734: ACUTE INFECTIOUS DISEASES. 



red striae. The microscopic examination of such spots shows that in 

 them the muscular fibrillae have broken down to a granular detritus 

 mass, while the interstitial connective tissue is increased by fresh pro- 

 liferation. The number of trichinae in the muscles is the greater, and 

 the parts affected more extensive, the longer the disease has lasted. 

 In protracted cases we find even the muscles of the extremities con- 

 taining quantities of trichinae. This circumstance, and the experience 

 that even in the seventh and eighth week we find living intestinal 

 trichinae, filled with eggs and embryos, render it not improbable that 

 the intestinal trichinae bear young not only once but repeatedly, and 

 that they pass into the muscles at different times. The other changes 

 found in the bodies of trichina patients are not pathognomonic, and cor- 

 respond with those found in the bodies of persons who have died of 

 other diseases, accompanied by high fever and rapid exhaustion. Ac- 

 cording to Cohnheim, even the muscles have no constant and charac- 

 teristic appearances, except the above-mentioned anomalies, and a cer- 

 tain density and toughness, but in regard to their color and moisture 

 vary greatly, just as they do in typhus. In many cases there are signs 

 of extensive bronchitis, and of hypostasis in the lungs, or pneumonic 

 infiltration, and sometimes thromboses in the veins. Lastly, when the 

 disease has lasted a long while, and the fever has been very severe, in 

 some bodies we find the parenchymatous degenerations of the liver, 

 kidneys, and heart, which we have already mentioned. 



SYMPTOMS AND COURSE. Since Zenker, in 1860, made the impor- 

 tant discovery that the entrance of trichinae into the human body 

 caused a severe and even fatal disease, a number of violent epidemics 

 of trichinosis have been so carefully observed and described, that the 

 symptomatology of the newly-discovered disease is now as well de- 

 termined as that of most other maladies that have been known a long 

 time. 



Before the trichinae which have entered the stomach are set free 

 by the digestion of the flesh in which they are embedded, the patients 

 have no trouble. In some cases, which Renz calls insidious trichino- 

 sis, even when the trichinae have become free, when they have mated 

 and are rearing their young, and when the young brood perforate the 

 intestinal canal, there are no signs of an intestinal disease. Such pa- 

 tients have a good appetite, regular bowels ; they feel fatigued and 

 depressed, and complain of travelling pains, and a certain stiffness in 

 bhe limbs, it is true, but they can go out and attend to their business. 

 Gradually the vague pains are localized in certain muscles : these swell, 

 become hard and rigid ; oedema, fever, and other symptoms characteris- 

 tic of trichinous myositis are developed. It is most probable that, when 

 the disease runs this course, onlv a few trichinae have reached the stonv 



