67 
opment of the body due to this disease. The point at issue calls for 
the opinion of a dentist rather than that of a zoolojrist. The decayed 
teeth of dirt-eaters have been recorded in earlv writincfs on this habit. 
Tongue . — In some cases the tongue was coated. A number of 
observers have already called attention to this symi)tom, which was 
In^ no means general in the cases I observed. 
Several authors have remarked upon the presence of black, brown, 
or purple spots on the tongue in cases of uncinariasis, and the view 
has been advanced that these present a valuable aid in diagnosis, and 
in some cases, at least, that they disappear on treatment. In tlie 
cases which came under my observation, I looked very carefully for 
this s^uiiptom. In many instances I found more or less distinct 
purplish to brownish spots, irregularly round or elongate in shape, 
and these may or may not be identical with the spots desci*ibed by the 
authors cited. It was, however, noticeable that in many cases where 
the.se spots were observed, the patients were accustomed either to 
chewing tobacco or to dipping snuff. In fact, some of the spots in 
question I am inclined to refer to the use of tobacco or snuff. 
Whether all cases are to be explained in this way is, however, open 
to question, with probabilities against such explanation. Neverthe- 
le.ss, it is well for practitioners to be forewarned upon this chance 
of error in diagnosis. Several authors have assumed that the spots 
on the tongue represent a symptom which has only recently been 
ob.served in this disease. In this connection, it is interesting to note 
that early authors — for instance, Cmgin (1836a) and Imray (1813) — in 
writing upon dirt-eating have de.scribed these same spots. 
NECK. 
The cervical pulsations are often verv evident, and in some cases 
may be seen from 6 to 12 feet away. (See Circulatory .system, ]). 72.) 
THORAX. 
In emaciation the thorax corresponds to the general emaciation of 
the extremities. In .some ca.ses the ribs are very prominent.. 
Heart . — See page 72. 
BreasU . — See page 61. 
ABDOMEN. 
Pot-hell or huttermilk-helly T dropsy ^ and tympanitr.t . — The con- 
dition known as ‘‘pot-belly” or “ buttermilk-l)elly ' is exceedingly 
common in uncinariasis, especially in extreme cases in summer. It is 
a di.stension of the abdomen, due apparently to two factors: (1) a 
gaseous distension of the bowels, and (2) the presence of an excess of 
fluid in the abdominal cavity. 
I hasten to add that I have not seen a single autopsy in man infeettvi 
with uncinariasis, but the .same abdominal distention is found i: 
