S YMPTOMA TOLOG Y 



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the spleen is dark-coloured and soft, with enlarged follicles, and on 

 microscopical examination shows congestion and a cellular in- 

 crease. The liver is" enlarged, and its lobules are poorly defined, 

 while microscopically cloudy swelling and fatty infiltration may be 

 seen, as well as leucocytic infiltration into the portal system. The 

 kidneys are enlarged and congested, and microscopically show 

 cloudy swelling and fatty degeneration of the cells, while the 

 stomach shows signs of inflammation, and the heart is soft and 

 flabby. The bronchi are generally congested, and contain frothy 

 mucus, and the lungs show hypostasis. The brain may be con- 

 gested, and all the organs may be stained yellow with bile. 



Symptomatology. — The incubation period is said to vary between 

 two and twelve days, but in accidental inoculations it is about seven 

 days. During this period prodromal symptoms, in the form of 

 slight malaise, may be felt. 



Fig. 648. — Temperature Chart of the Relapsing Fever of Europe. 



The onset is usually sudden, but it may be gradual, the patient 

 suffering from rheumatic-like pains, headache, and constipation. 

 When it begins suddenly, there are rigors, with severe frontal head- 

 ache, pains in the back and limbs, epigastric pain and tenderness, 

 associated with a sense of weakness. The face becomes flushed, the 

 conjunctivae injected, and the temperature rises to 103° to 104° F., 

 with a pulse-rate of no to 120, quickened respirations, and some- 

 times nausea and vomiting. 



The Course. — ^The temperature continues high until the sixth or 

 seventh day, during which period the skin may be yeUowish in colour, 

 hot and damp from perspiration, with at times a rose-coloured 

 macular eruption, disappearing on pressure, on the thorax, abdomen, 

 and legs, which lasts for a day or so. The tongue is moist, red at the 

 tip, and covered with a white fur. Vomiting of greenish-yellow 

 matter may occur, but nausea is always present, and thirst is com- 

 mon; the bowels are usually constipated, and diarrhoea is more a 



