, since in this disease
particularly every mistake of any importance whatsoever, may cost the
life of the patient.

Besides this specific form of typhus which commands general attention,
the others are of merely theoretical interest. One, however, I wish to
mention in passing; namely:

_E. Relapsing Fever (Typhus Recurrens)._

This also begins with chills and shivering, and a general tired feeling,
and is immediately followed by high fever, up to a temperature of 104 deg..
The skin is covered with excretory perspiration. The brain symptoms are
lacking. The illness reaches its climax very quickly; but suddenly the
patient feels much better, after extremely free perspiration. He
continues remarkably well for about a week, when a new attack of the
illness, a relapse, occurs. There are frequently from three to four
relapses of this kind, which severely tax the strength of the patient.

The number and the intensity of these relapses determines the degree of
the illness.

The treatment is regulated in accordance with the principles to be
applied in abdominal typhus. The relapses may be averted or at any rate
reduced to a great degree, by strict observance of the methods herein
prescribed, especially in regard to diet.

_F. Diet in Cases of Typhus._

Typhus abdominalis is a form of disease which requires the most careful
dietetic treatment, since it combines high fever, which lasts for
several weeks, with a severe ulcerous process in the small and large
intestines.

Nutrition is seriously hampered by the long duration of the illness,
usually considerable lack of appetite and the absolute necessity of
nursing the ulcerous intestines in the most studiously careful way.

In cases which develop to the highest degree, it naturally follows that
the patient wastes away to a great extent.

_In the first place, all solid food must be strictly avoided. Too great
stress cannot be laid on this point_, since the patient, especially in
lighter cases, frequently s