TYPHOID FEVER. 181 



of these cases typhoid fever would be ahsent. With 

 typhoid fever there is bloating and soreness along the 

 digestive tract, yet everyone understands that bloating 

 and soreness can and usually do occur without typhoid. 

 Can constipation exist during typhoid? Some physi- 

 cians say it can,, some say it cannot, yet neither verdict 

 is of importance, since either constipation or diarrhea 

 may and usually does occur without typhoid. Some 

 doctors consider diarrhea marked evidence of typhoid 

 fever when occurring with other symptoms, yet there 

 may be typhoid symptoms with diarrhea, and no ty- 

 phoid. Because first, there may be constipation; this 

 may and usually does produce all the symptoms of ty- 

 phoid fever. The constipation allows fermentation to 

 take place in the digestive tract; this causes irrita- 

 tion which may stimulate increased activity and result 

 in diarrhea; or the morbid effects of constipation may 

 cause paralysis of the nerves supplying the arteries 

 along the digestive tract; this would allow the arteries 

 to dilate and discharge large quantities of water, which 

 would cause diarrhea of a typical typhoid variety, yet 

 there would be no typhoid. The word typhoid means 

 stupor, therefore, strictly speaking, any condition of 

 stupor where fever is present may be called typhoid, 

 and some doctors do apply the term to many low condi- 

 tions where fever is present. Bacteriologists claim that 

 typhoid fever is caused by a certain specific germ, yet 

 all the symptoms and even the ulceration may occur 

 without their germ. Suppose the bacteriologist is 

 called and he pronounces the case typhoid fever, and 

 to make assurance doubly sure, he takes his microscope 



