42 
a feeling of malaise for a few days, gTadnally growing worse and merging into a well- 
defined ‘ ‘ bone ache ' ’ and slight chilly sensations, mostly in the morning. 
Wilson and Chowning 1902a, p. 132) say that many of the cases are preceded by 
a short period of malaise; this is followed by a marked chill, which is usnally most 
severe at the beginning of the attack and recurs at irregular intervals, though with 
decreasing severity; at the onset there is a severe aching in the bones and muscles, 
with pain in the back and joints; the patient is usually very weak and the headache 
may be severe: constipation at this period is usually present; there is considerable 
restlessness; a bronchial cough is frequently present; the urine is small in amount 
and highly colored; albumen is sometimes present; the skin is dry and the tongue, 
even at the onset, is thickly coated; the coat at first is white, but it becomes brownish 
as the fever increases, while the tongue becomes dry and cracked; sordes appear 
early, and may 1)e quite pronounced; indeed, the whole facies in these respects is 
like typhoid. Wilson and Chowning 1904a, p. 37 ) also rejx^rt that cases Xos. 94, 
96, 97, 115, 116, 117, 119, and 120 gave a history of soreness about the tick bite and 
pains radiating therefrom which continue<i until the initial chill. 
According to Anderson (1903a, p. 50; 1903c, p. 21), the patient may have chilly 
sensations, malaise, and nausea for a few days, then there is a distinct chill, and the 
pei-son takes to bed; there is some pain in the back and head, soreness of the 
muscles and bones, causing a sensation as if the limbs were in a vise; bowels con- 
stipated; tongue with heavy white coat, red edge and tip; conjunctivse congested, 
becoming yellowish; urine usually small in amount, with albumen and a few casts; 
slight bronchitis after a few days; nose bleed, sometimes quite severe, is always 
present. In case 74 1903a, p. 15) the symptoms were about three days in reaching 
their height. 
CoMPAnisox. — In Texas fever the fever usually precedes the outward symptoms 
by several days: pulse and respiration rise with the temperature: loss of appetite 
always, and ces.sation of rumination usually accompany the high fever after the 
third or fourth day. 
Hemoglobinuria begins with exhaustion, loss of appetite, and fever; carceag with 
chill, exhaustion, and fever. Canine piroplasmosis is ushered in by a fever and loss 
of appetite, followed by increasmg prostration, ending in complete helplessness. 
DrsATiox. 
Idaho . — The period of incubation is uncertain, probably 10 to 21 days: from the 
apfiearance of prodromal symptoms until convalescence, 12 to 20 days; average period 
of convalescence, 1 month, very iufrecjuently several months; in 1 case, 2 years elapseil 
Ijefore sunlight was lx)rne without intense cephalalgia ( Bowers, 1896, p. 63). Accord- 
ing to Figgins 1896, p. 64 ) the duration is 14 to 42 days, the eruption showing for 4 
or 5 months after the patient is up and around, especially when subject to heat or 
physical exercise. Fairchild ( 1896. p. 62 ) gives the duration as 14 to 28 days. Springer 
(1896, p. 61) reports duration as 2 to 3 weeks. Sweet 1896, p. 61 » states that the 
duration is 3 weeks to 3 or 4 months, i. e., although the fever may not last longer than 
21 days, the lesions may continue for months. The disease usually terminates in 
course of 2 or 3 weeks by lysis, usually in recovery Medical Sentinel, 1899, p. 457). 
Montana . — Gwinn il902 > reports that one case persisted 3 months before recovery. 
CTiites (1905) reports convalescence in 14 of his 17 cases as follows: 
In a few days. 1 case: 10 days. 1 case: 12 days. 2 cases; 14 days, 1 case: 
15 days, 1 case: IS days. 1 case: 20 days. 1 case: 21 days. 1 case: 22 
days. 2 cases: about 25 days. 1 case: 28 day.'?. 1 case: not given, 1 case. 
See also Deaths, page S9. 
In the 2 Bitter Boot Valiev recovery eases of 19<»4 1 (Xo. 4) was 
