75 
1 Durino- the season of 1904: nervous symptoms were prominent. 
’ In case 2 h^-peresthesia (see above, p. 51) was extreme, the weio*ht 
^ of a palpating hand or even of the bed clothing caused extreme pain. 
, For case 4: severe intracranial and supraorbital neuralgia, May 12, was 
I reported; condition improved under codeine ; in general the nervousness 
j of the patient was marked in this case, as also in case 5. In case 6, 
! who was of a neurotic temperament, the nervous symptoms were 
prominent, very marked, and constant; twitching of muscles, etc. On 
I May 19, when touched anywhere on the body the patient was thrown 
I into a state of tonus. In case 7 nervous disturbance was important 
and marked throughout illness. The patient thrashed around in bed, 
; rolling head and throwing the arms around. He could not be made 
i to lie on the left side for a minute at a time, but would immediately 
throw himself upon his right side or his back. In case 8 nervousness 
! increased May 21; dullness increased with slight delirium; May 25 
: hyperesthesia was very marked; there was high nervmus tension, the 
I muscles of the back and limbs became very rigid; ail nervous symp- 
^ toms increased May 26, 27, and 28; a drink of water would produce 
i spasm of pharynx and diaphragm; reflex excitability was so intense 
! for 21 hours before death that a slight touch used in putting a spoon 
! to the mouth, or sponging, etc., would cause spasm and rigidit}^ of 
^ entire body. In case 11 the severity of the nervous symptoms pointed 
i strongly to cerebrospinal meningitis. In case 13 there was picking at 
I the bed clothing, muttering, and restless rolling from side to side. 
MALAISE. 
j Idaho. — During incubation there is a feeling of lassitude and inaptitude for work 
II (Bowers, 1896, p. 63). Many cases are taken suddenly without previous malaise 
I (Collister, 1896, p. 63). Lassitude is mentioned by Dubois (1896, p. 64). Fairchild 
j (1896, p. 62) says there are usually 2 or 3 days of malaise. Springer (1896, p. 61) 
j states that there is a feeling of malaise for a few' days preceding the chill, and Maxey 
(1899, p. 435) reports that the patient first notices a general malaise, 
j Montana. — In a few cases the disease seems to be preceded by a prodromal period 
■ of malaise for a few' days (Gw'inn, 1902). According to McCullough (1902, p. 226) 
I the attack may come on insidiously w'ith a feeling of malaise for a few' days, gradu- 
1! ally grow'ing worse and merging into a well-defined “bone ache.” 
Wilson and Chow'ning (1902a, p. 132; 1903a, p. 61) and Anderson (1903a, p. 507; 
j 1903c, p. 21) agree that many cases are preceded by a short period of malaise. 
, In 1901 case 3 complained of slight malaise on May 10; on May 12 
' this case showed stupor. 
RESTLESSNESS AND INSOMNIA. 
i Idaho. — Sleeplessness is common during the first w'eek (Bow'ers, 1896, p. 64). On 
account of the fever and the soreness and the ]iains in the extremities and back the 
j patient rolls and tosses in a restless effort to find a comfortalile iiosition (Maxey, 
jj 1899, p. 435). 
|! Montana. — There is considerable restlessness (Wilson and Chow’ning, 1902a, j). 132; 
I 1903a, p. 62; 1904a, p. 37). Anderson (1903c, p. 23) says that the soreness of the 
