39 
TYPES OF CASES. 
Idaho . — The type of the disease which appears in Idaho, as described by Doctor 
Maxey,~is apparently very much milder than that of the severe form appearing in 
Montana, though all cases show the peculiar eruption, (Wilson and Chowning, 
1902a, p. 182; 1903a, p. 44; 1904a, p. 37.) 
Montana . — Gwinn (1902) divides the cases into mild, medium, and most severe. 
Most physicians in the Bitter Root Valley who have had experience with the dis- 
ease recognize but one type — a severe and usually fatal form— the principal diagnos- 
tic feature of which is the “spots.” Several physicians recognize a mild type in 
which there are no “spots.” There is much difficulty in the accurate diagnosis of 
the mild type and, though its existence must be recognized, yet during the investi- 
gations herewith reported all of the examinations except 1 w^ere made on cases of 
the severe type. (Wilson and Chowning, 1902a, p. 132; 1903a, p. 44; 1904a, p. 36.) 
Some of the physicians in the Bitter Root Valley speak of cases of “local infec- 
tion” with “spotted fever.” Wilson and Chowning (1903a, p. 61) report one such 
case, but do not include it in their statistics. I am unable at present to admit these 
cases. (See Stiles, 1905, pp. 14-15). 
Comparison : 
Smith and Kilborne (1893, p. 15) describe for Texas fever two types, an acute 
fatal type and a mild, rather prolonged, usually nonfatal type. 
For canine piroplasmosis, acute and chronic types are described. 
SYMPTOMATOLOGY. 
The symptomatology of the disease under consideration has been 
discussed by Wood (1890), Maxey (1899), McCullough (1902), Gwinn 
(1902), Wilson and Chowning (1902, 1903, 1904), Anderson (1903), and 
Gates (1903). Wood and Maxe}" have described the s^miptoms as the\" 
are observed in Idaho and the other authors as they are observed in 
Montana, As no one has as yet brought all these observations 
together it may be well to do so at this time in connection with the 
symptoms observed in Montana in 1904. 
As stated in the introduction (see above, p. 10), my trip did not 
contemplate a study of s}unptomatolog 3 G but it naturall}^ became nec- 
essary for me to familiarize myself more or less with this phase of the 
subject. 
The symptoms are quite well marked and very constant (Maxey, 1899, p. 435). 
All symptoms and lesions indicate that the disease is due to a specific infection 
(Wilson and Chowning, 1903a, p. 68; 1904a, p. 43). 
Previous Condition op Patient. 
Idaho . — Bowers (1896, p. 63) refers to exposure to cold, drafts, and dampness as 
auxiliary causes. 
Montana . — Gwinn (1902) says that at least 90 per cent of the cases give a history 
of having been exposed to wet or cold, or both, from one-half to three days prior to 
the attack; and although the exposure and constipation are so constant a feature as 
to be apparently operative in the cause, yet little stress can be laid upon them from 
the fact that they do not have such effect at other times of the year or in other 
localities. Wilson and Chowning (1902a, p. 132; 1903a, p. 43; 1904a, p. 35) say that 
