In this version, Miller closely follows the basic outlines his earlier composition for William T. Walters (CR# 440B), but makes some subtle, yet significant changes. First, Miller has toned down the coloring to avoid contrasts and create a more muted, gray tonality. The absence of the craggy tree at right, along with the placement of the horse closer to the edge of the page, rather than against an open space, contributes to a less suspenseful image. By compressing the space of the image and placing the three circles of bison skulls closer together across the expanse of the page, Miller gives this version a compositional orderliness the others lack. Here, the rhythmic row of skulls is echoed by the foreground grass and scattered trees, making the composition more predictable and thus less ominous. Finally, the Indian figure pictured here has long hair, as opposed to the bald skull of the Indian in the Walters image.
As with the image, so Miller’s text also deemphasizes the spookiness of the circles, instead focusing on Indian healing practices. Although Miller notes that “‘Medicine,’ with the Indians, signifies charm or mystery,” the second half of his note goes on to detail how healers cure illnesses with incantations and fevers with a sweat lodge.