87 
GENITAL SYSTEM. 
See Genitalia, page 55. 
Several M^omeii have been taken sick while pregnant. Case 121 M-as two months 
pregnant (Anderson, 1903c, p. 34), but apparently did not abort. 
Wilson and Chowning (1904a, p. 42) report the uterus as aiiparently normal in the 
3 females examined. 
In case 11 (1901:) patient aborted; the uterus, upon autopsy, meas- 
ured 11 by 13 cm., was soft, but normal in appearance for a recently 
delivered uterus; on section it was normal; the vagina showed slight 
blood}^ discharge; the ovaries were normal; right ovary contained 
corpus luteum. 
In case 3 menstruation occurred for one hour on May 11, and then 
stopped; it began again during the night of May 11-15, and flowed 
freely until death. Her former menstruation was on April 11, so 
that the disease appears to have delayed her menses. Case 5 men- 
struated just prior to attack. 
' Relapses. 
Case 53 (Gwinn’s patient, 1899) relapsed after abortive treatment (Wilson and 
Chowning, 1903a, p. 35; Anderson, 1903c, p. 15). According to Gwinn (1902) 
relapse is favored by getting up from bed too soon, or by muscular exertion, or 
exposure to cold. 
We saw no relapses in 1901. 
Comparison. — In carceag there is usually 1 attack; in some cases there is 1 or 2 
days of remission, then a second attack. 
COMPLICATIONS. 
Idaho , — Some cases develop rheumatic trouble, particularly of the larger joints. 
Montana . — Hypostatic pneumonia, rheumatism, gangrene, and hemorrhagic diathe- 
sis seem the most usually to complicate the disease (McCullough, 1902, p. 226); 
pneumonia predominates in frequency as a complication, and such involvement of 
the lungs along with the predominating illness generally terminates the case. 
Hypostatic pneumonia is a frequent complication for a day or so before death; one 
case had to all appearances genuine lobar pneumonia; one case gave well-marked 
symptoms of acute inflammatory rheumatism as complication; one case was compli- 
cated with abscess and gangrene (Gwinn, 1902). 
The symptoms noted are sometimes complicated by gangrene, hypostatic pneu- 
monia, articular rheumatism, etc. ; hypostatic pneumonia sometimes develops; lobar 
pneumonia occasionally occurs as a complication, and usually hastens the end ( Wilson 
and Chowning, 1904a, p. 40). 
According to Anderson (1903c, p. 23) lobar pneumonia is a frequent complication 
in fatal cases; cases 44, 74, and 75 were complicated \vith pneumonia (1903c, p. 15). 
CONVALESCENCE. 
Idaho . — Convalescence is established during the third week, and is usually pro- 
longed (Bowers, 1896). It is remarkably slovq and may be prolonged for months 
(Dubois, 1896, p. 64). It usually begins by or follows a stage of profuse sweating 
(Fairchild, 1896), and during convalescence the cough remains (Figgins, 1896, p. 64). 
Sweet (1896, p. 61), on the-other hand, states that convalescence is usually rapid. 
Montana . — Convalescence in case 78 began at the end of 23 days, and about the 
