54 
red edges; in the later stages it becomes red, or dry and brown. According to 
Springer (1896) the tongue is always coated, a thin, white fur persisting for a long 
time. Zipf (1896, p. 65) also reports coated tongue. Maxey (1899, p. 435) reports 
the tongue as at first covered with a whitish coating, but about the time the fever 
reaches its maximum the tongue changes to a dry, brownish condition, which con- 
tinues until the general symptoms begin to ameliorate, when the tongue clears in an 
irregular manner, beginning at the base. 
Montana . — According to Gwinn (1902) the tongue at first has a white coat, but it 
soon becomes brown and is accompanied by sordes. IVilson and Chowning (1903a, 
pp. 44, 46, 62; 1904a, p. 37) describe the tongue as dry with heavy white or yellow- 
ish coat in the middle, but red at the tip and along the edges; it may be thickly 
coated even at the onset (1902a, p. 132) ; while the coat is whitish at first, it becomes 
brownish as the fever progresses, and the tongue may become dry and cracked 
(1902a, p. 132). Anderson (1903a, p. 21, 23, 29, 31) agrees that at first the tongue 
has a heavy, whitish coat with red edge and tip; later it becomes dark brown; in 
case 117 it was coated throughout the disease; in case 120 it was furred on April 29, 
and on May 6 it showed a heavy white coat with red tip and margins; in case 121 it 
had a heavy white coat in the center with red tip and edges. Gates (1903, p. 49) 
says in regard to one case when first seen that the tongue was coated white on the 
sides and was rather dry. 
In 1904 the tono'ue was moist in case 1; tremulous and with a heavy 
white moist coat in case 3; it had a heavy white moist coat in cases 5 
and 10; in case 8 there was a heav}" white coat, which became dry and 
brown; in case 7 there was a heavy moist coat which became dry, 
brown, and somewhat glazed; in case 9 the tongue was heavily coated; 
in case 11 it was red and moist, with white streaks; in case 13 the 
tongue was furred. 
Gates (1905, p. Ill) reports that in his case (11) the tongue quivered 
verv much when extruded, and it was loaded with a heavv dirtv- 
brown coat, the sides of the tongue were so livid as to be almost blue; 
his case (14) showed a grayish coat on the tongue; in his case (16) 
the tongue became veiA^ diy early in the disease. 
TEETH. 
Gwinn (1902) and McCullough (1902, p. 227) say that sordes are present. Wilson 
and Chowning (1902a, p. 132; 1903a, p. 62; 1904a, p. 37) state that sordes appear 
early and may be quite pronounced. Anderson (1903c, p. 23) also agrees that the 
teeth may be covered with sordes. 
Neck. 
In case 109 there was no stiffness of the muscles of the neck and back, though 
some pain was present on pressure over the spinal process of the vertebrae, especially 
in the dorsal lumbar region. (Wilson and Chowning, 1903a, jj. 45.) 
In case 115 the postcervical glands were enlarged, particularly on the right side; 
in case 116 the axillary glands were swollen and sore the day after the tick bite; in 
case 120 the mesenteric and retroperitoneal glands were pale, but not enlarged 
(autopsy). — Anderson, 1903c, pp. 24, 25, 33. 
In 1904, case 9 showed no stiffness of the neck, and the head could 
be readilv bent forward; in case 6 there was general rigiditv of the 
y m.' 
