or so are most likely to
die of the disease.

The average duration of the disease is about one month. During the
first week the onset is gradual, the temperature mounting a little
higher each day--as 99.5 deg. F. the first evening, 101 deg. the second, 102 deg.
the fourth, 104 deg. the fifth, 105 deg. the sixth, and 105.5 deg. the seventh. In
the morning of each day the temperature is usually about a degree or
more lower than that of the previous night. From the end of the first
week to the beginning of the third the temperature remains at its
highest point, being about the same each evening and falling one or
two degrees in the morning. During the third week the temperature
gradually falls, the highest point each evening being a degree or so
lower than the previous day, while in the fourth week the temperature
may be below normal in the morning and a degree or so above normal at
night. So much for this symptom. After the entrance of typhoid germs
into the bowels and before the recognized onset of the disease, there
may be lassitude and disinclination for exertion. The disease begins
with headache, backache, loss of appetite, sometimes a chill in adults
or a convulsion in children, soreness in the muscles, pains in the
belly, nosebleed, occasional vomiting, diarrhea, coated tongue, often
some cough, flushed face, pulse 100, gradually increasing as
described.

These symptoms are, to a considerable extent, characteristic of the
beginning of many acute diseases, but the gradual onset with constant
fever, nosebleed, and looseness of the bowels are the most suggestive
features. Then, if at the end of the first week or ten days pink-red
spots, about as large as a pin head, appear on the chest and belly to
the number of two or three to a dozen, of very numerously, and
disappear on pressure (only to return immediately), the existence of
typhoid fever is pretty certain. Headache is now intense. These rose
spots--as they are called--often appear in crops during the second and
third weeks, lasting for a few days, then departing.

During the second week there is often delirium and wandering at night;
the headache goes, but the patient is stupid and has a dusky, flushed
face. The tongue becomes brownish in color, and its coat is cracked,
and the teeth are covered with a brownish matter. The skin is
generally red and the belly distended and tender. Diarrhea is often
present with three to ten discharges daily of a light-yellow, pea