77 
Just how much the indigestion is due to uncinariasis and how much 
to other causes may be considered an open question. Foul breath is 
mentioned b}’ some authors as a common symptom of uncinarisisis, but 
this has not been particularly noticeable in many of the cases I saw. 
Many authors explain the tendency to dirt-eating as an effort to neu- 
tralize the hyperacidity of the stomach. As 1 have just shown (p. 74), 
however, manv patients with uncinariasis eat pickles and suck lemons. 
According to Sand with, a gnawing, throbbing pain in the epigas- 
trium is the first symptom complained of, chiefly because it is constant, 
whereas a severe colic and borborygmi (rumbling of bowels caused bv 
gas) of intestine are present from time to time. 1 was unable to con- 
firm the constancv of the pain. 
CONSTIPATION AND DIARRHEA. 
Sandwith (1S94, p. 11) states that when the patient is not under 
thymol and purgative treatment, constipation is a very constant symp- 
tom in hospital cases; 6U per cent had suffered for a long time from 
obstinate constipation, 28 per cent had had diarrhea before admission, 
and 12 per cent had no recollection of being troubled with either. 
“ None of the figures depending upon the memory of the patients 
must be taken as absolute truth, as the intelligence of main’ is of a 
very low order.” Diarrhea, and even dysentery, are not uncommon 
in very advanced cases, especially those complicated with BUharzia 
{— Schistos(/rna , which has not been reported as endemic in the Fnited 
States), or ulceration in the rectum; and unless the patient is robust 
enough to support thymol, such cases are apt to end fatally. 
In 1113" own cases I found both constipation and diarrhea, but I am 
not in a position to state that either symptom was regular or charac- 
teristic for an\" given degree or stage of infection. In severe ciLses 
diarrhea was certainlv more or less common. 
Feces . — See page b8. 
NERVOUS SYSTEM. 
The nervous s3Uuptoms usuallv develop later than either the intes- 
tinal or the circulatorv svmptoms. 
See page 65. 
EYES. 
EAR.‘<. 
According to Sandwith (IS‘4, p. 12), noises in the ear arc present. 
None of mv patients complained of this svmptom. 
MENTAL LASSITUDE, HEADACHE, DIZZINESS, AND NEKVOUSNfXS. 
Not onh* does plwsical exertion result in exhaustion, but mental 
exertion has to be avoided. The childnm complain that thev aie 
unable to stud}' and that anv continued application to books results in 
