79 
p. 50) reports a patient in a semicomatose condition, from which he conld be aroused 
only-^vith much effort (early symi3tom). Case 6 (1900) was in a very deep stupor 
for 10 days prior to death (Gates, 1905, p. 115). 
In 1901, coma in case 1 followed the delirium and lasted till death; 
! coma was also present in case 2 for some hours before death ; case 3 was 
i marked by the smdden onset and prolonged duration of coma; in case 
I 6 coma preceded death a few hours; in case 8 coma was present to 
! some extent May 26, and almost complete coma was reported May 27. 
! 
|. coxvrLsioxs. 
^ Case 95, a child of 2 years, had convulsions (Wilson and Chowning, 1903a, p. 60). 
In 1901, case 7 showed convulsions about 8 hours before death, and 
there was almost a state of convulsion in case 6. 
; OPISTHOTONOS. 
Idaho . — ‘‘In one case I found marked opisthotonos during the fourth week of the 
disease, which proved fatal. In this case there were marked cerebral conditions.” 
(Fairchild, 1896.) 
) Montana . — Gwinn (1902) in one case observed rigidity of the muscles of the neck 
I and back, very much resembling that of cerebrospinal meningitis. Wilson and 
i Chowning (1902a, p. 133; 1903a, pp. 50, 57; 1904a, p. 38) and Anderson (1903c, p. 23) 
state that there is no opisthotonos. 
In 1901, cases 2 and 3 presented toward death a tendency" to opisthot- 
I onos, but the patients had received stiychnine. Two unpublished cases 
I of 1902 were described to me (not by a pht^sician) as presenting marked 
■ opisthotonos. In Howard’s case 7 there was slight opisthotonos 
reported during the convulsions. 
li SPAIN AND SPINAL CORD. 
I In one autopsy, Gwinn (1902) has been told, there was found a serous fluid in the 
{ fourth ventricle of the brain. 
I There is a slight congestion of the capillaries of the meninges; a few vessels of the 
|, cortex contain infected red blood cells; there is some distention of the pericellular 
I spaces in the cortex; little or no chromatolysis is shown by Aissl’s stain (Wilson and 
! Chowning, 1904a, p. 43). The meninges of the brain and spinal cord showed a 
slight congestion, apparently hypostatic; there was no basilar (or other) meningitis 
j (Wilson and Chowning, 1904a, p. 42). The vessels are somewhat congested in the 
I spinal cord, as in the brain, and contain a small number of infected corpuscles; in 
one case the anterior horn cells show considerable chromatolysis with Xissl’s stain; 
t no fiber degeneration is shown bv Weigert’s stain (AVilson and Chowning, 1904a, 
p. 43). 
'] Upon autopsy the brain substance was normal in color and consistency in cases 91 
ii and 107; examination of the central nervous system in cases 89, 93, 94, and 97 was 
not permitted (AAdlson and Chowning, 1903a, pp. 48, 52, 53, 55, 56, 58). Anderson 
I (1903c, p. 33) makes no mention of the central nervous system of case 120. 
In 1901, case 11, the veins on the surface of the brain were distended 
' with blood; no pus nor hunph was found at base of skull; ventricles 
