﻿374 The Philippme Journal of Science wu 



arch; in 11 cases it was enlarged to percussion; in 4 cases it 

 was not enlarged at all; and in 14 cases it was not mentioned. 

 Only one case showed an enlargement of 10 centimeters below 

 the costal arch. The diagnostic significance of enlargement of 

 the spleen is greatly reduced in the tropics, on account of the 

 many diseases giving rise to an enlargement of this organ. 

 However, when viewed in connection with the other symptoms, 

 it has some value in this respect. 



The respiratory system. — The lungs showed the usual com- 

 plications encountered in this disease. Bronchitis was found in 

 55 cases. Pneumonic consolidation was noted in 13 cases and 

 tuberculosis in 6 cases. In two of the tubercular patients a 

 latent infection was probably excited by the typhoid, because 

 the patients showed no active lesions of tuberculosis at the time 

 of entrance. 



The digestive system. — The typhoid tongue was fairly con- 

 stant, being present in 108, or 78.83 per cent. Tympanitis has 

 not been so marked as to cause alarm; in only one was it a 

 very severe symptom. The bowels were more often constipated 

 than loose. There were 9 cases that showed diarrhoea through- 

 out the disease, making 6.56 per cent of the cases, and 21 

 cases, or 15.36 per cent, had transient diarrhoea. The rest 

 were constipated throughout the course of the illness. 



Intestinal haemorrhage. — This complication occurred in 21 

 eases, or 15.23 per cent of the series. In one patient with haem- 

 orrhage, diarrhoea persisted throughout the course of the 

 disease, while two other cases showed transient diarrhoea, thus 

 making a total of 3 cases which showed diarrhoea, or 13.33 per 

 cent of patients with haemorrhage associated with diarrhoea in 

 the same person. In 8 cases with haemorrhage, or 38.14 per 

 cent, special attention was called to the severity of the disease. 

 Out of the 21 cases with haemorrhage, 11 lived and 10 termi- 

 nated fatally. 



Intestinal perforation. — Probably next in frequency to haemor- 

 rhage is perforation. In this series there were 10 patients 

 who had perforation, or 7.29 per cent of the total cases. This 

 figure probably is higher than the normal percentage of per- 

 forations in the Philippines, because frequently only the most 

 severe cases, or those with complications, are sent to the hospital. 

 Three cases in this series had general peritonitis when they 

 were admitted. 



Malarial incidence. — Intermittent malarial infection was found 

 four times in this series. In one, the fever was ushered in 

 with chills and the malaria was not discovered until its re- 



