75 
Diirino’ the season of 190J: nervous symptoms were prominent. 
In case 2 hyperesthesia (see ai)ove. p. 51) was extreme, the weight 
of a palpating hand or even of the bed clothing caused extreme pain. 
For case d severe intracranial and supraorbital neuralgia, Ma^^ 12, was 
reported; condition improved under codeine ; in general the nervousness 
of the patient was marked in this case, as also in case 5. In case 6, 
who Aras of a neurotic temperament, the neiwous symptoms were 
prominent, A^ery marked, and constant; twitching of muscles, etc. On 
May 19, when touched anvwhere on the body the patient was thrown 
into a state of tonus. In case 7 nervous disturbance was important 
and marked throughout illness. The patient thrashed around in bed, 
rolling head and throwing the arms around. He could not be made 
to lie on the left side for a minute at a time, but would immediate^ 
throAv himself upon his right side or his back. In case 8 nerAmusness 
increased May 21; dullness increased with slight delirium; May 25 
hyperesthesia Avas Amry marked; thei'e was high nervous tension, the 
muscles of the back and limbs became very rigid; all neiwous symp- 
toms increased MaA" 26, 27, and 28; a drink of water would produce 
spasm of pharynx and diaphragm; reflex excitability was so intense 
for 21 hours before death that a slight touch used in putting a spoon 
to the mouth, or sponging, etc., would cause spasm and rigidity of 
entire body. In case 11 the seAwriHof the nerAmus symptoms pointed 
strongly to cerebrospinal meningitis. In case 13 there Avas picking at 
the bed clothing, muttering, and restless rolling from side to side. 
MALAISE. 
Idaho . — During incubation there is a feeling of lassitude and inaptitude for work 
(Bowers, 1896, p. 63). Many cases are taken suddenly without previous malaise 
(Collister, 1896, p. 63). Lassitude is mentioned by Dubois (1896, p. 64). Fairchild 
(1896, p. 62) says there are usually 2 or 3 days of malaise. Springer (1896, p. 61) 
states that there is a feeling of malaise for a few days preceding the chill, and Maxey 
(1899, p. 435) reports that the patient first notices a general malaise. 
Montana . — In a few cases the disease seems to be preceded by a prodromal period 
of malaise for a few days (Gwinn, 1902). According to McCullough (1902, p. 226) 
the attack may come on insidiously with a feeling of malaise for a few days, gradu- 
ally growing worse and merging into a well-defined “bone ache.” 
Wilson and Chowning (1902a, p. 132; 1903a, p. 61) and Anderson (1903a, p. 507; 
1903c, p. 21) agree that many cases are preceded by a short period of malaise. 
In 1901 case 3 complained of slight malaise on May 10: on May 12 
this case showed stupor. 
RESTLESSNESS AND INSOMNIA. 
Idaho . — Sleeplessness is common during the first week (Bowers, 1896, p. 64). On 
account of the feA^er and the soreness and the pains in the extremities and back the 
patient rolls and tosses in a restless effort to find a comfortable position (Maxey, 
1899, p. 435). . ^ 
Montana . — There is considerable restlessness (IVilson and Chowning, 1902a, p. 132; 
1903a, p. 62; 1904a, p. 37)7 Anderson (1903c, p. 23) says that the soreness of the 
