82 
Spots on back bright red, do not disappear on pressure; on arms and 
lower limbs disapjDear reiy slowly and return slowly. 
Red blood corpuscles 4,458,000 
Hemoglobin percent.. 82 
Few intracellular bodies seen in fresh blood in red cells. Paired 
organisms, united by fine threads in two cells, seen for the first time. 
Albumin present; granular and epithelial casts. 
May 10, 1903, 11 a. m., patient seen by Drs. Mills, Wilson, and 
Anderson. Much weaker than yesterday. Had nosebleed durinn 
night. Pulse about 102 and of poor yolume. Spots on back of a 
petechial character and do not disappear on pressure; on hands and 
legs disappear yery slowly. 
Red blood corpuscles 3,858,000 
Hemoglobin per cent. . 77 
Man}" intracellular bodies seen in fresh preparations. A few paired 
ones united by fine thread. 
May 10, 1903, 8 p. m., patient seen by Drs. Mills and Anderson. 
Pulse stronger and fuller than this morning. Had nosebleed for about 
thirty minutes in afternoon and morning. 
May 11, 1903, patient seen by Drs. Mills, Wilson, and Anderson. 
Very much weaker. The coniunctiyee much in]‘ected and jaundiced. 
Pulse about 120; yery poor yolume. Spots on back distinctly petech- 
ial and dark purple; on hands and lower limbs petechial in charac- 
ter; dark spots on hands; skin distinctly yellow. 
Red blood corpuscles 3, 672, 000 
Hemoglobin percent.. 75 
Albumin present in urine; granular and epithelial casts; no red 
cells. Blood taken on the 12th day of the disease did not giye positiye 
widal reaction with typhosus in a dilution of 1:20. 
Patient died May 12 at 5 a. m. At 6 a. m. was remoyed to under- 
taking rooms, surface of body cleaned and sponged with embalm- 
ing fluid (formaldehyde).. Autopsy at 2 p. m. b}" Drs. Anderson and 
Wilson, in presence of Drs. Mills, Pixley, Gwinn, Spottswood, and 
Olson. 
Body that of a well-nourished man. Panniculus adiposis about 
normal. Some edema about ankles, hands, and face. Rigor mortis 
not intense. Small to large petechial hemorrhages coyering body, 
somewhat obscured by tan on face and hands, and by thickened skin 
of hands and feet. Petechial spots oyer chest and abdomen from pin 
point to 5 mm. in diameter. Oyer dependent portions of elbows, 
thig’hs, and back areas are largest, being from 1 to 3 cm. in diameter. 
Oyer inner aspect of arm and forearm petechial spots are yery thick- 
