738 



ACUTE INFECTIOUS DISEASES. 



bered later in the disease, since it is proved that, after weeks, liv- 

 ing intestinal trichinae, filled with embryos, may exist in the bowels, 

 and consequently it is not improbable that there may be new emi- 

 grations of trichinae into the muscles. The presence of diarrhoea 

 should not deter us from beginning the treatment with a few doses 

 of calomel or castor-oil, and, if necessary, repeating this treatment 

 occasionally, as advised by Ruprecht. It does not seem to me to 

 be proved that benzine, of which Hosier gives 3 j to 3 i j in gela- 

 tin capsules, is inefficacious against intestinal trichinae, so that we 

 should cease using it. The rest of the treatment is symptomatic. 

 For the fever, quinine is advised ; for progressive prostration, stim- 

 ulants ; for the subsequent anaemia, the preparations of iron. Mos- 

 ler proposes, as the most efficacious remedy for the painful swelling 

 of the muscles, the use of long-continued warm baths. 



[The origin of the trichinae in swine is an interesting question. 

 The assertion that the disease originates in the rat is doubted, for it 

 is said that trichinous rats come from slaughter-houses, where they 

 may have fed on hogs' flesh. It is at least as probable that trichinae 

 are original with swine as that they are so with rats ; and they 

 may be propagated by pigs which eat offal of other pigs containing 

 intestinal trichinae and embryos, or by their eating the flesh itself, 

 as sometimes happens.] 



ADDITIONS TO THE REVISED EDITION OF 1880. 



SECTION I. ACUTE INFECTIOUS DISEASES. 



1. P. 586. 



Bacteria have been found in the blood of scarlatina patients, as 

 in that of measles and small-pox patients ; when rabbits were inoc- 

 ulated with this blood, the bacteria were found in their blood. Dr. 

 Carpenter thinks that scarlatina is sometimes caused by decompos- 

 ing blood from slaughter-houses. It has been variously stated that 

 cases occur from defective sewerage. The sources of contagion are 

 so varied and often so obscure that in a large city at least it is dif- 

 ficult to exclude this mode of origin from any case. 



Among the complications of scarlatina, acute nephritis is proba- 

 bly the most common. Its symptoms usually begin in the desqua- 

 mative stage during the third week. In this stage also comes a 

 rarer complication, viz., acute articular rheumatism ; this has the 

 same symptoms and endocardial complications as simple rheuma- 



