76 
muscles an<i bones causes the patient to change position often; he reports (pp. 14, 15) 
marked jactitation for cases 56 and 57, and says (p. 28) that restlessness in case 118 
was allayed by darkening the room. 
Gates (1905, p. Ill) reports insomnia as especially well marked in his case Xo. 11, 
persistent in case 14, not troublesome in case 15. 
In 1901 all cases were reported as very restless, especially cases 2, 
6, 7, and 11 . Case 2 was markedly drows}^ on May 4:. 
DIZZINESS. 
McCullouo’h (1902, p. 226) reports dizziness among the initial sym- 
toms. This was not complained of in cases 1 to 11 (1901). 
HEADACHE. 
Idaho . — Cephalalgia is the most common and persistent symptom in the develop- 
ment of this disease; the pain is intense and persists without intermission; it is 
referred to the frontal region or to the occiput, or to the entire head (Bowers, 1896, 
p. 64). Collister (1896, p. 63) states that there is generally a severe headache. 
According to Dubois (1896, p. 64) the patient may be stricken down without warn- 
ing with a severe frontal headache. Severe headache, particularh- in the back part 
of the head, is mentioned by Fairchild (1896, p. 62) as an early symptom. Sweet 
(1896) also mentions headache. Violent headache is recorded by Zipf (1896, p. 65) 
as an initial symptom. On the second day the pain in the head becomes quite 
severe (Maxey, 1899, p. 435). 
Montana . — There is a general aching and soreness of the whole body (Gwinn, 1902). 
According to IVilson and Chowning (1902a, p. 132; 1903a, p. 62; 1904a, p. 37) the 
headache may be severe at the onset. Anderson (1903a, p. 507; 1903c, p. 21) 
reports some pain in the head; he gives (1903c, pp. 24, 27) headache as following the 
tick bites in case 115 and as present in case 118. Gates (1905, pp. 111-113) reports for 
his cases 11 and 16 severe headache; for case 11, frontal headache following the chill. 
Headache was present, to a greater or less degree, in cases 1 to 11 
during 1901. In case 1 it was reported as frontal; in case 5 it began 
at the time of the chill; in case 8 it was very severe; in case 11 it was 
both frontal and occipital. 
PAIN, OTHER THAN HEADACHE. 
Idaho . — During the first week following the incubation period there is pain in the 
back and legs and a muscular soreness over the entire body; it is severe in the 
lumbar region or along the entire spine and in the lower extremities (Bower, 1896, 
pp. 63, 64) . Collister (1896, p. 63) states that there is jiain of a rheumatic character 
in the back and limbs, mostly referred to the joints. Dubois (1896, p. 64) mentions 
intensely severe pains in joints and muscles as an early symptom; this pain “is 
boring, breaking, and stabbing, and appears to penetrate into the very substance of 
the bones.” Fairchild (1896, p. 62) reports shooting pains throughout the body and 
limbs, usually more severe in the bowels and back; it is neuralgic in type and is 
controlled only by morjihine; the pain may appear early, and continues throughout 
the attack. Figgins (1896, p. 64) records pains in the extremities, and muscular 
soreness. According to Springer (1896, p. 62) the patient usually complains of 
severe pains throughout the body, especially in the back and stomach, and in many 
cases in the larger joints; these pains are not continuous, but are of a shooting 
character and cause the patient to cny out on any movement. Sweet (1896, p. 61) 
says that the onset is usually accompanied by severe breakbone pains; the intense 
