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digestive system: Embaras gaslrique febrile. In young children 
the types are milder. These forms are rarely diagnosed, and the 
patients recover after a few days. The danger is that the cases 
remain unscreened and serve to infect Stegomyia. The types which 
require treatment are numerous, and I believe it will be as well to 
describe an average case, and to call your attention to the pathological 
lesions met with in this disease ; and if you will only bear in mind 
what macroscopic and microscopic changes are occurring in some of 
the organs of the body, you will be able to appreciate better the reason 
for the occurrence of black vomit, anuria, etc., and the multiplication 
of symptoms and complications seen so frequently in this disease. 
You will probably be called some morning to see a patient who 
will give a history that he had been at work the day before and had 
gone to bed feeling well. Some hours later he woke up feeling 
uneasy, with a certain amount of frontal headache and nausea. He 
possibly shivered or had an actual rigor. He began to notice that his 
back and lower limbs ached, and gradually his symptoms increased. 
On your arrival you find your patient tossing about in bed because 
of his pains. He will have vomited once or twice; his headache is 
very severe and increasing; his eyes are bright and shining an 
sensitive to light and, as he lies in bed, you note the general con te este 
appearance of his head and shoulders. The mucous membranes o 
the lips are bright red, the conjunctivae show slight congestion, ve 
tongue is reddened and slightly coated, the papillae appear as brigJi 
red points. 1 he temperature a few hours after the onset w 1 
ioo to ioi° F. (3;-8 to 38-4° C.); the pulse 100 to no, hard and 
bounding; the respirations slightly quickened. Y oui patient y 
have vomited die remains of the last meal or some bile-stained mucus 
and complain of the acidity of the vomited matter. T ie s 
usually moist; the urine is generally scanty and high co oure 
are the usual symptoms in a case of eight to ten hours duratio , 
symptoms which are common to all acute fevers. 
In a few hours, i.e., eighteen hours after the onset, t ie app 
of the case is much worse. 'I he congestion has increase , 
face, ears, neck and upper part of the chest arc tinge a u 
more or less of a boiled lobster shade. The mucous membranes 
congested and tinged. The conjunctival injection has mtrea , 
eyelids through the engorgement of the capillaries arc 
