45 
Position in Bed. 
Owing to the muscular and articular soreness, the patients lie in a position of 
general flexion for hours without moving (Bowers, 1896, p. 64). 
See also Kestlessness, page 75. 
Odor. 
There is a peculiar urinous odor to maii}^ of the patients, even when 
the greatest care and cleanliness are exercised in nursing them. This 
odor was especially marked in 1904 in cases 2, 3, 7, and 11. 
In case 12, upon removing the clothing, the odor of the body led the 
ph 3 ^sician to ask the patient whether he had ever had measles, to 
which he replied in the affirmative. 
Skin. 
GENERAL CONDITION. 
Idaho . — During the first week the skin is usually dry, later it is somewhat moist, 
and night sweats are common during the third week (Bowers, 1896, p. 63). Collister 
states that the skin shows no abnormal appearances. According to Figgins (1896, 
p. 64) it is swollen and sensitive to the touch. Maxey (1899, p. 435) describes the 
skill as dry and harsh. 
Montana . — Gwinn (1902) speaks of the flushed, dusky-red color of the skin; if 
it is pressed while in a congested condition, it appears blanched upon removal of 
the fingers and is much slower in regaining its color than in health; this fact being 
true, in spite of the strong pulse, leads Gwinn to believe that the blood current is 
obstructed in the capillaries, and this belief is supported also bv the nature of the 
eruption, the oft-occurring gangrene,* and the really thick unoxygenated blood; 
whether this obstruction be due to changes or to alteration in the blood is hard to 
determine, but Gwinn inclines to the latter explanation; in addition to the eruption, 
the skin takes on a congested, jaundiced color; the congested and cyanotic condition 
of the skin causes a bloated, stupid expression of the face in most cases, which is a 
very diagnostic symptom. Gwinn also states that at the beginning of the second 
week there may be noticed a glazed appearance of the skin which, upon close exami- 
nation, is found to be due to epithelium coating; it begins to scale up and shed off 
at the beginning of the third week. 
Wilson and Chowning (1902a, p. 132; 1903a, p. 62; 1904a, p. 37) describe the skin 
as dry; there is a peculiar ashy paleness present, more readily observed in children 
and women, a few days before death (1902a, p. 132; 1903a, p. 63; 1904a, p. 38); about 
the second week, ordinarily, the skin presents a glazed ajjpearance. 
Anderson (1903a, p. 33) speaks of the lividity on dependent portions of skin and 
thighs (case 120); he also refers (1903c, p. 38) to a marbled appearance of the skin. 
Gates (1903, p. 48) reports hot and dry skin in one case; he later (1905, p. Ill) 
reports the skin as very dry in an additional case (1903, case 11). 
SPOTS. 
LOCATION, 
Idaho. — The spots first appear about the ankles and wrists, and by the end of the 
first week they have extended over the entire body. (Bowers, 1896, p. 63.) Accord- 
ing to Collister (1896, p. 63) they first appear on the feet and from there spread over 
the body. Dubois (1896, p. 64) states that they first appear on the palms of the 
hands and extend from there over the body. Fairchild ( 1896) reports that they first 
are seen on the legs and arms, and soon cover the whole body, Fairchild ( 1896) says 
