43 
taken sick about May 8 and was able to sit up May 21, thus giving a 
duration of 13 days from onset to convalescence; 1 (No. 10) noticed 
first symptoms June 2 and was discharged from the hospital June 17, 
giving a duration of 15 days. 
Comparison. — Extremely acute cases of canine piroplasmosis may last only 24 
hours, but it appears more often to last 3 to 6 days; subacute cases last about 10 days; 
chronic cases, 21 to 62 days. Starcovici states that in hemoglobinuria the fever lasts 
about 5 days. In Texas fever the continuous high temperature rarely lasts longer 
than 8 to 10 days. 
Epidemic Character. 
Under the heading ‘‘Seasonal distribution” (p. 32) it is shown that 
spotted fever occurs chiefly during the spring months and in certain 
localities, and on page 44 it is shown that all authors agree that it is 
not contagious. The question naturalU arises as to the distribution of 
cases b}^ families. 
Idaho . — Bowers (1896, p. 63) states that spotted fever occurs sporadically. Fig- 
gins (1896, p. 64) says that he has seen it in families who used water from springs 
and where the entire family had the disease. In the experience of Fairchild (1896) 
the cases have been sporadic, and it is exceptional to find more than 1 or 2 cases in 
the same house. Sweet (1896), how’ever, says that frequently several cases occur in 
a household, again only a single case. This latter fact is often due to the patient’s 
returning home ill after sojourning in another place up to the malaise. 
Montana . — It is common for quite a number of the patients to come down with the 
disease near the same time; then perhaps there will be a respite for a week or ten 
days, when there will be a number of other almost simultaneous attacks in the 
neighborhood. If upon further investigation this proves true it may be significant 
in detecting the cause. (Gwinn, 1902.) 
According to Wilson and Chowning (1903a, p. 68; 1904a, p. 43), in no instance have 
two or more persons with the same food or water supply been simultaneously stricken 
with the disease. 
In no instance which Ashburn and I saw personally was there more 
than one patient in the same house, but the following cases are inter- 
esting, and possibl}" important, in this connection: 
Cases 45 and 46 (Doctor Gwinn’s patients in 1899) were two chil- 
dren, 3 and 5 3 "ears old, respectively (Wilson and Chowning, 1903a, 
p. 34). Gwinn writes me that he believes some confusion has arisen 
in connection with the dates of these two cases. 
Cases 113 and 114 (Doctor Heine’s patients at Butte in 1893) were 
husband and wife (Anderson, 1903c, p. 16). They were living together, 
and one was taken sick ten da}’s later than the other. 
In 1903 there occurred 3 cases (father and two sons) of illness in the 
famiU of A. M., on Lo Lo Creek. None of these cases is reported 
either b}- Wilson and Chowning or by Anderson: 
One boy was sick with a disease which his mother supposed was “spotted fever.” 
His father went to town to obtain medicine for the boy, and encountering a storm he 
became thoroughly “wet through.” The father was then taken sick and was seen 
at the hotel in Missoula by Doctors Gwinn and Wilson. Doctor Gwinn informs me 
