69 
others with little or no chill (Collister, 1896, p. 63). The disease is sometimes ush- 
ered in by a chill (Fairchild, 1896, p. 62). Figgins (1896, p. 64) states that the attack 
begins with a chill. According to Springer ( 1896, p. 61 ), the chill follows the malaise. 
INlaxey (1899, p. 435) states that the patient feels flashes of heat and cold, but no 
marked chill. 
Montana . — The attack comes on by either a well-marked chill or by chilliness, 
simultaneous with fever; the chilliness, although most severe at the onset often con- 
tinues more or less throughout the attack, coming on at intervals, generally mornings, 
and becoming lighter day after day until within a week or so it seems but little more 
than chilliness from light covering (Gwinn, 1902). According to McCullough (1902, 
p. 226), the onset may be marked by a sudden and severe chill or by slight chilly 
sensations, mostly in the morning. Wilson and drowning (1902a, p. 132; 1903a, 
p. 61; 1904a, p. 37) report that the malaise is followed by a well-marked chill, which 
is usually most severe at the beginning and recurs at irregular intervals, though with 
decreasing severity. Anderson (1903a, p. 507 ; 1903c, p. 21) states that for a few days 
the patient may have chilly sensations, and Anally there is a well-marked chill; he 
reports cases as follows: 
Case 97 began with chills and vomiting, and with a rapid rise in temperature (pp. 
16-17). 
Case 115 was bitten by ticks April 1; complained of being chilly on April 7 or 8 
(p. 24). 
Case 116 was bitten by tick April 13; severe chill on April 19 (p. 26), 
Case 117 was bitten by tick April 16; marked chill on April 20 (p. 27). 
Case 118 was bitten by tick; chill April 20 (p. 27). 
Case 120 found tick bites April 28; had chill same day (p. 29). 
Gates (1903, p. 48) reports for one patient a hard chill during the last of the 1st 
week; he (1905, pp. 111-112) also reports chill for cases 11 and 14, in the latter case 
10 days after the bite; later the chill recurred; pronounced chill for case 16. 
During the 190T season, chills occurred in cases 2, 3, 5, 6, 8, and 9. 
CoMPAEisoN. — Chills are reported for carceag. 
FEVER. 
Idaho . — During the flrst week following the incubation, the patient takes to bed 
with a temperature of 102° to 105° F., pulse 90 to 120; in favorable cases and in those 
of moderate severity there is a gradual decline in fever during the second week; the 
temperature varies in different cases; there is a daily rise during the flrst 4 or 5 days; 
the evening temperature is about 1° to 1J° higher than the morning remission; a 
temperature of 102^° to 104° is not uncommon by the fourth or fifth day; having 
reached its acme, the fever persists for several days; at the end of the second and 
during the third week the fever falls by lysis to an evening record of 98.4° (Bowers, 
1896, p. 63). According to Collister (1896, p. 63) the febrile stage gradually follows 
the chill; it continues 2 or 3 weeks; it is not common to find a temperature over 103°, 
except in occasional cases. Fairchild (1896) states that in some cases febrile action 
runs high; it usually ranges from 101° to 104^° or 105°, and is continuous, showing 
but slight remissions. Figgins (1896, p. 64) reports the fever as remittent; the tem- 
perature ranges from 100° to 105°; pulse, 100 to 120. Springer (1896, p. 61, 62) says 
that after the chill the fever sets in, ranging from 103° to 105°; the fever ranges high 
and continues from 10 to 14 days; then it intermits for the following week or two. 
Zipf (1896, p. 65) says that the usually sudden onset is accompanied by high fever; 
the fever is continuous, lasting one to two weeks and is out of proportion to the dan- 
ger of the disease; it also leaves the patient weak for weeks. Maxey (1899, p. 435) 
describes the fever as of the^continuous type, beginning on the first day and rising 
gradual' y until it reaches 102° to 103° on the third or fourth day, when the eruption 
