Sawbones: A Marital Tour of Misguided Medicine - Sawbones: Trichinosis

Episode Date: June 13, 2019

We all know it's probably smart not to eat raw pork, but this week on Sawbones, we'll meet the inspiring people brave enough to ask "Why?" (Note: We're publishing this week's episode a little early because we're headed out on tour!) Music: "Medicines" by The Taxpayers

Saubones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, time is about to books. One, two, one, two, three, four. Hello everybody and welcome to SoRloans, Emerald Tour of Miss Guy,

to Medicine, I'm your GoHos, Justin McAroy. Oh! Oh! Oh! Oh! Oh! And I'm Sydney McAroy. Oh!

Oh! Oh! Oh! Oh! About the same. That time I was about the same. Oh, that's cool. That's about the same. That's about the same. That time I was about the same. Oh, that's cool. It's about the same that time.

It's pretty close. We are, if you live in Huntington, what's Virginia? And you want to see concert. You're going to come to Cincinnati. It's kind of like a home away from home. If you had concerts at your home. That's true. that's true. If you had asked me when I was like a teenager,

what do you know about Cincinnati? I would have said Bo-Garts. Bo-Garts? It's where I talk about shows. Jimmy Buffett plays a river band every year. Jimmy Buffett. It's where I facilitated Sydney's dad meeting Jimmy Buffett and basically becoming the greatest son of law

and reading the history of all time. That's true. No big deal. It's the Queen City. I don't need to tell you that. And you didn't even mention the Smurf Ice Cream at King's Island. Smurf Ice Cream at King's Island. Her they're getting some faceless on Main Street,

putting a little funding into that, bring the antique cars back. Love it. Bring back Tomb Raider and we'll talk. Ain't street putting a little funding into that, bring the antique cars back, loving. Bring back Tomb Raider and we'll talk. Yeah. Anyway, anyway. So when we first started talking about what do we wanna do a show on in Cincinnati, Justin's first suggestion was, well, chili. Yeah.

And, and inexplicably, we've done a show on chili. That's the kind of podcast this is. We've already done chili. In our medical history podcast. I suggested a lot of whack things that were only tangentially related to Cincinnati. Yes. And so, I just started looking into the history of Cincinnati.

And I found a nickname that the city used to have. That maybe has gone away for the years, because I think people weren't a big fan of it. Or maybe it's hot as ever, and it's back. We have no idea if you're not locals. But apparently, you're fine cities to be known as Port Gopolis. So Sydney hears that, and she decides to do an episode on? Trick and Ella.

Okay. I mean, when you think of pigs, of course you think of eating raw pigs and how that could make you sick, right? It's what everybody thinks about. Just catching all Wilbur and getting a big bite. Now, let me preface with, before I start talking about worms in your food, that this is incredibly rare and almost never happens in the US anymore. So this is not something to worry about.

Unless you're a big fan of consistently eating raw pig and other wild game, then you might. But otherwise, don't worry about it. But it used to be a bigger problem. And so I thought we could talk a little bit about chicken allosis. And for everybody who's like, I know I shouldn't eat raw pork, but I don't know why.

This is why. So as we already alluded to, Cincinnati used to be the biggest pork producing city in the world in the 1800s. And meat was packed and shipped down the Ohio River, and the city obviously was called pork opulence because of that. And that is why one of your fine local delicacies that used to be called strip grutes or dunking grits. But now you call Getta. That's sort of the connection there.

I think Getta is a way better name, by the way, than Dunkin' Grits. I'm on the fence, honestly. But extremely good. I wouldn't eat Dunkin' Grits, but Getta's good, so I'll eat that. Sidney told me that Cincinnati is like the number one producer of Getta, and I was like, nah, nice.

She said, they're also the number one consumer of it. I was like, that's beautiful. I love that they're also the number one consumer of it. I was like, that's beautiful. I love that. The self-contained ecosystem of ghetto. I'm into it. It's good. And I like pork. I like sausage.

I like nuts. I like spices. What do we got? We got ghetto, Justin. So you're probably aware that pork has been, has had certain religious prohibitions throughout history as to who should consume it and who shouldn't. And there are lots of reasons for that, but one thought throughout ancient history is that it may be also due to the fact that people would observe someone eating pork back

before we had proper cooking techniques and preservation techniques, and then they might get really sick. And so that would be a really good reason to say, like, don't eat any pig. That's a bad idea. There are lots of other reasons, but that's one possibility. The reason is triccanella. Now triccanella is a kind of worm. It's a kind of round worm.

