818 PARASITIC DISEASES, 



general malaise ; to which succeed nausea and retchii.g, prostra- 

 tion, diarrhoea, a sense of thorough indisposition, and a painful 

 stiffness about the neck and arms and legs. This pain is due 

 to the immigration of the young trichince into the muscles ; and 

 it is accompanied with high fever, and an oedematous swelling 

 about the eyelids and face. The pulse is frequent, and there 

 are copious offensive perspirations ; but although the temperature 

 of the body is raised it does not reach the same height as in 

 typhus and typhoid fever. For some days the stiffness of the 

 limbs continues to increase ; while all the muscles seem to be 

 painful and swollen and very sensitive to the touch. The 

 movements of the intercostal muscles in respiration are attended 

 with suffering, so that repose is impossible ; while there will be 

 troublesome hiccup if the diaphragm be invaded, with hoarseness 

 and loss of voice where the laryngeal muscles get inhabited. 

 Neuralgia of a very severe description, in the cceliac and mesen- 

 teric plexuses, has likewise been present in certain cases. When 

 a large quantity of trichinous meat has been eaten, so that the 

 immigration of the trichinee into the muscles is great, the patient 

 may lie almost paralyzed in a state of great exhaustion. The 

 facial oedema generally lasts about a week, its disappearance 

 being followed by swelling of the feet and legs, and ultimately 

 of the trunk. There is no effusion, however, into any of the 

 cavities ; nor does the urine become albuminous, although it is 

 always lessened in quantity and may be loaded with urates. 

 A.bout the beginning of the fourth week the patient is in a 

 pitiable condition. The pulse and respirations are very frequent, 

 the tongue is red and dry, the pain is severe, the sweating is 

 profuse, the mouth can scarcely be opened, no sleep can be 

 obtained, and there is great anxiety or delirium ; death not un- 

 frequently occurring with all the symptoms of profound exhaus- 

 tion. Such complications as pneumonia, peritonitis, and pleurisy 

 with effusion, are not uncommon. In favourable cases, however, 

 the pain and swelling and diarrhoea abate ; the oppression of 

 the chest passes off ; sleep is obtained ; a desire for nourishing 

 food is evinced ; the power of the limbs is regained ; and there is 

 only left great anaemia, with a falling off of the hair, &c. Tlie 

 parasites have taken up their abode in the muscles, and have 

 fortunately become encysted." 



It appears that the symptoms are much more severe in the 



