81 
Symptoms as noted b}"Dr. Biyce continued after initial slight abate- 
ment until May 1, when patient felt worse. On the morning of May 
5 Dr. Mills observed small red spots on right side over region of liver; 
more spots on back and on wrists in the afternoon. On the morning 
of May 6 spots were quite abundant over regions noted above and also 
over thighs and forearms. Specimens of blood taken, fixed, and 
stained by Dr. Charles Pixie}" showed a few intracellular bodies. 
At 3 p. m., May 6, patient was examined by Drs. Mills, Pixley, 
Ashburn, Merritt, Anderson, and Wilson. Patient apathetic; tongue 
with heavy, white coat, red margins and tip. Spots were numerous 
on extremities and back; few or almost absent over abdomen; scat- 
tered, but larger and more plentiful, over chest; obscured on face by 
tan, beard, and pockmarks. Spots were 2 to 5 mm. in diameter, rosy 
in color, not elevated, and disappeared readily on pressure, also readily 
reappeared when pressure was removed. Spleen much enlarged; 
liver normal. Considerable gurgling and tenderness in right iliac 
fossa. Fresh blood showed a very few organisms in red cells, mostly 
of small type. Count gave — 
Ked blood corpuscles 
Leucocytes 
Hemoglobin 
4,744,000 
4, 800 
percent.. 90 
Examined again 10.30 a. m. May 7, 1903, by Drs. Mills, Pixley, 
Bryce, Anderson, and Wilson. Spots more general over body, but 
somewhat lighter in color than on previous day. Patient feeling bet- 
ter. Spleen and liver as on previous day. Gurgling in right iliac 
fossa still present; no tenderness. Fresh blood showed a few organ- 
isms, mostly of small type. 
Red blood corpuscles 4, 722, 000 
Leucocytes 6, 900 
Hemoglobin per cent. . 87 
Patient seen on the 8th of May, 10 a. m., by Drs. Mills and Ander- 
son. Patient sleeping, having had sulphonal, grains 10, the night 
before. Conjunctiv^e much injected. Spots bright red, very numer- 
ous on back, plentiful on legs, thighs, arms, and especially on fore- 
arms; disappear very slowly on pressure and return slowly. Spleen 
and liver as yesterday; pulse of fair volume. 
Red blood corpuscles 4, 721, 000 
Hemoglobin l)ercent.. 85 
Very few intracellular bodies seen in fresh blood preparations. 
Small amount of albumin in urine, heavy deposit phosphates; no casts 
or red blood cells. 
May 9, 1903, patient seen by Drs. Mills, Wilson, and Anderson. 
Apparently not as well as yesterday. Conjunctivae much injected. 
