Predisposing causes are: youthfulness, female sex, scrophulosis, worm affections, disposition to chronic blennorrhcea of the abdominal organs, especially the stomach. The outbreak of the disease is favoured by wet and cold or damp summer weather, and by confining one's self to a vegetable diet, consisting principally of indigestible, heavy food; these causes are often sufficient to make the fever epidemic.

The course of the disease is always slow; in the most favourable circumstances it lasts a fortnight, sometimes much longer, as the patient is liable to relapses and temporary aggravations. As the disease progresses, the symptoms frequently change; sometimes the increased secretion of mucus spreads over the mucous membrane of the whole abdomen, the respiratory, urinary, and genital organs; or the fever assumes the so-called typhoid character, with muttering delirium, humming in the ears, dull and stupid feeling of the head, hardness of hearing, subsultus tendinum, grasping at flocks. Very often a rash, in the shape of white crystal-coloured vesicles, makes its appearance, accompanied with profuse, fetid, exhausting sweats. Sometimes aphthae form in the mouth with fetid, cadaverous smell from the mouth, and ptyalism; the aphthae may even affect the mucous membrane of the whole abdomen, as may be inferred from the existing tenesmus and the shreds which are discharged from the rectum.

The disease is rarely complicated with other diseases; in young, plethoric individuals, however, the mucous membrane may become inflamed and ulcerated.

Post-mortem examination has shown the following results: the mucous membrane of the chylopoetic canal is covered with thick viscid mucus, the mucous membrane itself is interstitially distended, of a dingy grey colour, reddish, and softened to such an extent that it can be pulled off or even wiped off, like pap; the criptae mucosae are enormously enlarged, distinctly visible; some parts look as if the mucous membrane had been cut off, without redness, swelling, or interstitial distention about the edges.

The prognosis is not unfavourable even when the disease is perfectly developed, or the treatment has been neglected. Slimy diarrhoea, supervention of typhoid or putrid conditions, with rash and aphthae, discharge of decayed worms make the prognosis very doubtful. Recovery is generally characterized by the following appearances: mild sweat (a rash making its appearance which afterwards scales off), straw-coloured urine, with a thick clayish sediment, and calm sleep, but it is almost always slow, and the patient is greatly inclined to have relapses. Death either takes place by the formation of aphthae covering the mucous membrane of the abdominal and respiratory organs and becoming gangrened, or in consequence of the non-appearance or the retrocession of the rash, or by paralysis of the abdominal nerves causing meteorism, involuntary discharges of cadaverous stools, small, weak and trembling pulse, and sopor, or lastly the brain may become paralyzed.

§ 50. It is of great importance in this disease to employ suitable remedies before the fever is fully developed; this will frequently enable us to cure the patient in a very short time, whereas, if the precursory stage be neglected, the disease becomes very obstinate. The principal remedies for the precursory symptoms of mucous fever are: Pulsatilla, Ammonium muriati-cum, Nux vomica, Ipec, Merc, Dulc, Ignat., Staphys., Senega.

Pulsatilla deserves a preference over every other remedy in individuals of a flaccid, lax, venous-lymphatic constitution, who, by eating too much fat and rich food, have brought on a total want of appetite, flat, slimy taste, coated tongue, chilliness, ill humour, and a want of muscular tonicity.

The physiological effects of Ammonium correspond perfectly to the symptoms of the status pituitosus. For centuries past Ammonium has been recommended for those morbid phenomena which it produces in the healthy organism in the most striking manner. White slimy coating of the tongue, constant hawking, occasioned by a quantity of viscid mucus in the throat; a disagreeable, pappy taste in the mouth, with confluence of water, aversion to food, loathing, empty eructations, gulping up of bitter, sour water, malaise and warmth in the stomach, discharge of glassy, tenacious mucus by the rectum, etc., indicate the use of Ammonium.

Nux vomica is suitable when the patient has been irritated by chagrin, and when the following symptoms occur: dry tongue, coated with white mucus, disposition to acidity of stomach, dyspeptic symptoms after every meal, heartburn, distention of the pit of the stomach, constipation, dull and obtuse feeling about the head. Dulcamara is recommended when the fever has heen occasioned by a cold, and when it is characterized by the following group of symptoms : flat, soaplike taste, great thirst, dryness of the tongue, increased secretion of saliva, aversion to any kind of food, dingy white coating of the tongue.

Another distinguished remedy is Mercurius, which corresponds both to the precursory symptoms and to the disease itself, when it has reached a certain degree of development. Mercurius is indicated by the following symptoms: increasing diminution of appetite, tongue coated with white mucus, excessive and painful dryness in the throat when swallowing, putrid taste and smell, loathing and nausea, tearing burning pains in the temples, pressure and tension in the pit of the stomach, in the region of the stomach and liver, regurgitation of an acrid fluid into the mouth, turbid, slimy urine depositing a sediment, irregular evacuations, with frequent tenesmus, pale, livid, yellowish 8 countenance, debility, want of irritability; characteristic symptoms are: thick coating of a dirty mucus on the tongue, flat, pappy taste as of soap, great desire for piquant dishes, dryness of the mouth and throat, sluggish stools or else constipation, or diarrhoeic stools of fetid mucus, great mental and physical prostration.