THE EXAMINATION OF FJECES 635 



Muscle fibres looking like brown splinters of wood will indicate 

 the powers of protein digestion in the small intestines. 



Connective tissue indicates gastric indigestion and that organ 

 should be minutely examined. 



A normal stool contains 23 per cent, of fat of the dry substance, 

 slight variations from this are unimportant ; a morbid increase gives a 

 clay coloured sour copious stool, and the sebacic acid flocculi in a cold 

 acetic acid preparation are much increased as are also neulral fat drops, 

 salts of lime and soap crystals. If bile is absent and fat increased the 

 disease is in all probability in the biliary duct system. If \\ith excess 

 of fat there are muscle fibres and hydrobilirubin present and mucus 

 is absent the pancreas is the* seat of the disease. When biliary and 

 pancreatic disorders are excluded the excess of fat may be due to severe 

 intestinal disease such as tuberculosis, amyloid disease or tabes 

 mesenterica. 



Errors in the examination of faeces are not uncommon. 



Banana fibres may be mistaken for tapeworms, especially T. nana 

 and T. diniinuta, owing to the fact that they are made up of segments 

 resembling tapeworm strobilje. 



Orange debris resembles certain trematodes, liver flukes, &c. 



Celery shreds may be mistaken for hookworms. 



Oatmeal may simulate the segments of worms. 



Undigested pollen grains might be mistaken for eggs. 



The ascus of a mould mistaken for an egg-shell. 



The oncospheres for a dividing ovum. 



Always consider the patient's vegetable diet first. 



Bacteria, &o. 



The microscope will demonstrate mild infections due to staphylococci 

 from the more dangerous streptococcal infections. Typhoid, cholera 

 and dysentery bacilli can be detected by culture. These are dealt with 

 under their respective headings. The amoebae can be seen in fresh 

 stools and when the slide is kept warm their movements can be recog- 

 nized. Water kills them and should not be added in examining 

 them. 



Free moving larva? in fresh stools are never ankylostomes but 

 probably Strongylus stercoralis. 



Blood. 



Blood in small quantities and altered blood can be recognized by 

 Weber's test : — 



Extract the fat with ether. 

 Rub the stool up with water. 



Add one-third bulk of acetic acid and shake up the whole Avilh 

 ether. 



