294 TRICHINA WORMS 



The duration and final outcome of the disease is variable, 

 according to the heaviness of the infection. Death, as remarked 

 before, may frequently result, and according to Ransom most 

 commonly occurs from the fourth to the sixth week. It rarely 

 occurs before the end of the second week or after the seventh. 

 Recovery usually does not occur in less than from five to six 

 weeks after infection, and often not for several months. Re- 

 current muscular pains and weakness may continue for years and 

 a stiffness may persist indefinitely in the invaded muscles. Com- 

 monly cases in which a copious diarrhea appears early in the 

 disease are of short duration and mild in type. Young children, 

 due either to smaller quantities of pork eaten or to greater tend- 

 enc}' to diarrhea, are likely to recover quickly. 



Treatment and Prevention. — The search for a specific remedy 

 for trichiniasls has so far been futile. Even the adult worms in 

 the intestine are much more difficult to dislodge or destroy tliaii 

 are other intestinal worms, since they bore so deeply into the 

 intestinal walls that the ordinary drugs do not affect them. Even 

 were it possible to drive out the adults readily, this often could not 

 be done in time to prevent disease or death, since the infection is 

 seldom recognized before the larvae are already produced and are 

 migrating throughout the body. This is the critical stage of the 

 disease; if the system can endure the irritation and inflam- 

 mation produced by the burrowing of millions of worms and 

 can withstand the effects of the toxins produced both from the 

 worms themselves and from the destroyed tissues during the 

 first and heaviest onslaught of the newly produced larvae, the 

 danger is past. The fever, the muscular pains, amounting to 

 agony for a time, and the intestinal disorders continue for weeks 

 but gradually subside. The treatment employed during all this 

 time can only be systematic and of general nature — efforts to 

 reduce the fever, to permit sleep, to keep the digestive system 

 in as good order as possible and to do all that can be done to keep 

 up the vitality and general health. 



It is possible that if the trichina worms could be isolated and 

 ground up, and injected into the blood, an active immunity 

 could be built up as in the case of typhoid vaccinations. Passive 

 innnunity by injection of serum from a convalescent has been 

 stated by Salzman to have some curative as well as preventive 

 value, but this work needs confirmation. The disease, however, 