And it's actually a genus of multiple different round worms, different species. The way your eyes slide up, you used to look at me that way. The way your eyes, whenever you get to talk about worms. I love worms, I love parasites. I love parasites. Uh... ... ...

Dude! Fine, it's fine. It's fine. It's fine. It's fine. They're just trying to... It's fine. They live their little lives and they happen to cause some damage in their while they're doing it. They don't mean to. Anyway, so there are seven different species that can cause problems for humans. There's one in particular, Trichanella spuralis, which causes most disease in humans, but there's

a variety of roundworms that can cause problems. We always associate them with pigs, like we always say don't eat raw pork or under pork because you'll get a worm of some sort. But there's actually a variety of animals that could cause this problem. So pigs kind of get like an unfair shake here because some more recent cases have been because of horses. Eating raw horses.

Bears. Eating raw bears. Moose or wild boar. You mentioned getting sick, and you're just like, have you done anything totally but wild lately? I did eat a raw bear. Is that frown on in the mental community?

I'm up to date on the literature. I know that this has always been an easy thing for me because I've always been a fan of meat that maybe is more cooked than everybody else likes it. I like my meat done, sorry. But generally speaking, if you're not sure how long you should cook meat, just keep cooking it. Don't eat it.

Is that bear done? I don't know. Let's keep going. Just be really sure. I'm not taking Be really sure I'm not taking chances So what happens is the larva of the worm are in that they're actually in the muscles So they're in the meat that you're eating and they're in sit there in these little cysts and because the meat wasn't cooked thoroughly

They're still viable in there. So they're just these Little cysts in your meat and you're eating them. And once they get into your stomach, some of the chemicals in there, the pepsin and the acid, the gastric acid, can start helping these cysts open up and blossom into little baby worms that then can, you know,

burrow into the walls of your small intestine where they grow into adult worms. Good, yes, good, yes, good. Uh, they're good. They're good. Good, yes. They're just like a couple millimeters big. Not even that big of a worm.

Oh, welcome. Welcome aboard, friend. Welcome aboard, sprout. Welcome aboard, Sprout. Little fella. There's massive tapeworms or anything. There's a little worm. Just a little worm for fun. For the weekend.

A weekend worm. For kids. So they grow and they grow over the course of four weeks, and then they can start releasing their own larva. And she gets nice. And to your body. They grow up so fast, don't they? And those little larvae can migrate.

Unrise, sunset. Unrise, sunset. Those little larvae can migrate all over the place, and mainly into your muscles. It's a sad part. You wanted him to stay at home. I'm just going to go wherever they're going to go. It'd be better if they just stayed in your GI tract because then they would. That's what I tell them. Naturally.

Exit at some point. You kids don't know what it's like out there. Stay on the GI tract with papa. But they... The papa will protect you But they don't go the kidneys Tough characters over there. They don't typically go to the kidneys It was a joke. I'm just saying How could you embarrass me in front of Cincinnati?

They mainly like to just go to like your skeletal muscles So they'll just be in like your arms or your legs or just in your big muscles We're in my big muscles And your papa muscles. I'm in trouble If they love oh no, these worms love big muscles Don't it Hoistor by my own pertard. So if you only get a few larvae that travel around to your muscles, and by a few, I mean

less than 10 per gram of muscle would be a few, which still seems like a lot. You might not ever know that anything has happened to you. You may just have these, just have some more. Yeah, just have these insisted larvae in your own muscle. They just get there and some species make sense. Some don't, the ones you probably would get do and they just kind of insist and chill in your muscle for a long time. If you do get a larger infection, then you will have some symptoms. The first stage is when they're in your stomach, when they're in the intestinal stage,

and then you're gonna get like what you think of as general, like I have a parasite symptoms, my stomach hurts and I'm nauseous and I'm vomiting and I have lots of diarrhea. Lots of diarrhea is an interesting. I feel like it's one of the situations where some diarrhea is lots of diarrhea, you know? I've got diarrhea, but it's a manageable amount. As a member of the Macroi family, I have found that that's a relative term.

Once they get to your muscles, they hurt. If you get enough of them in there, just a few, you won't notice it. If you get enough in your muscles, then they can start causing pain and weakness and tenderness. I mean, if you get a lot in there you can be bed ridden because of the pain of all the little cysts in your in your muscles you get fevers there are some rare cases where people get really sick that it has been fatal throughout history but it's not commonly that serious but it can infect things like your heart muscle and obviously that's a big deal

it can inflame your central nervous system. So in rare cases it's been deadly, but most of the time that doesn't happen. Most of the time these little cysts migrate to your muscles. It might hurt a lot at first, but then after they insist they start to calcify over time and they die, and then they're just there. Mmm. And that's... That's it. That's it, end of story. And we have found them. We know that they have existed with humans for a very long time.

