22 
Case 2. — E. C., patient of Doctor Buckley; fatal case. History of 3 tick bites April 
24, back of the ear; bites caused swelling next day, fever at that time; eruption 
appeared April 27. 
Case 3. — Mrs. K. A. , patient of Doctor Fitzgerald ; fatal case. Mrs. A. positively 
denied any history of tick bite, but thought she had been bitten by a chicken louse 
about April 27. On account of the tick theory she was on her guard for tick bites. 
Every inch of her body, including hair, pubis, and armpits, was carefully examined 
by the nurses, but no sign of ticks or tick bites was discovered. 
Case 4- — Mrs. M. S., patient of Doctor Merrick; recovered case. Mrs. S. noticed a 
tick upon her, but claims that it did not bite her; no sign of tick bite was discovered, 
but there were parts of her body (perineum) which were not examined. 
Case 5. — Miss McM., patient of Doctor Mills; fatal case. So far as could be deter- 
mined, tick bites seem to be excluded in this case. Patient was aware of the tick 
theory and had been sharply on the lookout for these parasites; she had an unusually 
delicate and sensitive skin; about three weeks prior to the attack, she found a free 
tick between her shoulders, but she most positively denied that any ticks had bitten 
her. Every inch of body was carefully examined by two nurses, but no ticks were 
found; nor was anything found which could be interpreted as tick bite. 
Cased. — Mr. F. W., patient of Doctor Pixley; fatal case. History of tick bites 
about May 5; had chill May 13. 
Case 7 . — G. M., patient of Doctor Howard; fatal case. History of tick bites. 
Case 8. — R. K., patient of Doctor Minshall; fatal case. History of tick bites in four 
places May 14 or 15; tick bites cauterized May 18; chill May 16 or 17. 
Case 9 . — Mr. G. C. E., patient of Doctor Gwinn; fatal case. History of many tick 
bites which were cauterized with carbolic acid. 
Case 10. — J. B., patient of Doctor Mills; recovered case. Tick bite was denied in 
this case. An examination of the body showed a slight wound on one ankle, which 
might have been due to a mosquito, a thorn, a tick, or something else. 
Case 11. — Mrs. E., patient of Doctor Mills; fatal case. Tick bites were positively 
denied. Careful examination of the body showed numerous abrasions, said to be 
due to mosquito bites which the patient had scratched, but no positive evidence of 
tick bite was found. This patient and her husband were aware of the tick theory 
and were prepared to treat the bites 
Thus, of the 11 cases which occurred in the Bitter Root Valley 6 
patients gave a positive history of tick bites. In none of these cases 
was the tick determined zoologically, but ail specimens were supposed 
to be Dermacentor andersoni. In one of the cases the tick bite was 
promptly treated with carbolic acid. 
In the 5 remaining cases tick bites were denied by the patients and 
their families. In 2 of these cases, however, it was admitted that 
ticks had been found crawling on the body. In 1 case the entire body 
was not carefully examined, but tick bite was denied. In 1 case 
numerous bites, claimed to be due to mosquitoes, were found. In 1 
case a slight abrasion was found which could not be delinitel}^ explained. 
In 1 case it was claimed that the patient had been bitten by chicken lice. 
In addition to these Bitter Root Valle}^ cases, I am able to refer to 
2 cases reported to me by Doctor Alton: 
Case 12. — Patient noticed 4 tick bites in vicinity of left elbow about May 3; is 
positive regarding the presence of the- ticks and also positive that he was not bitten 
by anything else. 
Case 13. — Tick bite twelve days before illness. 
