APPENDIX. 
A REPORT OF TWO CASES OF “SPOTTED FEVER.” 
By Dr. G. A. Gates, 
Bridger, Mont. 
CASE I. 
On May 29, 1898, I was called to see L. M., at Thermopolis, Wyo. 
Patient was a male, white, aged 23 years, sandy or red hair, rather 
spare built; had come from Iowa about three months previous to 
present attack. He became ill while traveling overland from Lander 
to Thermopolis, Wyo. Having camped out several nights during the 
journe}^ on one or two occasions his bedding became thoroughly wet 
from the heavy rains of that season. 
When first seen patient’s face was deeplv" flushed, eyes bright, skin 
hot and dry, with a beginning petechia on the forehead, back of hands, 
wrists, and ankles. Headache, thirst, slightly sore throat, and a sore- 
ness of muscles and aching throughout the bodv^ were complained of 
by the patient. Temperature 104^ F., pulse 120, urine highly col- 
ored, no albumin. Complete loss of appetite ; no other gastro-intestinal 
symptoms. 
Patient was given small doses of aconite and spirit of nitrous ether 
and small doses of alcohol until fever was reduced and bowels moved 
freely. 
This was followed by a prescription containing salol, hj^drate of 
chloral, with soda bicarbonate, caffein citrate, and pepsin, combined 
in a powder and given every four or six hours. Patient was sponged 
with cool or cold water, as needed for high temperature, and placed on 
a diet of milk, gruel, raw eggs, and whisk}\ 
The fever ran an irregular course, with great A^ariation, reaching at 
times a temperature of 101.5° F. and again sinking to 97° F. This low 
temperature was observed during the last of the first Aveek of the 
disease, at which time patient was in a state of collapse, being almost 
pulseless and having a hard chill at the time. 
Slight albuminuria appeared during the second Aveek. 
Delirium was A^ery slight; patient could be aroused at aiiA" time. 
Fever gradually subsided after eighteen days. 
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