558 THE ANIMAL PARASITES, OF MAN 



aroused a suspicion of trichinosis which has been later confirmed. Perhaps 

 the eosinophilic cells originate from the polymorphonuclear neutrophilic cells 

 of the diseased musculature. 



Lately, in isolated cases, the temporary absence of the patella tendon reflex 

 as well as anomalies of the electric contractility of the muscles has been deter- 

 mined. 



The urine shows the usual characteristics of fever urine. Konne and 

 Hopfner have recently called attention to the not infrequent occurrence of 

 parenchymatous nephritis. Menstrual irregularities are common in some 

 epidemics. In pregnant women abortion is not rare. 



Insomnia is one of the chief complaints of the patient. The mind, as a 

 rule, is perfectly clear; only in severe cases associated with high fever does 

 delirium occur. 



It is obvious that the nutrition must suffer, particularly in grave cases. 



In mild cases the course of the disease is from one to two weeks; in all 

 other cases one to two months intervene before recovery takes place. Death 

 is not rare. The mortality varies in different epidemics. In Hedersleben the 

 mortality amounted to 39.8 per cent., in Calbe 21 per cent., in Burg 20 per 

 cent., in Klein-Quenstedt 14 per cent. In children a favorable course of the 

 affection is frequent; recovery often takes place at the end of the third week. 

 Complications are rare. The slight predisposition of children to trichinosis 

 may be accounted for, first, by the lesser activity of their gastric juice, and 

 secondly, by their more frequent fecal movements in consequence of which 

 large portions of meat containing trichinae may be discharged. 



At the AUTOPSY the intestines reveal but slight changes, and these consist 

 principally in a catarrhal condition of the small intestine. Swelling of the 

 solitary glands, of Peyer's patches, and of the mesenteric glands is observed. 

 In the intestinal mucus, up to the seventh week, intestinal trichinse are found. 

 Spleen is normal or enlarged. Fatty liver is frequent. Heart muscles and 

 kidneys often show granular opacity. Fatty liver and nephritis, according to 

 V. Linstow and Askanazy, are due to the toxic products of metabolism of the 

 trichinse. The lungs usually reveal the signs of a marked bronchitis. The 

 bronchial mucous membrane is intensely reddened, and has a tenacious mucus 

 coating. In the lower posterior portions lobular hepatization is revealed; 

 rarely hemorrhagic infarcts or metastatic abscesses. The color of the muscles 

 often resembles " smoked goose breast " ; the smaller muscles are much paler 

 and " wax-colored." From the end of the fifth week macroscopic changes in 

 the form of pale gray striae of from J to 1 cm. in length may be recognized. 

 Upon microscopic examination these are seen to be dark, granular, detritus- 

 like masses. Granular and fatty degeneration, sometimes also waxy degen- 

 eration, are found in the surrounding muscle fibers. Not rarely giant cell- 

 like structures are noted. Nonne and Hopfner describe the appearance of 

 vacuoles in the muscle fibers. In the later stages this musculature dis- 

 appears to a great extent and is pale. The number of muscle trichinae 

 may be enormous. The most intense permeation, according to Cohnheini, 

 IS found in the diaphragm, in the intercostals, in the muscles of the neck, 

 of the larynx and of the eyes, of the biceps and triceps. In milder cases 



