22 
CIRCULATORY SYSTEM. 
The pulse appears out of all proportion to the temperature, usually 
running- from 110 to 140, a pulse of 120 being not unusual with a tem- 
perature of 102°. It is rather thread}^, though sometimes full and 
strong, occasionally dicrotic in the first week. Red blood counts show 
a progressiye decrease in red cells, but as soon as the temperature 
becomes normal an increase begins. The white blood corpuscles are 
increased in number, A^arying from 8,000 to 12,000. A differential 
count in two cases gaA^e an aA^erage of — 
Polymorphonuclear leucocytes 
Large mononuclear leucocytes 
Small lymphocytes 
Eosinophiles 
Total 
Per cent. 
77. 7 . 
.. 11.4 
.. 10.0 
.9 
ICO.O 
This shows as its most interesting feature an increase in the large 
mononuclears. 
There was a steady, but neA^er Axry rapid, decrease in the percentage 
of hemoglobin, one case going as low as 50 per cent. 
The blood failed at all times to agglutinate hacilliis ty}:)hosus. 
Fresh and stained blood shoAA^ed the three forms of parasites described 
under etiology. 
THE ERUPTION. 
Tlie eruption appears usually on the third day, first on the wrists 
and ankles, then on arms, legs, forehead, back, chest, and, last and 
least, on the abdomen. It is neAxr A^ery abundant on the abdomen, 
but the other portions of the body in some cases are literall}" coA^ered 
b}" the eruption. 
At first the spots are of a bright-red color, macular at all times, 
from a pin point to a split pea in size. At first they disappear readil}" 
on pressure and return quicklAh but if the case is a seA^ere one they 
soon become darker and in some cases are almost purple. From about 
the sixth to the tenth day of the disease they fail to disappear on 
pressure and are distinctly petechial in character. In faA^orable cases, 
about the fourteenth day they begin to lose their petechial character 
and disappear slowl}- on pressure. In some cases the eruption con- 
sists of small, broAAUiish spots, giying a turkey-egg appearance, w^ell 
shown by the photographs on pages 22 and 23. 
As the feA^er declines the eruption begins to fade; but a slight 
return of feA^er or a free perspiration will cause it to show distinctly. 
I am informed that, folloAAfing a AAaarm bath in a case ten months recoA- 
«The average normal red blood count at this eleA^ation (3,500 feet) gives over 
5,500,000. 
