46 
that the eruption, in many cases, invades the eyes, making them very sensitive to 
light. According to Figgins (1896, p. 64) the spots first affect the face and hands, 
then the trunk, and, finally, the extremities. Maxey (1899, p. 436) states that the 
eruption first shows itself on the wrists and ankles, next on the forehead and chest, 
and in 24 to 36 hours spreads over the entire surface of the body; even the palms of 
the hands, soles of the feet, and the scalp are spotted. 
Montana. — The spots are first discernible on the back, requiring about 24 hours to 
appear over the remainder of the body. (Gwinn, 1892. ) McCullough says that they 
first appear more frequently upon the back, or simultaneously with ankles or wrists, 
and extend over the entire body. 
According to Wilson and Chowning (1902a, p. 132; 1903a, p. 62; 1904a, p. 38) the 
eruption appears first about the wrist and ankles or back. It then extends over the 
entire body, the abdomen usually being last involved. Sometimes it spreads very rap- 
idly, the entire surface being covered in 12 hours, but more usually one or two days 
pass before it reaches the maximum. The scalp, palms of the hands, and soles of the 
feet are frequently covered with the rash. Occasionally, though perhaps rarely, pur- 
plish spots are found on the mucous membrane of the inside of the cheeks. 
Anderson (1903c, pp. 22, 38, 39) states that the spots appear first on the wrists and 
ankles, then on the arms, legs, forehead, back, chest, and, last and least, on the 
abdomen. They are never abundant on the abdomen, but other portions of the body 
are in some cases literally covered by the eruption. They are most abundant on the 
wrists, ankles, arms, and back (post-mortem). The abundance of the spots apparently 
bears no relation to the severity of the attack. 
Gates (1903, p. 49) records a case where the spots first appeared on the buttocks, 
back, and thighs; the face was only slightly affected; and another case in which the 
spots appeared on the forehead, back of hands, wrists, and ankles. Later he (1905, 
p. Ill) reports for his case 11 that the spots first appeared on the palms of the hands 
and on the feet, and they invaded the scalp in this case. In case 15 the spots appeared 
first on feet and hands. In case 16 they appeared first on feet, ankles, hands, and 
wrists. 
TIME OF APPEARANCE. 
Idaho . — The eruption appears during the fii*st week about the fourth or fifth day of 
the attack (Bowers, 1896, p. 65) and matures during the second week. Accordi g 
to Dubois (1896, p. 64) it appears early, within 48 to 72 hours. Fairchild (1896) 
reports its appearance about the third or fourth day; Figgins (1896, p. 64) from the 
third to the fifth day; Springer (1896, p. 61) from the second to the fifth day; S^yeet 
(1896) says the eruption appears within 1 to 3 days; Maxey (1899, p. 436) says the 
spots appear on the third to the seventh day of the fever. 
Montana . — The spots usually appear about 3 days after the beginning of the sick- 
ness, but a few cases show no eruption until late, or a few hours before death (Gwinn, 
1902). According to McCullough (1902, p. 226) they usually appear upon the third 
to the sixth day. Wilson and Chowning (1902a, p. 132; 1903a, p. 62; 1904a, p. 37-38) 
give more exact statistics on this subject; in their last summary (1904a) they say that 
the eruption usually begins from the second to the fifth day after the chill; in 126 cases 
collated, the eruption appeared on the second day in 11 cases, on the third in 65, on 
the fourth in 22, on the fifth in 7, on the sixth in 3, on the seventh in 2, on the 
eighth in 2 (both doubtful), on the ninth in 2, and on unknown dates in 12 cases. 
Anderson (1903a, p. 507; 1903c, p. 22) says that the spots usually appear on the 
third day. 
Gates (1905, p. 114) report.s the eruption as appearing* on tne second 
or third day in 1 case, third da}^ in 1 case, third or fourth day in 1 
case, fourth day in 5 cases, fifth day in 3 cases, sixth day in 1 case; no 
record in 5 cases. 