Because we found these little cysts, these little calcified cysts, in a 3,200-year-old mummy that we dug up. And we looked through the muscles and found all these little white things that were opened up and found to be trick-n-e-l-assists. So at some point, this Egyptian dude ate some raw meat of some sort and got trick-n-e-l-l-a. Probably bear. It would have been, he probably either would have been a member of the upper class or somehow associated with the upper class because otherwise he wouldn't have had access to meat. That's the only thing I know. They named him.

Warm man. McCot. McCot ate meat and they don't know why because they think he doesn't look like the upper class but he did get some meat because we have all these systems. Good for him. Yeah, good for him. He's on that grind. You can get your meat. Medicine, medicines, the estimate my copy for the mouth. So there is a, there are records throughout history of diseases that kind of sound like they were probably trick-and-le-la, even if we didn't know that, nobody wrote like, oh, we found worms in their muscles because nobody looked for them.

But if you go back to like 404 BCE, you find this record of a disease with severe dysentery, and there was pain all over the body, and it was like in certain parts of Sicily, and it sounds a lot like it was probably tricanella, so modern-day scholars have thought, well, maybe this was a big outbreak of tricanella. You find other times where there was something called the English sweat with a pseudo-englicus.

That was my wrestling name. And you find instances of this, all there are the 15th and 16th century. And the thought is that these might be outbreaks of Trichonilla. So somebody got like some sort of, they brought down some wild game or something and like shared it with a big part of their village and everybody ate this meat and then everybody got sick. And so you'd see these like isolated outbreaks

where a bunch of people got sick, probably from sharing a big infected animal. And then it would go away. And they often called it things related to sweating because you'd be in a lot of, you'd get the fevers in the stomach pain and you'd sweat a lot and then you'd get all this muscle pain and you'd sweat even more. And so the sweating fever, the sweating plague, sometimes it was called things like dandy fever. I don't know why. Feb. Diaria because you got diarrhea and a fever. So all these different names throughout history,

especially in Germany, there were a lot of cases that happened in Germany. They had a lot of problems with parasites. And so you saw a lot of these pseudo-anglicus cases. Of course, they blame the English. The Germans were like, it's the English. They sent the sweating sickness down to us. And again, it's all the same thing

where you get descriptions of an illness that probably is trick-and-allow-by, you know, we don't know for sure. We think so. We didn't figure out the worm that was responsible until the 1800s, and there was like, the nicest, most like collegiate little battle over who first discovered it.

It's like a very polite controversy. And it's really not between the two original guys. It's like scientists throughout history who write about it. So. It's almost like they weren't eager to be known forever as Dr. Pigworm. I really think it's like, well, we found this gross worm. It's so gross. Don't tell my kids. My buddy found it.

On February 2nd, 1835, James Paget was a medical student, and he was practicing at St. Bartholomew's in London. And he was dissecting the cadaver of this guy who had died of tuberculosis, but he found in his muscles all of these little white, calcified cystic structures. And he thought this was very odd. He didn't know what they were. So he called them anemacules at first. Thought they would be tiny little animals that had infested. Accurate. Sort of. Sort of. And so he-

Sort of. There were arms. There were animals. Tiny animals. Yes. Yes. So he was sort of right. And so he started- Not sort of. Littleuss. Stop it. He did it with no knowledge whatsoever. It was very impressive. He had to go like borrow a microscope because he didn't have like a good one. He had to go around like the department like does anyone have a microscope? I don't know what these are and I need something. My microscope sucks. Does anybody have a good one? I don't know.

I'm pretty sure there's little animals in here. So he went around. So he was like, I don't know. I'm pretty sure there's little animals in here. So he went around. So he was like, I don't know. I'm pretty sure there's little animals in here. I'm pretty sure there's little animals in here.. My microscope sucks. Does anybody have a good one?

I don't know. There's little animals in here. So he went around until he found a good microscope and he started opening up these cysts and he saw that these were these little larvae. These were these little worms. And after he kind of made this discovery, he got the help of his anatomy professor, Richard Owen. And he got him to come take a look at him, and he actually helped him with figuring out exactly what part was

what, and what are we looking at, and getting a better dissection of the cyst, and all this kind of stuff. And so when it all came to present it, and Pazzie wrote this up, by the way, which if you're in the scientific field, you know that's like a big deal. He made this discovery and he wrote a whole like paper on it to be published, to send in, to say like, hey I found a new worm that nobody knows about and it might be responsible for some sort of illness and we can figure this out. But he never sent it anywhere. You can you can still read it. It's like in the historical record but he never sent it anywhere. He never published it because he said, you know what? Oh and is like

he's a better known guy. He has a lot more respect in the community, so I'm just gonna let my anatomy professor present the whole thing. So Owen presented the findings at the Zoological Society of London. Later that year he called it the fleshworm. Oh no. Oh no. Which is just the worst name? It's a terrible name. Just the worst. So he presented his Owens fleshworm. You messed up. And I mean the z zoological society, I guess, was just crazy about it. And he... Yeah.

