part of the bowels are liable to come at any time of the year; but
in hot weather the tendency to fermentation is much greater than at
other times of the year, and bodily resistance is reduced because of
the enervating influence of the heat, of too long working hours, and
of too short nights for sleep, and of the ever-present, omnipotent
and omnivorous appetite which is taking into the stomach and bowels
food beyond the digestive capacity both in quantity and quality; all
these join in intensifying the habitual toxcicity of the bowel
contents to such a state of virulence that those parts of the bowels
already weakened, because of the mechanical injuries before referred
to, take on a local inflammation. Diarrhea may be the consequence
and the bowels may have a thorough cleaning out and the whole
trouble end in a few days. Or the constipation may be of a nature
that evacuations, such as the patient has been having, have been
passing through the center, leaving a coating on the lumen, but
hollowed out in the center. When the inflammation starts causing
increased bowel contractions--peristalsis--there is a breaking down
of the walls of this fecal ring resulting in complete obstruction.
The ineffectual bowel contractions then serve to irritate and
inflame the affected part still more. The local inflammation is at
first superficial but the increasing toxicity of the fluids that are
held on these parts causes the inflammation to take on ulceration.

The inflammation or ulceration may remain superficial, and be
located in the lower portion of the small intestine, then the
disease is enteritis. If the bowels are cleared out and the
patient's blood freed from intoxication, the attack ends; if not the
disease will be called enteritis or catarrh. If the infection is a
little greater and extends a little deeper causes inflammation of
Peyer's glands then the type of the disease will be typhoid fever.