87 
' 
;s 
I s 
GENITA L SYSTEM. 
See Genitalia, page 55. 
Several women have been taken sick while pregnant. Case 121 was two months 
j pregnant (Anderson, 1903c, p. 34), but apparently did not abort. 
I Wilson and Chowning (1904a, p. 42) report the uterus as apparently normal in the 
j 3 females examined. 
i ■ case 11 (1904) patient aborted; the uterus, upon autopsy, meas- 
j ured 11 by 13 cm., was soft, but normal in appearance for a recently 
delivered uterus; on section it was normal; the vagina showed slight 
bloody discharge; the ovaries were normal; right ovary contained 
! corpus luteum. 
In case 3 menstruation occurred for one hour on May 14, and then 
I stopped; it began again during the night of May 14-15, and flowed 
ji freely until death. Her former menstruation was on April 11, so 
|! that the disease appears to have delayed her menses. Case 5 men- 
i struated just prior to attack. 
Relapses. 
I Case 53 (Gwinn’s patient, 1899) relapsed after abortive treatment (AVilson and 
I Chowning, 1903a, p. 35; Anderson, 1903c, p. 15). According to Gwinn (1902) 
'! relapse is favored by getting up from bed too soon, or by muscular exertion, or 
exposure to cold. 
I We saw no relapses in 1904. 
, Comparison. — In carceag there is usually 1 attack; in some cases there is 1 or 2 
I days of remission, then a second attack. 
t 
COMPLICATIONS. 
Idaho . — Some cases develop rheumatic trouble, particularly of the larger joints. 
Montana . — Hypostatic pneumonia, rheumatism, gangrene, and hemorrhagic diathe- 
: sis seem the most usually to complicate the disease (McCullough, 1902, p. 226); 
pneumonia predominates in frequency as a complication, and such involvement of 
the lungs along with the predominating illness generally terminates the case. 
Hypostatic pneumonia is a frequent complication for a day or so before death; one 
case had to all appearances genuine lobar pneumonia; one case gave well-marked 
j symptoms of acute inflammatory rheumatism as complication; one case was compli- 
1 cated with abscess and gangrene (Gwinn, 1902). 
! The symptoms noted are sometimes complicated by gangrene, hypostatic pneu- 
I monia, articular rheumatism, etc. ; hypostatic pneumonia sometimes develops; lobar 
pneumonia occasionally occurs as a complication, and usually hastens the end (Wilson 
\ and Chowning, 1904a, p. 40). 
j According to Anderson (1903c, p. 23) lobar pneumonia is a frequent complication 
j in fatal cases; cases 44, 74, and 75 were complicated with pneumonia (1903c, p. 15). 
CONVALESCENCE. 
j Idaho . — Convalescence is established during the third week, and is usually pro- 
longed (Bowers, 1896). It is remarkably slow; and may be prolonged for months 
(Dubois, 1896, p. 64). It usually begins by or follows a stage of profuse sweating 
(Fairchild, 1896), and during convalescence the cough remains (Figgins, 1896, p. 64). 
Sweet (1896, p. 61), on the other hand, states that convalescence is usually rapid. 
Montana . — Convalescence in case 78 began at the end of 23 days, and about the 
