APPENDIX. 
A REPORT OF TWO CASES OF "SPOTTED FEVER.” 
By Dr. G. A. Gates, 
Bi'idger, Mont. 
CASE I. 
On May 29. ^898, I was called to see L. M.. at Thermopolis. Wyo. 
Patient was a male, white, aged 23 years, sandy or red hair, rather 
spare built; had come from Iowa about three months previous to 
present attack. He became ill while traveling- overland from Lander 
to Thermopolis, Myo. Having camped out several nights during the 
journey, on one or two occasions his bedding became thoroughly wet 
from the heavy rains of that season. 
When first seen patient's face was deeply flushed, eyes bright, skin 
hot and dry, with a beginning petechia on the forehead, back of bands, 
wrists, and ankles. Headache, thirst, slightly sore throat, and a sore- 
ness of muscles and aching throughout the body were complained of 
by the patient. Temperature lO-f" F., pulse 120. urine highly col- 
ored, no albumin. Complete loss of appetite : no other gastro-intestinal 
symptoms. 
Patient was given small doses of aconite and spirit of nitrous ether 
and small doses of alcohol until fever was reduced and bowels moved 
freely. 
This was followed by a prescription containing salol. hydrate of 
chloral, with soda bicarbonate, caffein citrate, and pepsin, combined 
in a powder and gWen ev'ery four or six hours. Patient was sponged 
with cool or cold water, as needed for high temperature, and placed on 
a diet of milk, gruel, raw eggs, and whisky. 
The fever ran an irregular course, with great vwiriation. reaching at 
times a temperature of lOd.5^ F. and again sinking to 97' F. This low 
temperature was observed during the last of the first week of the 
disease, at which time patient was in a state of collapse, being almost 
pulseless and having a hard chill at the time. 
Slight albuminuria appeared during the second week. 
Delirium was very slight: patient could be aroused at any time. 
Fever gradually subsided after eighteen days. 
48 
