12 
William A. Glasgow, and Dr. Joseph A. Tremblay (all of Missoula), to Dr. Brice 
and Dr. E. A. Brooke (of Stevensville), to Dr. Thomas H. Hanbidge (of Victor), and 
to Dr. J. W. Howard and Dr. George McGrath (of Hamilton) I am indebted for the 
prhdlege of seeing actual and suspected cases of “spotted fever,” for information, 
advice, and various other courtesies. 
To Sister Superior Gasper, Sister Gabriel, Sister Ignatius, Sister Wilfred, and the 
other sisters of St. Patrick’s Hospital I am indebted for the many courtesies they 
extended to me at the hospital. 
To Doctors Louis B. Wilson and William B. Chowning, of Minneapolis, I am 
indebted for one of their original slides and for various points of information. I 
also had the pleasure of personal association with Doctor Chowning for two weeks 
in Missoula, where we examined a case together. 
To Dr. L. A. Gates, of Bridger, Mont., I am indebted for an interesting account of 
4 cases of “spotted fever” which he treated, and a table of all 17 cases which 
have come to his notice. 
Last, but not least, I am indebted to Dr. Thomas D. Tuttle, secretary Montana 
State board of health, for his cordial cooperation and advice. 
The fact that I did not accomplish more than I have to report lies 
in the difficulties of the subject and the shortness of the season, and 
not in any lack of facilities which it was in the power of the local 
authorities and profession to offer me. 
Histoeical Review of Literature. 
For a proper understanding of the subject of this report it will be 
well to give extensive historical reviews of various phases of the 
matter at hand, more especially as no one has as yet collected all of 
the observations reported. 
The first printed account of this “spotted fever” which I have been able to trace 
is a summary given by Lieut. Col. W. M. Wood (1896, pp. 60-65), Deputy Surgeon- 
General (retired), L". S. Army, at Boise Barracks, Idaho. He himself had seen no 
cases, but he collected statements regarding the disease in Idaho from Drs. L. C. 
Bowers, George Collister, J. K. Dubois, E. M. Fairchild, D. W. Figgins, W. D. 
Springer, C. L. Sweet, and H. Zipf. The discussions are mainly of symptomatology 
and will be considered in detail in that part of the present report. 
Maxey (1899, pp. 433-438) presented before the Oregon State Medical Society an 
excellent paper on the disease as found in Idaho. He discussed its seasonal and topo- 
graphic distribution, symptoms, specific and differential diagnosis, prognosis, and treat- 
ment. He is of the opinion that ‘ ‘ spotted fever ’ ’ of Idaho is ‘ ‘ an independent, specific 
disease, and related in no way to any disease described in our text-books on practice.” 
Commenting editorially upon Maxey’s paper, the Medical Sentinel (1899, pp. 456- 
458), of Portland, Oreg., expressed the view, based solely upon the symptom- 
atology, that “this spotted fever bears a closer resemblance to the papular form of 
erythema exudativum multiforme than to any other known morbid entity.” 
McCullough (1902, July, pp. 225-228) presented a paper on “spotted fever” 
before the Montana State Medical Society at Anaconda, Mont., May 21, 1902. He dis- 
cussed the distribution of the malady, seasonal occurrence, symptoms, complications, 
prognosis, treatment, and its name. 
In the same number of the same medical journal in which McCullough’s paper 
was printed, there appears a summary of results obtained by Wilson and Chown- 
ing (1902c, pp. 238-239), who claim to have found a parasite in the red-blood cor- 
puscles which resembles the parasite of 'malaria. They think that evidence points to 
some kind of a tick as its transmitter. 
