79 
p. 50) reports a patient in a semicomatose condition, from which he could be aroused 
only with much effort (early symptom). Case 6 (1900) was in a very deep stupor 
for 10 days prior to death (Gates, 1905, p. 115). 
In 1901, coma in case 1 followed the delirium and lasted till death; 
coma was also present in case 2 for some hours before death ; case 3 was 
marked by the sudden onset and prolonged duration of coma; in case 
6 coma preceded death a few hours; in case 8 coma was present to 
some extent Ma}^ 26, and almost complete coma was reported May 27. 
CONWCLSIOXS. 
Case 95, a child of 2 years, had convulsions (Wilson and Chowning, 1903a, p. 60). 
In 1901, case 7 shoAved convulsions about 8 hours before death, and 
there Avas almost a state of coiiAutlsion in case 6. 
OPISTHOTOXOS. 
Idaho . — “In one case I found marked opisthotonos during the fourth week of the 
disease, which proA’ed fatal. In this case there were marked cerebral conditions.” 
(Fairchild, 1896.) 
Montana . — Gwinn (1902) in one case observed rigidity of the muscles of the neck 
and back, A^ery much resembling that of cerebrospinal meningitis. Wilson and 
Chowning (1902a, p. 133; 1903a, pp. 50, 57; 1904a, p. 38) and Anderson (1903c, p. 23) 
state that there is no opisthotonos. 
In 1901, cases 2 and 3 presented toward death a tendency to opisthot- 
onos, but the patients had received strychnine. Two unpublished cases 
of 1902 were described to me (not by a physician) as presenting marked 
opisthotonos. In HoAA^ard’s case 7 there AA^as slight opisthotonos 
reported during the convulsions. 
BRAIX AND SPIXAL COED. 
In one autopsy, Gwinn (1902) has been told, there was found a serous fluid in the 
fourth ventricle of the brain. 
There is a slight congestion of the capillaries of the meninges; a few A’essels of the 
cortex contain infected red blood cells; there is some distention of the pericellular 
spaces in the cortex; little or no chromatolysis is shown by Xissl’s stain (Wilson and 
Chowning, 1904a, p. 43). The meninges of the brain and spinal cord showed a 
slight congestion, apparently hypostatic; there was no basilar (or other) meningitis 
(Wilson and Chowning, 1904a, p. 42). The A’essels are somewhat congested in the 
spinal cord, as in the brain, and contain a small number of infected corpuscles; in 
one case the anterior horn cells show considerable chromatolysis with Xissl’s stain; 
no fiber degeneration is shoAvn bA’ Weigert’s stain (Wilson and Chowning, 1904a, 
' p. 43). 
Upon autopsy the brain substance was normal in color and consistency in cases 91 
and 107 ; examination of the central nervous system in cases 89, 93, 94, and 97 was 
not permitted (Wilson and Chowning, 1903a, pp. 48, 52, 53, 55, 56, 58). Anderson 
(1903c, p. 33) makes no mention of the central nervous system of case 120. 
In 1901, case 11, the A^eins on the surface of the brain were distended 
with blood; no pus nor llmiph aa as found at base of skull; A^entricles 
