86 
found that the eggs have settled more numerously in the fine sediment 
than in the coarse material. 
In case an unusual amount of large coarse material is present in the 
feces, it is sometimes convenient to pour the entire mass through a 
sieve, rejecting the portion left in the sieve; or to wash the feces in a 
sieve, holding the latter under water. As a rule, however, the sieve 
is not very useful in fecal examinations. 
The centrifuge does not appear to be of any special value in fecal 
examinations. 
If facilities are not at hand for making a microscopic examination, 
about half an ounce of either perfectl}^ fresh feces, or of rather dry 
feces, may be placed in a bottle, preferably with a large neck, prop- 
erly packed in a mailing case, and sent to any professional pathologist 
or zoologist for examination. 
GROSS EXAMINATION OF FECES. 
If uncinariasis is suspected and it is not practicable either to make 
a microscopic examination or to delay matters until a specimen can be 
sent away for examination, still another method of diagnosis is possi- 
ble. Give a small dose of thymol, followed by salts, and collect all of 
the stools passed. Wash the stools thoroughly several times in a 
bucket, and examine the sediment for worms about half an inch long, 
about as thick as a hairpin or hatpin, and with one end curved back to 
form a hook. If these are found, institute definite treatment. 
TREATMENT OF HOOKWORM DISEASE. 
ANTHELMINTHIC TREATMENT. 
The two drugs most commonly used in uncinariasis are thymol and 
male fern. The day before treatment the patient is placed on a milk 
and soup diet for three days. 
Thymol .— directions usually given for thymol treatment are 
these: Two grams (31 grains) of thymol at 8 a. m. ; 2 grams (31 grains) 
at 10 a. m. ; castor oil or magnesia at 12 noon. 
One week later the stools should be examined, and if eggs are still 
present, treatment should be repeated until the eggs disappear, but it 
is not best to give the thymol more than one day per week. Some 
cases of hookworm disease are quite obstinate and require a treatment 
extending over several weeks. It is, therefore, an unfortunate error 
to expel a few worms with one or two doses and then dismiss the 
patient as cured without having made further microscopic examination 
for eggs. 
Sand with (1894, p. 21) reports 42 men cured after a single dose; 58 
after 2 doses; 43 after 3 doses; 25 after 4 doses; 9 after 5 doses; 4 
after 6 doses; 2 after 7 doses, and 2 after 8 doses. 