It's almost like they wanted to say Owen's fleshworm a lot, because they nasty. And so he published the findings. And then he did. He mentioned that Paje also found it, but he really minimized his part. I think one of my med students may have been there. I don't know, med students, whatever. I think he was hanging around. So he really minimized

it. And so throughout history now, when you talk about who discovered Trichonelle, who found this one. You know how you talk about that sometimes? No, when you're at a dinner party. And somebody's like, let's talk about Owen's flesh work. And then there would be somebody else who'd be like, listen. Pajé found that worm. And Owen stole the credit and minimized his contributions. And I guess there's been this battle since then. Now, as far as Pajé and Owen were concerned, I don't think they really cared because Pajé was always like,

yeah, I love my mentor. Owen was great. I was really happy that he helped me out. And never said a bad word about him. So I don't think they really cared because Pajay was always like, yeah, I love my mentor. Oh, and what's great. I was really happy that he helped me out and never said a bad word about him. So I don't think he cared. But now you know the story. So the next time somebody gives, oh, and all the credit. In the conversation you have with them.

In your life, I mean. You can say not so fast. So once they had figured out, slow down. I want this conversation to last as long as humanly possible. I got to tell you about Paje. He just didn't have a good microscope if he had just had a decent microscope. So after that, over the next couple decades, a lot of scientists got involved and started

looking for these cysts and other cadavers and then eventually in animals to try to figure out where, because a lot of these things like parasites were getting from some sort of creature or something we're eating, something we're coming in contact with. And so they started looking in animals. A lot of these, again, were done in Germany, a lot of the early experiments, because this was a big problem. This was infecting a lot of people.

They were having a lot of outbreaks. So they were doing a lot of the early experiments to figure out what could get it. Eventually, Virchow and Zinker were the two big scientists doing all these studies and feeding muscle to different animals to try to see what they get infected if I do this. That kind of thing. Eventually Zinker figured out that pigs were a major source of this and that's where the connection came with pork.

And once Germany, the authorities, got wind that like, hey, we figured out that there's this worm that humans can get, and we're getting it from pigs, this actually created a lot of friction with the United States. Because at the time, Germany was importing a ton of pork from the United States. And so by default, a lot of the infected pigs were coming from the US,

because I mean, nobody knew about the worm. It wasn't like intentional, or nobody knew it was in there. And so this led to what was known as the German-American pork wars. Maybe not one of the most important wars that ever involved Germany, but I don't know, this is pork opalists, so. Maybe the button is wound still around you. So at the time, Germany imposed these strict bans on importing any American pork, and because

they did it, other European countries started following suit and saying like oh Well, we're not gonna get picks from America either and Americans were all mad about it and saying like it's not just I mean like we're just all learning about this It's not just our pigs like we can all do better screening meat and Anyway, there was this big like we're not gonna take your pork. Well, I don't know. We're we're not gonna take. Oh, yes you will We're already going to take your pork. Well, I don't know. We're not going to pick anything. Oh, yes you will. We're already in the abot. And what eventually had to happen is we had to find a way where we could like screen pigs and look for it and see if pigs were infected.

And they were able to do that. I like this because it's the most simplistic way possible. We need to figure out if pigs are infected. What can we do? Take a piece of pig muscle and put it between two slides. Just smash it and look under a microscope. And that is the, that's trick andoscopy, is what developed. And this was a whole scientific, like,

you just look under a microscope and look for cysts and say, like, not pig is good or not that pig is bad. It's good pig. Don't not that pig is bad. Pig. Something like... And what was this? Do you think that could have saved Wilbur? If he had had trickinosis? I mean nobody would have eaten him.

You're thinking that maybe Charlotte should have talked to a worm. If Charlotte had just written trickin' that one. Yeah. That's true. That's true. If Charlotte had just written Trick and Nellow. Yeah. That's true. That's true. But that dumb farmer was shady. He probably didn't like, oh well.

And the dude tarot down might nobody saw this web. Come on, sick little piggy. Just a little thing that I have learned. If you're a fellow parent or caregiver or raising a child and you think I'm gonna show them Charlotte's web because that was a pleasant film I remember from my youth just beat I mean I everybody remembers about Charlotte. I don't spoil it but Everybody knows that's coming but in the beginning there is a moment where that farmer is totally about to kill baby Wilbur and it's very intense. Just warn you, it's like be prepared.

