350 THE FAECES 



It was until recently thought that Cammidge's reaction (urine) when associated 

 with azotorrhoea and steatorrhcea made for a diagnosis of chronic pancreatitis. 

 At present very little importance is attached to the Cammidge reaction. 



Loss of weight, anaemia, diarrhoea and pains in the upper abdomen are important 

 indications of pancreatic trouble. As chronic pancreatitis is often associated with 

 cholelithiasis jaundice is frequently present. Glycosuria is not often present. 

 While functional tests are important they do not make for a sure diagnosis. 



Miiller's method for pancreatic functioning determination is to give a calomel 

 purge two hours after a meal. A little of the liquid stool is smeared on the surface 

 of blood-serum and the tube incubated at 60 C. (paraffin oven). If the surface is 

 smooth, no trypsin was present; if dotted with spots of digestion liquefaction, it 

 shows that the pancreatic secretion is present. 



In Schmidt's nucleus test small cubes of beef are hardened in absolute alcohol 

 and then tied up in tiny silk bags. These are recovered from the faeces and sec- 

 tioned. Complete preservation of nuclei indicates a total absence of pancreatic 

 functioning provided the passage of the tissue be not too rapid as by diarrhoea. 



Epithelial cells are generally more or less disintegrated. In the mucus of 

 bacillary dysenteric stools, however, large intact phagocytic cells are frequent, 

 which may be mistaken for encysted amoebae. 



Triple phosphate crystals are frequently observed in faeces, as may also be crys- 

 tals of various calcium salts. Charcot-Leyden crystals are rather indicative of 

 helminthiases. 



Various flagellates, and in particular Lamblia, may be responsible for diarrhceal 

 conditions which may cause rather serious symptoms. 



Balantidium coli has been reported several times as the cause of dysenteric 

 conditions. Coccidiadea are found in the fasces. 



It is in the faeces we examine either for the parasites or for their ova 

 in connection with practically all the flukes, except the lung fluke and 

 the bladder fluke; for intestinal taeniases and for practically all the 

 round worms, except the filarial ones. 



Bass has recommended that faeces which have been made fluid be centrifuged 

 and the supernatant fluid containing vegetable debris be poured off. The sediment 

 contains hookworm eggs. Then pour on sediment a calcium chloride solution of 

 sp. gr. 1050. Again centrifuge and decant. Next add calcium chloride solution 

 of a sp. gr. of 1250 and centrifuge. This brings to the surface the hookworm eggs 

 which may be pipetted off. As a rule, the finding of hookworm eggs is very easy 

 without such a technic. 



In the tropics, the examination of the faeces vastly exceeds in value 

 that of urine and is possibly more important than blood examinations. 



The larvae of various insects may at times be detected in the stools, as well as 

 certain acarines (cheese mites, etc.). 



The test for occult blood is indicated in helminthiases as well as in the conditions 

 for which it is usually tested. 



