Mother's Remedies Part 12

When the flesh containing the trichinae is eaten by man or by any animal in which the development can take place, the capsules are digested and the trichinae are set free. They pa.s.s into the small intestine and about the third day attain their full growth and become s.e.xually mature. The young produced by each female trichina have been estimated at several hundred.

The time from the eating of the flesh containing the muscle trichinae to the development of the brood of embryos in the intestines (bowels) is from seven to nine days. The female worm penetrates the intestinal wall and the embryos are probably discharged into the lymph s.p.a.ces, thence into the venous system, and by the blood stream to the muscles, which const.i.tutes their seat of election. After a preliminary migration in the inter-muscular connective tissue, they penetrate the primitive muscle- fibres and in about two weeks develop into the full grown muscle form. In this process interst.i.tial inflammation of the muscle is excited, and gradually an ovoid capsule develops about the parasite. Two, and occasionally three or four, worms may be seen within a single capsule.

This process of encapsulation has been estimated to take about six weeks.

Within the muscles the parasites do not undergo further development.

Gradually the capsule becomes thicker and ultimately lime salts are deposited within it. This change may take place in man within four or five months. The trichinae may live within the muscles for an indefinite period. They have been found alive and capable of developing as late as twenty or twenty-five years after their entrance into the system. These calcified capsules appear as white specks in the muscles. In many instances however these worms are completely calcified. In the hog the trichinae cause few if any symptoms. An animal, the muscles of which are swarming with living trichinae, may be well nourished and healthy looking.

An important point also is the fact that in the hog the capsule does not readily become calcified, so that the parasites are not visible as in the human muscles.

Modes of Infection.--The danger of infection depends entirely upon the mode of preparation of the flesh. Thorough cooking, so that all parts of the meat reach the boiling point, destroys the parasites; but, in larger joints, the central portions are not often raised to this temperature. The frequency of the disease in different countries depends largely upon the habits of the people in the preparation of pork. In North Germany, where raw ham and wurst are freely eaten, the greatest number of instances have occurred. In South Germany, France, and England cases are rare. Salting and smoking the flesh are not always sufficient, and the Havre experiments showed that animals are readily infected when fed with portions of the pickled or the smoked meat as prepared in this country.

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Symptoms.--The eating of trichinous flesh is not always followed by this disease.

In the course of a few days after eating the infected meat there are signs of disturbance of the stomach and bowels, and pain in the abdomen, loss of appet.i.te, vomiting and sometimes diarrhea; and yet, these preliminary symptoms do not always occur, for in some of the large epidemics cases have been observed in which they have been absent. Pain in different parts of the body, general debility and weakness have been noted in some of the epidemics. In some instances the stomach and bowel disturbances have been so marked from the outset that the attack resembled our cholera. The invasion symptoms develop between the seventh and tenth day. Sometimes not until the end of the second week, and they are marked by fever, a chill in some cases and pain and swelling and tenderness along the muscles involved. The migration of the parasites into the muscles excites a more or less intense inflammation of these muscles, which is characterized by pain on pressure and movement, and by swelling and tension of the muscles, over which the skin may be swollen. The limbs are placed in some position in which these muscles are more at rest. Difficulty in chewing and swallowing is caused by the involvement of the muscles controlling these acts. In severe cases the involvement of the diaphragm and intercostal muscles may lead to difficult breathing (Dyspnoea) which sometimes proves fatal. Watery swelling, a feature of great importance, may be seen early in the face, particularly about the, eyes. Later it develops in the extremities when the swelling and stiffness of the muscles are at their height. Profuse sweats, tingling and itching of the skin and in some instances hives (Urticaria) have been described.

There are emaciation and anemia. In the severe cases the appearance may be like that in the third week of typhoid fever. In mild cases the fever and muscular symptoms subside in ten to fourteen days, in others only after two or three months. The mortality, from one to thirty per cent, seems to depend upon the virulence and number of parasites.

PHYSICIANS' TREATMENT.--If discovered within twenty-four to thirty-six hours, thoroughly empty the bowel with purgatives. Rhubarb and senna, or an occasional dose of calomel may be given. Relieve the pains afterwards and support the strength.

[SKIN DISEASES 53]

DISEASES OF THE SKIN.

