TYPHOID FEVER IN THE PHILIPPINES. 321 



cent), was absent for 7, and for the remaining 61 there Avas no mention 

 of this symptom. Vomiting at some time during the disease occurred in 

 13 cases, (14 per cent). 



Haemorrhage was noted in 5 instances, 5.6 per cent of the entire 

 group. Also it was tlie cause of death in one of the fatal cases not 

 included in the series of 89. This percentage corresponds closely with 

 that found by Curschmann in Berlin and Osier in Baltimore but is much 

 lower than the experience of Eogers who records haemorrhage in 17 per 

 cent of his Indian series. Perforation was seen only in the fatal cases, 

 occurring three times. 



Symptoms referable to the nervous system. — Headache is recorded in 

 40 cases, or 45 per cent. Delirium was noted for 10 patients, (11 per 

 cent), stupor or coma for 7 (8 per cent), and subsultus tendinum in 

 2 (2 per cent). Under this heading may be mentioned the complications 

 occurring in four cases, two having developed post-febrile psychosis, one a 

 multiple neuritis of the lower extremities and the fourth a condition of 

 cardiac and nervous irritability. 



Miscellaneous signs and symptoms. — Eose spots were noted as present 

 in 26 cases (29 per cent), absent in 6 (7 per cent), and in the remain- 

 ing histories there is no mention. The spleen was enlarged in 18 cases 

 (20 per cent), not enlarged in 11 (12 per cent), and in the remaining 

 cases the records are silent on this point. Cough was present in 10 cases 

 and bronchitis is recorded in three. 



Urine. — Albumen was present in the urine of 13 patients (15 per 

 cent), was absent in 19 (21 per cent). Casts were present in 8 cases (9 

 per cent) and absent in 19 (21 per cent). In the remaining cases there 

 were no records of the urinary examinations. 



Complications and sequelae. — Out of the 89 non-fatal cases the follow- 

 ing complications and sequelse were recorded; malarial fever, twice; 

 catarrhal otitis media, once ; phlebitis of the internal saphenous, once ; 

 bronchial spirochetosis, twice; niultiple neuritis of the lower extremities, 

 oiice; post-typhoid psychosis, twice; cardiac and nervous irritability, once; 

 intestinal haemorrhage, five times. 



Among the fatal cases. Group I. it will be recalled there were 3 cases 

 of perforation and one of haemorrhage. 



TYPHOID FEVEE AMONG FILIPINOS. 



We have perfonned laboratory tests on 105 Filipinos suspected of 

 having typhoid fever and obtained positive serum reactions in sixty. 

 Bacillus typhosus was recovered from the stools of three of these and 

 from the blood of two. Twenty-one of the positive results were obtained 

 from the San Fei-nando epidemic, and no case histoi'ies are available. 

 From the remainder of the 60 we received clinical records for 26 patients 

 of whom 1 died with perforation, 1 ran an entirely atypical course, 12 



