556 THE ANIMAL PARASITES OF MAN 



does not prevail ; pork is either well cooked or boiled or smoked, and trichina 

 epidemics are rare. The question is much discussed, whether infection may 

 be brought about by the importation into Germany of American ham and 

 bacon. According to Billings trichinosis is met with in American pork in 

 4-5.7 per cent., but the above question, has been answered in the negative by a 

 majority of authors. Some observers, however, hold a directly contrary opin- 

 ion. Caution is therefore enjoined. Nevertheless, sporadic cases may and 

 will occur everywhere in the future. 



No age, no sex is exempt; all who partake of infected meat, either raw 

 or in a half-cooked state, are attacked. The severity of the disease depends 

 upon the amount of meat and the number of trichinse consumed. Man 

 appears capable of harboring a certain number of muscle trichinae without 

 symptoms. This is, at least, indicated by the accidental finding of muscle 

 trichinse at the autopsy of individuals who during life had shown no 

 symptoms. 



The SYMPTOMS produced by trichinosis correspond to the phases of develop- 

 ment of the trichinse. Frequently, a few hours after the ingestion of meat 

 containing trichinse, severe gastric and intestinal symptoms appear: Nausea, 

 vomiting, cardialgia, vertigo, headache, heaviness in the limbs, constipation 

 or diarrhea. If the infection be severe the symptoms often increase and simu- 

 late a severe intestinal catarrh, which in isolated cases may run its course 

 with choleraic symptoms. With increasing lassitude a more or less decided 

 fever develops. The patients become bedridden, v. Linstow quite properly 

 regards the severe initial intestinal symptoms as toxic, due to the toxic 

 products which have been set free by the dissolution of the capsules. The 

 presence of intestinal trichinse in the dejecta has up to the present been rarely - 

 demonstrated. 



In many cases, initial intestinal symptoms are wholly absent, and it is 

 therefore impossible to determine the period at which infection occurred. 

 There are indistinct symptoms ; rheumatic pains in the limbs and fever ; indi- 

 vidual muscles begin to swell and become edematous. Briefly, the symptoms 

 are those of myositis. Simon, Kratz and Rupprecht mention as characteristic, 

 even from the first days of .the disease, the so-called " sympathetic muscle lame- 

 ness." This consists in a drawing sensation in the limbs, tension and tender- 

 ness in the muscles, such as is observed otherwise only after unusual muscular 

 exertion. The flexors, the muscles of the nape of the neck, and those of the 

 lumbar region are particularly involved. Sometimes in the first, more fre- 

 quently in the second, week, Kratz observed neuralgic pains in the abdomen 

 which, recurring at irregular periods, sometimes as often as six times in the 

 twenty-four hours, resembled a neuralgia ccBliaca. 



The gastric and intestinal disturbances are frequently accompanied hy fever. 

 Only^ in mild cases is this absent during the second half of the second week, 

 and It is decidedly increased when the muscular symptoms become manifest. 

 Chillmess frequently accompanies the fever, though marked chills are rare. 

 The maximum rise of temperature (104° to 105.8° F.) is usually observed from 

 the ninth to the eleventh day after the beginning of the malady. At first con- 

 tmuous, the temperature finally shows a remittent type. The return to nor- 



