228 
F. S. BILLINGS. 
walls of tho intestines, along the connective tissue tracts, and into 
the adjoining musculature. Although the parasites may not bore 
directly through the fibre of the muscles of the intestinal mus¬ 
cles, but penetrate the walls by going between these films, thus 
separating them one from another, still, the passage of thousands 
of parasites through these tissues must cause much mechanical 
irritation, causing inflammation of the coatings of tho intestines, 
thereby giving rise to an inflammatory gastro intestinal catarrh, 
with more or less diarrhoea and vomiting, which are to be looked 
upon as the initial symptoms of a severe case of trichinosis, and 
frequently might be mistaken as “ choleroid ” phenomena. We 
never find fibrinous deposits or other intimations of inflammation 
upon the peritoneum, not even vascularisation as in mice, rabbits 
and swine, because the tissues arc coarser, and therefore an in¬ 
flammatory reaction in them is not so easily the result of the par¬ 
asitic migration in man as in these animals. 
Death may follow toward tho end of the first, and still more 
frequently in the second week of the invasion, especially when 
the complicated organisms have been antecedently in poor con¬ 
dition from diarrhoea, tubercular consumption, diabetes and kin¬ 
dred diseases. The cause of death may be attributed to exhaus¬ 
tion of the respiratory muscles in consequence of general disinte- 
giation of their active elements. On account of the great danger 
which threatens tho invaded organism, it is very important that 
these early phenomena of the choleroid form, which have in gen¬ 
eral very little characteristic about them, should be promptly'sus¬ 
pected. They generally indicate a most fatal and extensive inva¬ 
sion, especially when the pork has been purchased from a butcher 
or eaten by a large number of persons in a hotel, garrison, &c. 
At this early period one does not find the parasites in the motor 
muscles. The parasites are easily to be found in the lumen of the 
superior intestines and the foeces. 
Cholera, either in its epidemic or sporadic form, has so many 
chaiacteristic peculiarities that nothing but superficial observation 
can make possible a mistaken diagnosis btween the two diseases. 
Children are especially subject to choleroid attacks during the 
first ten years of their existence, giving one-quarter to one-half 
