SUPPLEMENT 68l 



generally from one to ten days after eating trichinous flesh, yet there 

 have been cases noted in.which the disease began several weeks after. 



Diagnosis in the presence of several cases, or in epidemics, is not 

 difficult, but in isolated cases, on the other hand, it is not easy. 

 If there is a suspicion of trichinosis, from the muscular fatigue and 

 the oedema of the eyelids, the diagnosis can be made by excision of 

 a piece of muscle and by finding the Trichinae in the tissue, taken 

 with the results of the examination of the previously eaten sausage or 

 meat. In contradistinction to this circumstantial process, there is 

 the examination of the blood, which, according to Schleip 1 

 (Homburg trichinosis epidemic, August 19 to 26, 1903, 130 cases), is 

 the most valuable method of diagnosing trichinosis when the Trichinae 

 have not yet penetrated the muscles, for a blood examination shows 

 a large increase in the numbers of the eosinophile cells; Staubli 

 detected his seven cases in this way, four of the severe on s showing 

 a marked hyperleucocytosis, and a combination of Kernig's sign with 

 absence of the patellar reflex. On account of the rarity of these two 

 signs in combination in other infective diseases, they have a certain 

 diagnostic value. Staubli 2 also observed in trichinosis the constant 

 appearance of a remarkably strong positive diazo-reaction of the 

 urine. 



Prophylaxis in trichinosis is fully considered under Trichindla 

 spiralis (p. 429). 



Treatment consists in those cases where it is known that trichinous 

 flesh has been swallowed in the first place of washing out the 

 stomach, but still more in a thorough evacuation of the bowels, for 

 which calomel (0-5 grm.), ol. ricini (a dessert-spoonful till the action 

 becomes marked), infusion of senna with sulphate of magnesia and 

 large enemata are employed, and should be repeated at intervals 

 during the first few weeks. Alcohol (cognac up to 250 c.c. a 

 day) is recommended by some, also glycerine (150 grm. at a dose) 

 and large doses of dilute hydrochloric acid. Beside these, a large 

 number of other remedies are recommended, of which, perhaps, 

 benzine and thymol, especially in the form of enemata, are worthy 

 of notice. 



When the disease is fully developed the treatment should be 

 symptomatic ; a protracted practically continuous luke-warm bath is 

 especially useful. 



Eustrongylus gigas. 



Eustrongyliis gigas is most frequently found in the pelvis of the 

 kidney. Infection in the majority of cases leads to pyelitis. The 



1 Schleip, Deutsch. Arch. f. klin. Med., Ixxx. 



2 Staubli, ibid., Ixxxv. 



