TRICHINOSIS.
Preventive measures are of much more importance than therapeutic methods, since little can he done once the larvx of Trichina spiralis have become encysted in the muscle of the human patient. Prophylaxis is obvious, since the disease can be entirely prevented by thorough cooking of all food obtained from the muscles and tissues of the pig. As the latter animal becomes infected from the excreta of rats which gain ad mission to the pigstyes, the sanitary environment of this food supplier should be most carefully attended to.
Where ham and some varieties of sausages are eaten in the uncooked state. as in Northern Germany, the pork is submitted to careful examina tion before being exposed to the curing process, as this latter does not destroy the parasite. A small portion of the tongue, diaphragm, inter costal and abdominal muscles are examined by a lens, and if the parasite is detected the carcass is rejected.
In Britain, where ham is never eaten in the raw state, the only danger of infection arises from incomplete boiling of large hams. A temperature of I 76' F. is necessary for the destruction of the parasite, and this tempera ture in the centre of a large ham is not reached till after at least S hours' continuous boiling„ hence heavy hams should always be cut in two before boiling. Freezing of ham and bacon has no effect upon the trichina.
After the ingestion of trichinised food in the stage in which nausea, vertigo, diarrhoea and fever are present, the best treatment will be to clear out the stomach by means of a good emetic, followed by a large (lose of some smart purgative, as I or 2 oz. of Castor Oil, to or 20 grs. of
Calomel, or 2 or 3 oz. of Black Draught or White Mixture. The only drug likely to be of any use in the early stage, before the parasites have left the intestinal canal, is Thvmol in doses of 15 to 3o grs. every two hours for three or four times. The colon should be thoroughly irrigate* the parasites have been found for weeks coming away in the washings. poring this time it should be realised that the trichinae continue to shower their living young into the lumen of the bowel, so that by repeated purging and the administration of thymol and colon irrigation much may be done to minimise the infection of the muscles.
Once the larvae have gained admission to the muscles no drug given by the mouth has any specific action upon them. Kahn dissolves 5o grs. thymol in co c,c. olive oil, and administers 2-3 c.c. of this subcutaneously or intermuscularly daily for one week, when after a rest for to days the injections arc repeated daily for another week. Cures, lie affirms, are to be expected, as the drug reaches and destroys the parasites in the muscles, as shown by great quantities of eosinophiles in the urine.
Salvarsan mind Neosalvarsan have been injected with varying success. Salter in an epidemic in New York successfully employed injections of the blood-serum of patients who had recover tom the disease. Pain, stiffness and tenderness of the muscles should be met by local anodynes. Fever may be relieved I iv small doses of Antipyrine or Aspirin, and the patient's strength maintained by rest, suitable liquid nourishment, rectal feeding with peptunised food, etc.