NURSING IN ACUTE FEVERS. TYPHOID OR ENTERIC FEVER. Typhoid fever is an acute infectious disease, excited by the _typhoid bacillus_. It is most prevalent in the autumn, although it occurs at all seasons. The disease is not directly contagious, and can only be acquired by taking the special bacillus into the alimentary canal. This is usually accomplished through the medium of polluted water, milk contaminated with infected water, raw vegetables (celery, lettuce, water-cress) which have grown in infected soil, or raw shell-fish (oysters) taken from the beds of polluted streams. Occasionally physicians and nurses are infected directly in handling the patient or his clothing which has become soiled with his discharges. The bacilli are contained in nearly all the secretions of the patients, especially in the stools and urine. While the bacilli are widely distributed through tissues, the only characteristic lesions of the disease are in the glands of the intestines (Peyer’s patches), which in the first few days become red and swollen, about the beginning of the second week soft and pale, and in the third week ulcerated. If the patient survive, cicatrization usually begins in the fourth week. Death may result from exhaustion, the result of the systemic poisoning, from perforation of the bowel by an ulcer, from intestinal hemorrhage, the result of erosion of a blood-vessel, or from some complication, like pneumonia. =Symptoms.=—The _initial symptoms_, which may last a week or two before there is any fever, are headache, weakness, loss of appetite, nose-bleed, and perhaps slight diarrhea. The _fever_ rises gradually, reaching its maximum (104°-105° F.) in about a week; it remains stationary for one, two, or three weeks, and then falls, reaching the normal in another week, thus making the febrile period of the disease of four or five weeks’ duration. Throughout its course the evening temperature is apt to be two or three degrees higher than the morning temperature. The abdominal symptoms consist of distention of the abdomen (tympanitis), pain and tenderness in the right iliac region, and often diarrhea. Between the seventh and ninth days a rash usually appears on the abdomen, consisting of small rose-red spots. These come out in crops and disappear on pressure. The _pulse_ becomes rapid and feeble, and the heart sounds become weak and dull. The _respiratory symptoms_ include cough, hurried breathing, and slight expectoration. _Nervous symptoms_ are not always marked. In severe cases there may be delirium, stupor, twitching of the muscles, picking at the bed-clothes, and coma. The _face_ is dull and listless. The _tongue_ is coated and tremulous. In severe cases it becomes dry, brown, and fissured, and sordes tend to collect upon the teeth. Relapses are common. In some cases they are due to the too early use of solid food, to excitement, or to overexertion.