23,6 Leach et al.: Hookworm Infestation 497 



The maximum loss in weight, 9.1 kilograms, was in a man 

 who showed no evidence of tuberculosis during the time he was 

 under our observation. He showed no abnormal reaction to the 

 drug beyond the passage of considerable bile and mucus in his 

 stool. This man presented a waxy, diabetic appearance. He 

 had a soft, fixed tumor mass, about the size of a hen's egg, in 

 the left lumbar region, about the level of the fourth lumbar 

 vertebra. 



VASCULAR SYSTEM 



Pulse rate and blood pressures were taken before treatment, 

 at the time the physical examination was made, and again one 

 hour after the administration of the drug while the men still 

 were partially under its effects. Nothing of especial significance 

 was noted by us, but we feel that a careful study of the cardio- 

 vascular system during treatment with carbon tetrachloride is 

 needed to make the picture complete. This of course should be 

 made with care, to avoid the fallacies that creep into such work 

 when it is undertaken under routine conditions. 



No subjects were encountered in the series who gave any 

 evidence of serious cardiac lesion. Physical examination, how- 

 ever, disclosed four with minor affections of the heart. These 

 were prisoners 14643, who showed a soft systolic murmur, best 

 heard over the mitral region ; 57342, with a roughened first sound 

 which was absent three months after treatment; 14710, with an 

 occasional reduplication of the second sound, which likewise had 

 disappeared three months later; and, 19369, with a short mitral 

 systolic murmur, best heard over the second interspace left 

 transmitted toward the left axilla. 



APPEARANCE OF WORMS IN STOOLS AFTER TREATMENT 



One of the most striking things noted in connection with the 

 treatment was the promptness with which the hookworms were 

 eliminated after treatment. Inspection of the figures at the con- 

 clusion of the work disclosed that 97 per cent of the hookworms 

 recovered on screening were passed within the first twenty-four 

 hours after treatment. This, however, was not the case with 

 either Ascaris or Trichuris. Only 54 per cent of the total num- 

 ber of Ascaris recovered were found in the first twenty-four 

 hours, and only 19 per cent of Trichuris recovered came down 

 in that time. The greater number of Trichuris was expelled on 

 the second day. 



To determine how soon worm findings could be made after 

 treatment, six men were treated on the basis of 1 cubic centimeter 



