16 
spring within the last few years from the Bitter Root Valley to other 
parts of Montana (as Bridger and Livingston) and to Wyoming is 
probably not fully warranted in our present knowledge of this malady, 
for whether these localities actually represent newly infected foci or 
only newly recognized foci can be definitely determined only by a more 
complete medical history of these places than is published at present. 
Names of the Disease. 
Idaho. — In Idaho the disease under discussion is generally spoken of fCs “spotted 
fever,” because of its eruption, and Maxey (1899, p. 434) states that he knows of no 
other or better name for it; he adds that, although confusing to physicians unac- 
quainted with the affection, this name admirably describes the disease from a lay 
standpoint, and very probably will be retained in use by the local profession until 
future research enables us to classify it where it belongs. Dubois (1896, p. 64) says 
that Exanthesis rosalia anthrodynia more nearly expresses the disease than does 
“spotted fever.” The Medical Sentinel (1899, p. 458) remarks editorially that “the 
opinion of the writer, based solely upon the symptomatology, is that this spotted 
fever bears a closer resemblance to the papular form of erythema exudativum multi- 
forme than to any other known morbid entity.” 
Nevada. — In Nevada this disease is known as “spotted fever.” 
Montana. — According to McCullough (1902, p. 225) it has been called “black 
fever” and “blue disease,” probably on account of the dusky or bluish appearance a 
short time before death of those afflicted. He considers the name “spotted fever” a 
good one, because to the laity it abodes grave responsibility; * * * “many of the 
cases terminating fatally with the best skill and untiring energy an intelligent physi- 
cian can give them, we feel the burden is somewhat lightened, and the responsibility 
is shared by the family and friends if they are preparedfor the inevitable.” * * * 
Crain (see Wilson and Chowning, 1902a, p. 33) states that in 1891 the disease was 
called “black measles” by the valley physicians. Wilson and Chowning (1902a) 
refer to the malady as the “so-called ‘spotted fever’ of the Eocky Mountains,” but 
remark (1903a, p. 27) that the name “spotted fever” as applied to it is an unfor- 
tunate one, since it has been applied to several other diseases. 
Anderson (1903a) proposes the name “tick fever,” on account of the relation of 
the tick to the spread of the disease, and because of the fact that there are already 
two diseases of man sometimes called “spotted fever.” Wilson and Chowning 
(1904a, p. 31) state that the name “tick fever” [also frequently “wood-tick fever”] 
was proposed by the local newspapers when the hypothesis of transmission by ticks 
was advanced by them in 1902; that it seems fairly distinctive, but is open to the 
objection that it has been previously used as a synonym of “Texas fever” in cattle, « 
and that it does not accurately indicate either symptoms or etiology; since “spotted 
fever” appears to be the first described infection of man attributed to a “Pyroplasma” 
[namely Piroplasma], they classify the malady as '' PyroidasmoHls hominis^^ [namely 
Piroplasmosis hominis]. Nuttall (1904, p. 221), in referring to the investigations by 
Wilson and Chowning, uses the term “human piroplasmosis.”^-' 
r 
Historical Review of Investigations. 
For a number of years this disease has been subjected to study by I 
the local physicians in the regions in which it occurs. Maxey, Gwinn, , 
McCullough, and Gates have published their ideas and it is to be | 
« Not to be confused with the African so-called “ tick fever ” of man, supposed to be transmitted by 
Ornithodoros savignyi. i 
fcNot to be confused with “ Dum Dum fever.’ ; 
