14 
Doctor Anderson investigated the disease on behalf of the Public Health and Marine- 
Hospital Service, and Doctors Wilson and Chowning continued their studies on 
behalf of the Montana State board of health. 
Anderson (1903c) introduced into medical literature the name ‘‘tick fever” for 
this disease, accepting the tick as the “very probable and almost proved” method 
of transmission. He reprinted the Wilson and Chowning map of distribution in 
Montana and added a general map of the States in which the disease is reported. 
He discussed the geographic distribution, climate, season, occupation of patients, 
their age and sex, the parasite, and reprinted the list of cases published by Wilson 
and Chowning, bringing it down to 1903; he discussed method of infection and the 
symptomatology, gave clinical histories of some of the 1903 cases, with clinical charts 
and blood counts, autopsy notes, morbid anatomy, prognosis, diagnosis, and treat- 
ment. He did not mention the spermophile theory advanced by Wilson and Chown- 
ing (1902, 1903), but accepted certain phases of the parasite of man described by 
Wilson and Chowning as “very probably the cause of spotted (tick) fever.” 
Gates (1903) gave clinical reports of two cases. 
In their third paper, Wilson and Chowning (1904a) cover much the same ground 
discussed in their second publication (1903a), adding some new observations and 
omitting the detailed clinical rej^orts. They apparently definitely accept the para- 
site, which they now name Pyroplasma hominis, as the cause of the disease, but they 
still speak of the idea of tick transmission as an “ hypothesis.” 
Since the appearance of this paper, a number of text-books and medical journals 
have referred to their work and have accepted it, at least to some extent. Manson 
(1903, pp. 174-176), however, points out that the experimental proof of the Wilson 
and Chowning hypotheses is lacking, and Nuttall (1904, j:). 221) remarks that in 
“spotted fever” the symptoms differ markedly from those observed in the bovine, 
ovine, equine, and canine [piroplasmatic] maladies, but he admits (p. 252) that the 
1904 paper by Wilson and Chowning is much more convincing than their former 
articles, so far as the parasite is concerned. Manson (1903) and Auttall (1904) cor- 
rect the name of the parasite to Piroplasma hominis. 
In August, Stiles (1904, pp. 1649-1650; 1904, pp. 362-363) published a preliminary 
report upon investigations conducted during the spring of 1904. 
October 31, 1904, Ashburn delivered an address upon “ sj^otted fever ” before the 
Cincinnati Academy of Medicine. This has not yet been published, but it gave rise 
to a rather vigorous editorial by Heidingsfeld (1904, pp. 492-493) who attacked the 
Wilson and Chowning hypotheses. 
Craig (1904, pp. 1016-1017) had no 02q3ortunity to examine slides of “spotted 
fever” blood, but he came to the conclusion that the objects described as Piroplasma 
hominis “ were not due to the presence of a parasite, but to certain changes, especially 
in the hemoglobin of the red cells, produced by the disease.” He claims to have 
observed appearances, coinciding in every particular with the description given by 
M’ilson and Chowning, and Anderson of P. hominis, in a large number of diseases, 
especially in fevers, such as typhoid, malaria, smallpox, measles, grippe, and fre- 
quently in pneumonia'and tuberculosis. 
In the Middleton-Goldsmith lecture (Nov. 30, 1904), before the New York Patho- 
logical Society, Stiles (1905, pp. 9-21) discussed his results more in detail than given 
in his preliminary report. 
Definition. 
Idaho. — Dubois (1896, p. 64) characterizes “spotted fever” as an “acute, febrile, 
eruptive disease, noncontagious but epidemic, found chiefly in March and April.” 
Fairchild (1896) speaks of it as a “ fever of typhoid type, self-limited, and charac- 
terized by a red eruption over whole body.” 