I was not. Charlie was scarred by that. What is he doing? Why? I don't know, honey. I didn't condone it. I rushed upstairs when I heard her showing that. Like, no, how could you?

So eventually, in addition to being... It was a war they called it, though. I just want to clarify. I thought maybe that might have predated the wars, all of them, and they're like, you know what guys? This is a war. And then everyone else is like, it's wicked not. You just wouldn't take the pigs,

and then you did after you did some science. That's not a war. You know, in science, sometimes the stakes aren't high day to day. And we just like to feel the drama. Miner skirmish, the German American pork skirmish. German American pork police action. So they figured out how to screen the pigs, and then we figured out also that if you cook the meat enough, then it's not a problem. And that was a big breakthrough, which is why you can, you know, I do this every time I'm cooking any meat, I have to

like ask Alexa, like, what's the temperature that I'm supposed to cook pork to? And that's where all that comes from is because if we cook meat enough, then we don't have to worry about things like tricunella being in the meat, but screening was still part of it. And after that, obviously we could start, I don't know, sending pigs all over the world once again. What a relief.

It has become much less of a problem. Trick and Ella, like I prefaced with, is very uncommon these days in the vast majority of the world. There are still places that have had more outbreaks, still like not a lot in the grand scheme of things. But in particular, Romania has had a lot of trouble with controlling, like, sporadic outbreaks of chicken nela through the years. And there are a lot of reasons for that,

but one that I found really interesting, and because we do a show about things that, I don't know, I think are interesting, and I hope you do, is a certain festival that is celebrated in Romania, which is like, it's like pig slaughter day. Which, it's kind of a cool holiday. It's also the feast day of St Ignatius. And on December 20th every year,

they like bring pigs out and kill them. Like if you- You probably guessed that from the name. In front of everybody. And I don't know that this is necessarily something I want to attend in my life, but you might. But one of the things that they do, and you can, this can apply to any time

when you're freshly killing a pig to share with your family, friends, neighbors. But specifically, this festival, one of the things they do is as they're butchering the pig, they cut off pieces and cook them right away and hand them out to you, to eat as you are observing the rest of the process. This is so rough. Boy, that's rough, huh?

It's so rough. It's so rough. It's so rough. It's so rough. It's so rough. like as they are, you're already kind of moving on to while you watch them. And there's a specific like plum brandy that you drink with it, and they give you these first pieces, and they call it pig's alms.

And this is a very important festival, but this has, they think, been the source of some outbreaks of Trichonella, unfortunately. Again, more recently, especially in the US, pigs are not often responsible. They can be. But there have been cases where specifically, there was a big outbreak in California a few years ago.

And it was because somebody killed a bear. And then, at the dinner party that ensued, somebody killed a bear and then... Okay. At the dinner party that ensued, people were partaking of raw and undercooked bear. Is this a thing? How did you let me say all that wax stuff early? You let me say all that wax stuff and then like you swoop in 20 minutes later and you're like

I actually there are raw bear eating parties in California How they do it over there. I was saving it for the love it So so there've been some cases because of that and like like specifically like game me like wild boar and stuff like that But again, it is largely not a concern in the US. There are treatments the sooner the better, the fewer cysts you have all over, the easier it is to treat. But we've got medicine that can treat it now.

So even if you are unfortunate enough to be one of the, I mean, handful of cases that we see a year in the US, you can still be okay. You heard it for your first folks, chat down. No, don't. Don't cut your hair, you can still be okay. You heard it for your first folks, chow down. No, don't. Don't cook your cat, you're wasting.

You're wasting time since Dr. Sidney Smr. McArroy. No, as a general Roy. Pointless. If you're about to eat an animal and you think, is this an animal that needs to be cooked? Yes. That's it. That's it.

Folks, thank you so much for coming out to our show. We have a book. It's called The Salbone's Book, and we wrote it, and Taylor illustrated it. You can buy it at bookstores. If you haven't listed our podcast before, this is your first time. Please subscribe to it on iTunes Thank you to or wherever Thanks the taxpayers for the source on medicines as the intro and outro of our program

Thank you to Those delightful McHoy brothers for letting us open for them what an honor Thank you to Paul. Thank you to the TAF, thank you to most of all. Of course, you for coming to Watch Us. And we will be with you again next week. So until then, my name is Justin McElroy. I'm Sydney McElroy. And as always, don't, Joel Holt in your head! Alright! Maximumfun.org

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