When a considerable number of these parasites are present, signs of antrimia soon appear, following preliminary gastro-intestinal symptoms. The latter may be of different intensity and associated with various clinical symptoms. Charcot's crystals are often encountered in large number in the stools, which often contain blood.
The diagnosis is made sure by finding the characteristic eggs. In anairnic children of day-laborers, especially those that come from the southern parts of Europe or live there only at certain periods of the year, the stools must always be investigated for these parasites.
Treatment.—Leichenstern gives 80 grains or less of the extract of filix Inas, according to the age of the child; Bozzolo reeommends thyrnol. After-treatment is required for the anannia, which soon im proves after the parasite has been removed. A short time after the cure, the stools must again bc investigated for eggs.
Prophylaxis consists chiefly in careful hygiene of the person and careful observation of the water supply. Subcutaneous infection, w-hieh may occur from bathing or wading in water, must be guarded against.
5. Trichina spiralis. —This thread-worm must be briefly consid ered here; since its presence has been discovered in children, as well as in adults. The mode of development is as follows: The encapsulated triehina,, male and feniale, enter the human stomach in trichinous pork. There they become free, and develop in the intestine into intestinal triehinfe. Two or three days after their entrance, the male and female meet; and four to five clays after this, the female, which ha:: a length of 2 to 4 rim. and a breadth of deposits living embryos. According to Leuckart, the female trichina may give birth to 1500 embryos, in successive relays, in a period of five or six weeks. Some of these embryos, which are .1 M711. long and .006 mat broad, are always evacuated with the feces; but the majority penetrate the intestinal wall and, partly by active migration and partly passively through the blood and lymph, reach the muscles, between whose fibres they develop to a size of 1 nun. and over. It the end of the third week, they roll themselves up; and by the fifth or sixth week, become encapsulated. The capsule later becomes calcified. In this form, the muscle trichime may: prolong their lives for y-ears; although some of them die.
Swine are usually- infected from eating rats, which in many- local ities arc very generally infected with trichina,. Since the rats consume the dead bodies of their oxvn species, they constantly reinfect themselves with the parasites.
Symptorns.—Trichinosis offers the following symptoms:—In the first, stage, after the importation, vague gastro-intestinal symptoms arise, wit,h here and there diarrin(ra and vomiting, and moderate fever. Eight to ten days later, general rheumatic pains develop, with high fever. The muscles are swollen and extremely painful on pressure, and also on active and passive movenicnt. Difficulty in swallowing and attacks of dysplura arise. ffihe face and the eyelids become markedly tudematous. This (edema is transitory, but often recurs. The pupils are usually fixed ancl dilated. Sleepiness is the rule; but exceptionally, lack of sleep is noticed in children. According to the degree of infection and the strength of the eonstitution of the patient, the disease ends in death or in a very protracted convalescence.
'The prognosis is always uncertain in the beginning of the disease.
The diagnosis is made certain liy finding the intestinal trichinre or embryos in the (-radiations; and, later, by finding musele-triehime in excised portions of muscle. As a rule, the source of infection has been discovered in all epidemics.
The treatment consists in removing the intestinal trichinm or embryos with laxatives (calomel, castor-oil, etc.): and, later, in destroy ing them with gdycerin (Fiedler) or benzol (Mosier).
In addition to eareful nourishment, we must institute a symptom atic treatment : for the musele-pains, protracted lukewarm baths, with packs and friction of chloroform liniment, etc.; in convalescence, tonic treatment. From the prnphylactic standpoint, an obligatory and care ful meat-inspection on the part of the State would accomplish very much. The most certain personal prophylaxis consists in using no pork that has not been boiled or broiled. The possibility- of acquiring trichi nosis from sausage, which is the most frequent source of infection, will lye great in countries in which most of the rats have trichinosis.