394 APPENDIX 



Test for Pancreatic Ferments. To obtain a stool for ferment examination, 

 calomel 2 to 3 grains, or phenolphthalein 5 grains is to be preferred to salts. The 

 Fuld-Gross-Goldschmidt test uses for trypsin testing a solution of casein, i gram, 

 sodium carbonate, i gram chloroform i c.c. to i liter of water. If the stool is not 

 very liquid 5 grams of faeces are rubbed up with 20 c.c. salt solution and filtered. 

 Dilutions of i to 10, i to 100 and i to 1000 are made and 0.5 and i c.c. of these dilu- 

 tions added to 6 test-tubes each containing 5 c.c. of the casein solution. The tubes 

 are incubated for 24 hours at 38 C. and completion of the digestion tested by add- 

 ing 5% acetic acid which should not cause a precipitate in tubes in which digestion 

 is complete. 



The estimation is made by units, one unit being the digestive power of one c.c. 

 of faeces filtrate to digest i c.c. of casein solution. If i c.c. of the i to 1000 faeces 

 dilution digested 5 c.c. of casein solution it would represent 5000 units. If i c.c. of 

 i to 10 dilution it would be 50. As there are 5 c.c. of the casein solution we multi- 

 ply the dilution of faeces by 5 for i c.c. or by 10 if we had only 0.5 c.c. of faeces dilution 

 in the tube tested. 



For amylopsin a similar technic is followed using a i % solution of soluble starch 

 instead of the 0.1%. casein solution. The end reaction is tested by adding i 

 drop of N/io iodine solution to each of the starch tubes and fasces dilution after 

 24 hours of incubation. The absence of a blue color shows completion of starch 

 digestion. 



The normal ferment content of the fasces rarely falls below 200 units and 

 may be as high as 10,000. Cases showing a ferment value of only 25 to 50 units 

 are very suspicious as regards pancreatic disease. 



H DISINFECTANTS AND INSECTICIDES. 



By disinfection is meant the destruction of injurious bacteria. 



Sterilization is where all living things are destroyed. 



Germicides are substances which kill bacteria while antiseptics are those which 

 are inimical to the growth of bacteria. 



Formalin is antiseptic in 1-50,000 dilution but germicidal only in 1-20. 



Deodorants may or may not be antiseptic or germicidal. An insecticide may 

 or may not be a germicide and vice versa. 



In disinfection we must consider 



(1) Strength of solution. 



(2) Time of application. 



(3) Nature of medium in which disinfectant acts. 



By Coefficient of Inhibition we mean time and concentration necessary to prevent 

 development of bacteria. 



By Inferior Lethal Coefficient we mean time and concentration necessary to kill 

 nonspore-bearing bacteria. 



By Superior Lethal Coefficient we mean time and concentration necessary to 

 kill spore-bearing bacteria. 



Disinfectants may be (A) physical (B) gaseous (C) chemical. 



(A) Of the physical disinfectants we have 



(i) Sunlight. The red and yellow rays practically inert. The violet and 



