49 
The petechia increased in size and number very rapidly during the 
first two weeks, forming large, irregularl}" shaped spots from the size 
of a little finger nail to sjjots one-half b}- one-half inch in size. These 
spots darkened in color, becoming bluish, with a surrounding j^ellow 
tinge. The spots were slow in disappearing, some traces of them 
being visible seven months after recovery. 
CASE 8. 
Mrs. H., white, aged 67 years, was bitten by a tick May 4 and 8, 
the tick being removed from the left thigh on May 8, 1903. The spe- 
cies of ticks to which this one belonged is said to have been brought 
to this section of country by sheep from Bozeman or vicinity. This 
tick is recognized by having a grayish or whitish spot on the back of 
the head. The tick which bit patient came from near the mouth of Diy 
Creek, on the west side of the Clarke Fork River, 7 miles south of 
Bridger. 
Patient first complained of feeling ill on May 9. She complained of 
headache, tired feeling, general soreness of the muscles, and loss of 
appetite. 
I saw patient first May 11. Temperature 103, pulse 104, cheeks 
flushed, tongue white coat on sides, rather dry. Quite severe headache 
and tired feeling were the only subjective symptoms. Urine dark; 
on examination showed slight amount of albumin and some hyaline 
and granular blood casts and numerous bacteria; the quantit}" for fol- 
lowing twenty-four hours was 32 ounces; the quantity gradually 
diminished from this time until two days before death, when there 
was complete anuria. Red and white blood cells, with an enormous 
number of granular, blood, and epithelial casts, were present in last 
samples of urine obtained. 
During the 12th and 13th temperature varied from 101 to 103.5 F. 
On the 14th it rose to 104.4, slowly dropping to 101 on the morning 
of the 17th, where it remained until death. 
Food and medicine were taken well until the last thirt 3 "-six hours. 
Vomiting occurred once. A number of wateiy evacuations were pro- 
duced bv the action of elaterium. 
Rectal and subcutaneous injections of normal saline solution were 
given. The combined use of the above and hot packs, together with 
hot elder water and liquor ammonii acetatis internalhy produced onh^ 
slight diaphoresis, and that niostU about the head. 
On the loth petechial eruption began to make its appearance upon 
the buttocks, back, and thighs. These increased in number and size 
until every portion of the body was covered, though but little show- 
ing on the face. The}" seemed to be subcutaneous or intracutaneous 
extravasations of blood, rapidU darkening in color. 
