TYPHOID FEVER 111 



one of the widespread diseases, which has been char- 

 acterized by appalling epidemics. As the disease is 

 contracted by taking the germs into the mouth, and 

 as the organisms originate only in the feces and 

 urine of typhoid-fever patients,these epidemics are a 

 sad comment upon our private and public cleanliness. 



The fever prevails mostly in August, September, 

 and October, favored no doubt by the beginning of 

 decay in vegetation ; it is more common in men than 

 women, probably because more men drink water 

 from varied sources than women ; it occurs more 

 frequently between the ages of sixteen and thirty- 

 five than at any other time. 



Symptoms of Typhoid Fever. - - The symptoms of 

 typhoid fever are widely different in different indi- 

 viduals, in fact so varied that diagnosis is often a 

 matter of great difficulty. 



The premonitory symptoms are commonly head- 

 ache, malaise, loss of appetite, nosebleed, and the 

 gradual increase of temperature. About the tenth 

 day characteristic rose-spots appear upon the 

 abdomen. The onset is usually gradual, but in some 

 instances is as sudden and violent as a typical pneu- 

 monia. 



During and after the second week, suppurations 

 may occur in various parts of the body, which may 



