112 
petechiye are present over the entire body except the face. There is great muscular | 
soreness, including the muscles of the eye. Has slept but little the last 2 or 3 nights. | 
Temperature, 102i° F. 
April 24: Patient feels better, eruption is not so well marked. He had a chill this 
a. m.; temperature, 102° F. ; pulse, 64. 
April 25: Patient complains bitterly of backache and pain in ankles and knee i 
joints; temperature, 103° F. ; pulse, 64. 
April 26: Patient has had two chills this a. m.; anorexia complete; says he feels 
very tired; temperature, 102|° F. ; pulse, 72. ; 
April 27 : Bowels moved twice during last 24 hours wiihout laxative or enema. ; 
The cough is not so troublesome; the eyes are very sensitive to light; the spots are I 
very conspicuous ; temperature, lOlf ° F. ; pulse, 62, full and regular. 
April 28: Complains of frontal headache and severe, heavy, aching pains in the I 
tibiae; the spots are very red; the insomnia persists; temperature, 103° F. ;• pulse, 70. i 
April 29: Patient has had a slight chill this a. m.; the pain has left the legs; the > 
eruption shows very bright and red; bowels loose; urine much reduced in quantity, ! 
no albumen; temperature, 102.7° F., pulse, 66. 
May 1: Patient says he feels very much better; free from all muscular soreness and j 
pain; slept fairly well last night; has some desire for food; the spots appear very I 
dark red; temperature, 101.5° F. ; pulse, 70. From this date the patient gradually ! 
recovered strength and was able to resume his work about the ranch June 1. This 
case was below average in severity for cases occurring in this valley. Of special ■ 
interest in connection with this case are the slow pulse and repeated chills. j 
The following facts, I believe, are unique as regards the theory of the tick-bite i 
origin of the disease, being, so far as I am aware, the only recorded instance in which i 
a tick, after having bitten a patient suffering from “ spotted fever ” has then become ! 
detached from the patient, bitten a second person, and this second individual thereby i 
contracting the disease. This is what actually occurred. The second party devel- | 
oped the disease in its most severe type, ending in death. (See p. 113.) 
On May 29, Mr. C. A. H. , of Bridger, Mont. , visited the Clarke Fork Canyon, some 60 i ' 
miles south of this place. He remained in the vicinity of the canyon about 4 days 
and while there was l)itten in 5 or 6 places by ticks. About 7 days from the time he 1 1 
was first bitten by the ticks, viz, June 5, he arrived at his home in Bridger, at which ; 
time he felt the first symptoms of the onset of the disease. When he arrived home ' 
there were two ticks attached to his body which of their own accord, or from friction |i 
of the clothes, became detached from the body on June 6 and then bit his wife, who, 
on June 12 — that is, after a period of incubation of 6 days — developed the first symp- : 
toms which marked the first symptoms of the disease. The petechise occurred on the 1 
3d day. The following is a rather meager clinical history of the disease as it occurred j 
in husband and wife. j 
Case 15. — C. A. H., male, age 46; occupation, stockman; residence, Bridger, Mont. 
June 10: The patient is a large man, weighing about 198 pounds; has indulged 
very freely in alcoholics the j^ast 3 years; has never been sick excepting 2 years ago, 
when he had smallpox. On the legs and abdomen are the marks of several tick I 
bites, one of them on the ankle being very tender and around it a dark, bluish spot. 
There are now a number of small petechial spots on feet and hands, this being the 
fourth or fifth day since the onset. The conjunctive^ are congested, temperature I 
103|° F., pulse 97. He complains of general muscular soreness, severe backache, f 
headache, and of being very tired and exhausted. No appetite whatever. Bowels 
are constipated, urine dark and shows a trace of albumen. During the course of the 1 
disease, which lasted 20 days in this case, the dry cough was most troublesome. 
Nervous symptoms were not marked. The urine was much lessened at times; 
besides a slight amount of albumen, it contained numerous blood and epithelial 