The skin is divided into three layers. Beginning with the outer one and naming inward, they are named as follows: The outer layer is called the epidermis or cuticle (near or upon the skin). The second layer is called the corium, derma cutis vera, or true skin. The third layer is called the sub-cutaneous (under the skin) (fatty or connective) tissue. This last layer contains the sweat glands, the lower end of the deep-seated hair follicles, (little sacs containing the roots of the hair) and larger branches of the lymphatics, blood vessels and nerves, and serves in general as a bed for the true skin to rest upon, and by which the true skin is connected with the deeper parts, muscles, etc. The appendages of the skin are the hair, nails, sebaceous and sweat-glands. The discharge from the sweat-glands form a little or larger tumor. The contents of a wen are from sebaceous glands--fat secretions--fat tumor. The following names are frequently mentioned in the skin diseases:

Macule. (Spots, patches). Skin is altered in color, but the skin is not raised or depressed; freckle, etc.

Papule. (Pimple). Elevated piece of skin, varying in size from a pin-head to a coffee bean.

Tubercle. (Node-lump). A solid elevation of the skin, varying in size from a pea to a cherry.

Tumors. These are soft or firm elevations of the skin, like a wen or hard lump. They are always deep-seated.

Wheel. A round flat, white or pink elevation of the skin; such as hives, mosquito bites, etc.

Vesicle. This is a pin-head or pea-sized elevation of the outer layer (epidermis) filled with a watery fluid.

Bleb. (Bulla). A circ.u.mscribed elevation of the skin and contains a watery fluid, such as a burn, etc.

Pustule. A rounded elevation of the outer layer (epidermis) of varying size, containing pus (matter).

A vesicle, bleb, and pustule are hollow; macule, papule, and tubercle are solid.

Scale. (Squama). This is a dry attached or unattached thin piece from the skin as a result of disease of the skin.

Crust. This is a dried ma.s.s as a result of fluid oozing from a diseased skin.

Excoriation. Like a scratch mark.

Fissures. This is a crack, like that found on chapped hands.

Ulcer. (Sore). Eating away of the parts.

Scar. Ulcer healed leaving a mark, like from a healed cut.

Pigmentation. Discoloration.

ACNE. (Simple Acne).--This is an inflammation of the sebaceous (fatty, cheesy) glands. It forms these pimples or pustules and these are intermingled with black-heads (comedones), flesh-worms. They vary from a pin-head to a split-pea in size, and are of a bright or dark red color.

They occur for the most part on the face; also on the back, neck and chest.

Condition.--An over secretion, or alteration and retention of the fatty (sebaceous) matter, and this is followed by inflammation involving the glands, ducts of the glands, and hair follicles. Pus often forms and tissue may be destroyed.

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Causes.--These skin glands are active at the time of p.u.b.erty. The active cause may be the stomach troubles, constipation, womb disorders, and poor general nutrition.

PHYSICIANS' TREATMENT for Acne.--All stomach troubles, constipation, and womb troubles should be looked into and remedied. The diet and hygiene must be regulated. Food that stimulates and is hard to digest should be prohibited. When there is dyspepsia and constipation, bitter tonics, like compound tincture of gentian, one dram before meals, or pepsin (five grains) and loosening medicines like salts should be given.

Tincture of Nux Vomica is a good stomach and bowel tonic given in doses of one to two drops before meals.

Calomel, one-half grain at night for a few nights, followed in the morning by epsom salts or some mineral water like Abilena or Hunjadi is useful.

The following is a good combination by Dr. Schalek:

Tincture of Nux Vomica 2 drams Dilute Nitro Muriatic Acid 4 drams Sherry Wine enough for 3 ounces

Mix and take one teaspoonful three times a day.

Diet.--See diet for dyspepsia and constipation. All fatty, greasy, rich foods are prohibited.

Local Treatment.--If the skin is quite red and tender, mild soothing applications should be used. Most cases require vigorous treatment. First wash the parts with warm water and the best soap, rinse with hot water and then dry carefully. Remove the black-heads by careful pressure of the fingers, or with black-head extractor; the pimples and pustules should be freely cut, to allow the matter to escape and all the matter taken out.

External Medication, Ointment and Lotions.--Lotions are to be preferred in cases of oily discharge. If the skin becomes rough and chapped, soap should not be used in washing, and a soothing ointment should be applied.

Drugs used are for stimulating the skin and healing the lesions.

1. Soothing Ointment.--

Precipitated Sulphur 1 dram Benzoinated Lard 1/2 ounce Lanolin 1/2 ounce

For local use but not in oily cases. (Dr. Schalek.)

2. The following used as a soothing lotion:

Washed Sulphur 2-1/2 drams Spirits of Camphor 3 drams Biborate of Sodium 2 drams Glycerin 6 drams Distilled water enough for 4 ounces

Mix and shake well and apply freely so as to leave a film on the face.

(Dr. Schalek.)