Die Krankheiten von Säuglingen und Kindern als charakteristisch für die Krankheit. Drynessdevelops, die in der Regel nur in den Fällen strenger sein, bei älteren Kindern. Typhus 395 den Zustand des Darms ist variabel. Verstopfung und diarrheaare etwa gleich häufig, der Ehemaligen vielleicht preponderating. Doch thisdepends auf die Epidemie, und es gab Jahre, in denen die Fälle nearlyall unter meiner Pflege Durchfall hatte, obwohl in der Regel nicht schwerwiegend. Die Stühle der typische pea-Suppe aussehen kann. Involuntaryevacuation erfolgt nur in Ausnahmefällen und in den schwersten Fällen. Der Bauch ist in der Regel nur Mo

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The diseases of infants and children . as characteristic of the disease. Drynessdevelops, as a rule, only in the severer cases in older children. TYPHOID FEVER 395 The condition of the bowels is variable. Constipation and diarrheaare about equally frequent, the former perhaps preponderating. Yet thisdepends upon the epidemic and there have been years in which nearlyall the cases under my care had diarrhea, although generally not severe.The stools may show the typical pea-soup appearance. Involuntaryevacuation occurs only exceptionally and in the severest cases. The abdomen is generally only moderately distended and may beslightly tender in the right iliac fossa, but great distention and decidedtenderness are much less often seen than in adult life. Enlargement of the spleen is always present, although not always de-monstrable. It can be detected in probably 80 to 90 per cent, of allcases in children. Russow^ observed it in 85 per cent, of 1034 cases inchildren. It is discoverable at about the same time as the eruption. As. Fig. 9.J.—Tvihuid Fever with ax L.u.slal Degree of Develui.ie.nt uk the Ehl ptiox.Minnie S., admitted to the Childrens Hospital of Philadelphia Feb. 22, aged 5 years.Illness began 5 days before. Spots on abdomen observed the day before admission. Theday after admission the spots were very numerous, and were seen also on the face. Spleenpalpable. Recovery. long as it persists the typhoid process cannot be considered completed.Lymphatic glandular enlargement is not infrequent but is generally slight.The typhoid roseola is sometimes stated to be less often present or lesswell developed in children. In my own experience this is not the case, andin 671 cases reported by Morse- the eruption was observed in GO percent. Henoch found it absent only 19 times in 381 cases. In averagecases it is discoverable about the end of the 1st week. As in the adult, the spots appear in successive crops, each lasting about 3 days. Excep-tionally the eruption is well m

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