70 
usually appears; it is highest on the fourth to seventh day, corresponding to the j 
period of most profuse eruption; there is a difference of i° to 1.5° F. between the I 
minimum morning and maximum evening temperature, which difference is main- I 
tained until about the tenth to fifteenth day, when the temperature line becomes i 
erratic, for at this time it is apt to take sudden jumps up and then as suddenly down, j 
while at tl^ie same time the average temperature is gradually going down, until by 
the end of the third week the patient is entirely free from fever. The Medical Sen- j 
tinel (1899, p. 457), speaking editorially, refers to the fever as remittent in type. ; 
Montana. — The fever comes on with or rapidly follows the initiative chill, so that 
upon the first visit the temperature is usually 102° to 104° F. ; it becomes graduail}- ^ 
higher day after day until it reaches its maximum in 2 to 7 days, when it ordinarily \ 
registers 103° to 106°; there seems to be a slight evening rise above that of mornings; | 
in probably all cases except the mildest, one may be misled in the latter days of the 
attack in thinking the fever abated upon feeling the skin, or by the thermometer ; 
registered in the axilla, while the rectal temperature shows to the contrary; this dif- j 
ference in temperature is apparently caused by the slow, feeble, obstructed circula- i 
tion, the exterior and the extremities becoming cool from a lack of blood supply; in t 
cases where recovery takes place, the fever begins to abate alx>ut the fourteenth day 
and gradually recedes until it disappears, on an average, on the twenty-first day; 2 
cases had subnormal temperature mornings and about 1° of fever at 6 p. m. almost ' 
during the entire attack. (Gwinn, 1902. ) ; 
McCullough (1902, p. 226) says that the temperature and pulse assume the form |- 
of most continued fevers, both gradually increasing, until the acme of the disease is 
reached in nonfatal cases about the end of the second week; very high temperature i 
is not usual, ranging from 102° to 106°. |, 
According to Wilson and Chowning (1902a, p. 132; 1903a, p. 62; 1904a, p. 37) i 
after the initial chill, fever rapidly develops, and may reach 103° to 104° F. on the 
second day; it gradually increases and reaches its maximum in from 5 to 7 days, 
when it may register 105° to 107° F. (rectal temperature); the difference between 
rectal and axillary temperature is sometimes as much as 2° F. ; usually a slight even- 
ing increase and morning decrease are noted; the temperature occasionally becomes 
normal or subnormal 18 to 24 hours before death; when recovery occurs, it is by ; 
lysis, much as in typhoid; the diminution of the fever begins about the end of the 
second week and reaches normal about 2 weeks later. 
Anderson (1903a, p. 507; 1903c, p. 21) states that before the distinct chill there is ' 
little or no fever in the morning, with a slight rise in the afternoon; after the chill | 
there is an abrupt rise, and from then on the fever gradually rises in the evening, | 
with a slight morning remission. The maximum is usually reached on the eighth to I 
the twelfth day; then, in a favorable case it gradually falls, becoming normal about i 
the fourteenth to the eighteenth day, usually going to subnormal for a few days; in 
fatal cases the fever remains high, from 104° to 105° or 106° F., and the morning i 
remissions are very slight or not present. 
Gates (1903, pp. 48, 49) reports the temperature for two cases; in one case the 
patient was given small doses of aconite and spirit of nitrous ether and small doses I 
of alcohol until the fever was reduced and bowels moved freely; the patient was 
sponged with cool and cold water, as needed for high temperature; the fever ran an i 
irregular course, with great variation, reaching at times a temperature 104.5° F., and I 
again sinking to 97° F. This low temperature was observed during the last of the : 
first week of the disease, at which time the patient was in a state of collapse, being ' 
almost pulseless and having a hard chill at the time. | 
Comparisons. — In Texas fever, if the temperature of exposed animals be taken 
once daily — say, in the morning — it will be found that at the onset of the disease it 
will rise within 24 hours from the normal to 104° F. or even higher. In the follow- 
ing 24 hours it may rise to 105° or 107° F. The continued daily record will then 
