Pomegranate root   1/2 ounce
Pumpkin seeds        1 ounce
Powdered ergot       1 dram
Boiling water       10 ounces

To an emulsion of the male fern (a dram of the ethereal extract) made with acacia powders, two drops of croton oil are added.  The patient should have had a low diet on the previous day and have taken a dose of salts in the evening.

The emulsion and infusion are mixed and taken at nine in the morning.  If the bowels do not move in two hours, salts should be taken.

4.  An Old Remedy.—­Chew freely of slippery elm bark.  This, it is stated, is very effective and as it is cheap and will not injure, it is worth a thorough trial.  I am often surprised at the value of the seemingly simple remedies.

[Animal parasites 51]

Trichiniasis (Trichinosis).—­The disease is caused by the trichina spiratis, a parasite introduced into the body by eating imperfectly cooked flesh of infected hogs.  The “embryos” pass from the bowel and reach the voluntary muscles, where they finally become “encapsulated larvae,”—­muscle trichinae.  It is in the migration of these embryos that the group of symptoms known as trichiniasis is produced.

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 pass into the small intestine and about the third day attain their full growth and become sexually 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 spaces, thence into the venous system, and by the blood stream to the muscles, which constitutes 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 interstitial 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.