100 
counts, etc., such as I should have done had time permitted. Fur- 
thermore. some of the hospital charts became lost, so that part of the 
notes had to be written from memorv or from brief memoranda. 
BITTER ROOT VAELET CASES. 190d. 
190Jf. Case 1 . — Attending physician. Doctor Buckley (notes writ- 
ten from memory later by Doctor Buckley: Ao microscopic examina- 
tion of blood). 
Male, age 66 years. Seen by Doctor Buckley, April 29, 19<M. TVhen first seen he 
had two wood-tick bites in the right inguinal region, each surrounde<i by an indu- 
rated inflammatory zone and showing an area of blackene^i s kin abaut ^ inch in 
diameter at the center. Patient had frontal headache and general body achinir. 
Temperature 102" P. Thought he had caught cold. 
April 30. temperature 103". Sclerotics much injecte^l and face congestel. Tongue 
moist. Pulse not high. 
Alay 1, restless. Ao sleep night before. DDwels open. Temperature 103.5" F.. 
a. m. ; 101", p. m. Motthng of skin notice<i. Ecchymotic sjwts the size of a dollar 
seen on the abdomen. Scrotum black. That evening patient was feeling better and 
Doctor Buckley was telephoned he need not see him. May 2. worse. Spots dark 
purple. Temperature, a. m.. 101"; p. m., 105". Began to have delirium, which 
scNjn pitsse<i to coma, which laste<l until death, on May 3. !9<>1. 
Case 2 . — Attending physician. Dr. J. J. Buckley (notes writ- 
ten later by Doctor Ashburn from hospital chart and from statement 
by Doctor Buckley: Patient seen by Doctors Buckley. Ashburn. and 
Stiles: microscopic examination of dried blood from lips by Doctor 
Stiles, unsatisfactory). 
Female, age 7 years 1 months. Born in Ravalh County, 15 miles sc*uth of present 
home. 
Family history, negative. 
Personal history previous to present illness): .scarlatina in fall of 1903. mild. Xo 
other sickness. 
Present illness: April 24. 1903. bitten back of ear by 3 ticks. Bites caused swell- 
ing next day. Xo discoloration; swelling was over upf»er part of stemo-mastoid, 
below bites. Had fever from that time on. 
April 27. eruption showel on arms, shoulders, hips, knees, ankles, palms, and 
soles. 5lother thought she had measles. She had also complained of S'lue eyes, 
some pain in back and head. Continuel that way with increasing eruption and 
some darkening of it bro^vning) until May 2, when seen by Doctor McGrath and 
pronounced spotte<:l fever. Brought to Missoula May 3. Complained of intense 
general sc»reness after app*earance of eruption. 
5Iay 4; More irritation in throat. Very sore to the touch. Very drowsy. Cramps 
in stomach. Ptestless in afternoon. 
May 5; Headache. Vomited twice. Sore throat. Very restless all night. Bash 
darker in color but not sore to the touch; patient very thirsty. 
5Iay 6: After .sponging reste<l all forenoon, retained milk, some water, and all 
medicine. Throat much better. Xot so thirsty as yesterday. Rested all afternoon. 
Xo vomiting. At 5 p. m.. cramps in stomach. 
5Iay 7 : Respiration a little more irregular: retains everything; apparently weaker, 
but pulse gcHxl: p. m.. breathing very poor, but change for the better late in the 
