Effect upon the digestive organs: The tongue is generally coated while the fever lasts; the lips are dry and chapped, and look brown from bleeding. If the patient is not carefully attended to during the extreme numbness, a fungus growth appears which forms a white coating over the tongue, the cavity of the mouth and the pharynx, and may extend into the oesophagus. Later on the tongue loses this coating and becomes red as before. Few symptoms are shown by the stomach, except occasional vomiting and lack of appetite. During convalescence there is great desire for food. The anatomical changes in the intestines have already been mentioned.
While obstruction prevails during the first week, the second week is characterized by diarrhoea of a pale and thin consistency.
When general improvement sets in, the stools gradually decrease in number, they grow more solid and finally reach the normal. The abdomen is not very sensitive to pressure and is usually intensely inflated with gas.
In the region of the right groin a cooing sound is often heard, caused by a liquid substance in the intestines, which can be felt under pressure of the finger.
Bleeding from the intestines is not infrequent and happens during the third week of the illness. It usually indicates a bad complication, since the result may be fatal. The stool assumes a tar-like appearance through the mixture of the coagulated blood with the faeces. Close attention must be given to minor hemorrhages, since they often herald others of a more intense nature.
In such extreme cases of serious complications, however, a cure has nevertheless been sometimes effected. They are occasionally followed by the immediate beginning of convalescence.
The perforation of the intestines, which is caused by an ulcer eating its way through the wall of the intestines, is much more dangerous. It happens most frequently during the third or the fourth week. The patient feels a sudden, most intense pain in the abdomen; he collapses rapidly, the cheeks become hollow, the nose pointed and cool. Vomiting follows, the pulse becomes weak and extremely rapid. The abdomen is enormously inflated and painful. In the severest cases death ensues, at latest, within two or three days, the cause being purulent and ichorous (or pus-laden) peritonitis.