Les maladies des nourrissons et enfants . comme caractéristique de la maladie. Drynessdevelops, en règle générale, uniquement dans les cas plus sévère chez les enfants plus âgés. La FIÈVRE TYPHOÏDE 395 l'état de l'intestin est variable. La constipation et l'diarrheaare à peu près aussi fréquentes, peut-être l'ancienne preponderating. Thisdepends encore sur l'épidémie et il y a eu des années où le nearlyall sous mes soins cas avait la diarrhée, bien que généralement pas graves.Les selles peuvent montrer l'aspect typique de la soupe de pois. Involuntaryevacuation se produit qu'exceptionnellement et dans les cas les plus graves. L'abdomen est généralement seulement 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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