23.6 Leach et al.: Hookworm Infestation 485 



men in the first group showed hookworm ova in their fasces 

 several weeks after treatment, and five men also were positive 

 in the fourth group on reexamination. The men in the middle 

 two groups all were microscopically negative when their faeces 

 were reexamined. 

 Two facts, therefore, are made plain by the foregoing, namely : 



1. Carbon tetrachloride may be safely given in a proportion 

 of 1 cubic centimeter to each 5.5 kilograms of body weight, up 

 to an actual dose of 12.5 cubic centimeters. It will be seen by 

 Table 10 that symptoms of an abnormal nature bear no real 

 relation to the actual amount of the drug taken, for they are 

 as likely to arise following the administration of the smaller 

 amounts as of the larger volumes. 



2. Moderate alcoholism is no contraindication to the use of 

 carbon tetrachloride, provided liquor is withheld from the 

 patient for several days before and after treatment, and pro- 

 vided there is no involvement of the liver or alimentary tract. 



THE URINE 



In the study of these men we obtained no evidence that would 

 indicate that carbon tetrachloride, administered in doses ranging 

 from 6.2 to 12.5 cubic centimeters, exerts a deleterious effect 

 on the kidneys that is more than transitory. In only two sub- 

 jects was albumin detected after treatment where it had not 

 already been found before treatment. In three instances albu- 

 min was found before treatment, but not afterwards, and in 

 four other cases albumin was present both before and after 

 treatment. 



In one instance we administered 9.3 cubic centimeters of the 

 drug to a man (prisoner 14712) who showed definite evidence 

 of renal disturbance. During treatment this man complained 

 of severe headache and abdominal pain, but the phenomena 

 differed in no way from those shown by several men exhibiting 

 the same symptoms, after treatment, but whose kidneys ap- 

 peared to be clear. Before treatment, this man's urine was 

 strongly positive for albumin; it contained also leucocytes and 

 erythrocytes. Forty-eight hours after treatment, the albumin 

 reaction was even stronger, and many leucocytes and hyaline 

 and granular casts were present. Physically, however, the man 

 seemed no worse during the period he was under observation. 



The occurrence of casts (hyaline and granular) was frequent, 

 however. Forty-two of the men had casts in their urine after 

 treatment, though none had been detected before. Casts were 

 present both before and after treatment in twenty-five subjects, 



