Suppression of urine occurs in some cases; and convulsions with coma, which sometimes occur, are probably caused by the retention in the blood of the excrementitious principles of the urine. The mode of death is generally by exhaustion. The muscular strength in some instances is preserved in a remarkable degree, patients not taking to the bed and sometimes continuing their avocations until shortly before death. These have been called "walking cases"' The duration of the disease in fatal cases ranges from three to nine days, the average being less than a week. -The treatment does not embrace any specially curative remedies. Quinia and mercury have been considered as exerting a controlling influence over the disease, but at the present time no one attributes such a power to these remedies. Complete rest is highly important. Opiates and other anodyne remedies are indicated if there be great restlessness. All per-turbatory and debilitating medication is injurious. Diaphoretic remedies are considered useful. Alcoholic stimulants are to be given, if tolerated, in proportion as the symptoms denote exhaustion. There is reason to believe that lives are sometimes saved by the free use of wine or spirits.

Remedies to palliate vomiting, and to avert haemorrhage if this occurs, enter into the treatment.

II. Continued Fevers. -3. Typhus Fever. Of the fevers distinguished as continued, typhus and typhoid were formerly considered identical; but the researches of Louis and later observers have established their non-identity. They are distinct species of fever, and not merely different varieties of one disease. The name typhus (Gr. stupor) has reference to the stupor which is a marked feature in the majority of the cases of the fever so called. It was applied to the disease in 1759 by Sauvages. In this country the disease has been known as ship fever from the fact that it is imported in emigrant vessels. It prevails especially in Ireland. It has also been called jail fever, camp fever, petechial fever, etc. It is a contagious disease, being communicated by an impalpable emanation from the bodies of those affected with it; that is, by an infectious miasm, the nature of which is not known. The extent of its diffusion, or what is termed the infecting distance, is not great, and it is rarely that the contagion is transported by means of clothing or other substances to which it adheres; that is. by fo-mites. In general, it is necessary that the miasm be concentrated, as when the emanations from a number of patients accumulate in hospital wards, or when the room in which a single patient is treated is small and ill ventilated, for the disease to be communicated, excepting to those who may be brought into close and continued contact with cases. Among nurses and physicians in the fever wards of a hospital, a considerable proportion contract the disease.

A single case in a hospital ward may communicate the disease to patients lying in close proximity. It is probable that the special cause is sometimes generated in the concentrated emanations from the bodies of healthy persons congregated in overcrowded and imperfectly ventilated apartments, as in jails, camps, almshouses, and crowded ships.-In typhus, as in other fevers, the intensity of the febrile condition is denoted especially by the temperature of the body, the range in different cases varying from 102° to 107° F. The temperature in the evening, as a rule, is somewhat higher than that of the morning; and approaching convalescence is often first denoted by a fall of temperature. The frequency of the pulse is also a good criterion of the severity of the disease. In most cases there is marked stupor throughout its course. The patient often lies in apparent somnolency, and when aroused the countenance has a stupid, besotted expression. The face has a dusky hue, from the retardation of the circulation through the capillary vessels. A low muttering delirium is frequent, patients often attempting to get out of bed from some transient delusion, but being easily induced for the moment to refrain from the attempt. Active delirium requiring forcible restraint is rare.

The tongue is often covered with a thick brown or black coating, and, if not prevented by the removal of the accumulations on the teeth and lips, these become covered with a dark or black material called sordes. Tremor of the muscles of the extremities, called subsultus tendinum, occurs in severe cases. The bowels are usually constipated. Swelling and suppuration of the parotid glands occasionally occur. In the great majority of cases there is an eruption on the skin, the character of which serves to distinguish this fever. It appears generally on the third day after the patient takes to the bed. The distinctive characters are as follows: It is maculated, that is, consists of spots, not elevated above the surface of the skin, of a dark or dusky color, and not readily obliterated by pressure with the finger. They continue throughout the disease, and are perceptible after death. Frequently the body and limbs are thickly studded with them, but in some cases they are few in number and limited to the trunk. This fever differs from the malarial fevers (intermittent and remittent) in being a self-limited disease. The length of its course varies between 8 and 20 days, the mean duration being about 14 days.

The mortality varies considerably at different times and places, the range of variation being from i) to 25 per cent.; the average mortality is as 1 to 5 or 6. The death rate differs according to the age of patients; it is least between 10 and 20 years, increases progressively after the age of 30, and the proportion of fatal cases is about one half after 50 years of age. A fatal termination is sometimes attributable to an important complication, as for example pneumonia; and it may be due to an antecedent disease, such as some affection of the kidneys. In general, the mode of dying is by exhaustion or asthenia.-4. Typhoid Fever. Although this has many symptoms in common with typhus, it differs in essential points. The name signifies resemblance to typhus. Owing to the existence of a characteristic affection of the intestines, it is called by German writers abdominal typhus, and by English and American writers, for the same reason, enteric fever. This characteristic intestinal affection is one of the essential points of distinction between typhoid and typhus fever. The affection is seated in the Peyerian and solitary glands of the small intestine.