69 
others with little or no chill (Collister, 1896, p. 63). The disease is sometimes ush- 
ered in by a chill (Fairchild, 1896, p. 62). Figgins (1896, p. 64) states that the attack 
begins with a chill. According to Springer ( 1896, p. 61 ), the chill follows the malaise. 
Maxey (1899, p. 435) states that the patient feels flashes of heat and cold, but no 
marked chill. 
Montana . — The attack comes on by either a well-marked chill or by chilliness, 
simultaneous with fever; the chilliness, although most severe at the onset often con- 
tinues more or less throughout the attack, coming on at intervals, generally mornings, 
and becoming lighter day after day until within a week or so it seems but little more 
than chilliness from light covering (Gwinn, 1902). According to McCullough (1902, 
p. 226), the onset may be marked by a sudden and severe chill or by slight chilly 
sensations, mostly in the morning. Wilson and Chowning (1902a, p. 132; 1903a, 
p. 61; 1904a, p. 37) report that the malaise is followed by a well-marked chill, which 
is usually most severe at the beginning and recurs at irregular intervals, though with 
decreasing severity. Anderson ( 1903a, p. 507 ; 1903c, p. 21 ) states that for a few days 
the patient may have chilly sensations, and Anally there is a well-marked chill; he 
reports cases as follows: 
Case 97 began with chills and vomiting, and with a rapid rise in temperature (pp. 
16-17). 
Case 115 was bitten by ticks April 1; complained of being chilly on April 7 or 8 
(p. 24). 
Case 116 was bitten by tick April 13; severe chill on April 19 (p. 26), 
Case 117 was bitten by tick April 16; marked chill on April 20 (p. 27). 
Case 118 was bitten by tick; chill April 20 (p. 27). 
Case 120 found tick bites April 28; had chill same day (p. 29). 
Gates (1903, p. 48) reports for one patient a hard chill during the last of the 1st 
week; he (1905, pp. 111-112) also reports chill for cases 11 and 14, in the latter case 
10 days after the bite; later the chill recurred; pronounced chill for case 16. 
During the 1904 season, chills occurred in cases 2, 3, 5, 6, 8, and 9. 
Comparison. — Chills are reported for carceag. 
FEVER. 
Idaho . — During the first week following the incubation, the patient takes to bed 
with a temperature of 102° to 105° F., pulse 90 to 120; in favorable cases and in those 
of moderate severity there is a gradual decline in fever during the second w.eek; the 
temperature varies in different cases; there is a daily rise during the first 4 or 5 days; 
the evening temperature is about 1° to 1J° higher than the morning remission; a 
temperature of 102 J° to 104° is not uncommon by the fourth or fifth day; having 
reached its acme, the fever persists for several days; at the end of the second and 
during the third week the fever falls by lysis to an evening record of 98.4° (Bowers, 
1896, p. 63). According to Collister (1896, p. 63) the febrile stage gradually follows 
the chill; it continues 2 or 3 weeks; it is not common to find a temperature over 103°, 
except in occasional cases. Fairchild (1896) states that in some cases febrile action 
runs high; it usually ranges from 101° to 104^-° or 105°, and is continuous, showing 
but slight remissions. Figgins (1896, p. 64) reports the fever as remittent; the tem- 
perature ranges from 100° to 105°; pulse, 100 to 120. Springer (1896, p. 61, 62) says 
that after the chill the fever sets in, ranging from 103° to 105°; the fever ranges high 
and continues from 10 to 14 days; then it intermits for the following week or two. 
Zipf (1896, p. 65) says that the usually sudden onset is accompanied by high fever; 
the fever is continuous, lasting one to two weeks and is out of proportion to the dan- 
ger of the disease; it also leaves the patient weak for weeks. Maxey (1899, p. 435) 
describes the fever as of the continuous type, beginning on the first day and rising 
gradual’y until it reaches 102° to 103° on the third or fourth day, when the eruption 
