To the Editor:

The presence of dark stools can be a cause of consternation to the patient and is made more anxiety-producing when accompanied by abdominal pain or other discomfort. The causes of melena are well outlined in several reviews, along with the usual non-heme causes of black stools, including iron, bismuth, charcoal, licorice, and certain fruits.

To this list should be added the colorings present in chocolate sandwich cookies. In several independent tests (with myself and several volunteers as experimental subjects), the presence of black stools approximately 18 to 24 hours after ingestion of 225 to 450 g of chocolate sandwich cookies has been observed. Variation in brand of cookie did not change the stool character. Testing with other types of cookie (oatmeal, peanut butter, and chocolate chip, among others) has not resulted in the same stool findings, although abdominal pain or nausea or both appear to be equally frequent associations.

This phenomenon may be on the increase because of shifts in U.S. dietary habits, so elicitation of a good dietary history in cases of black stools and abdominal pain should be pursued. Inasmuch as "cookie-induced pseudomelena" is both unprofessional sounding and too appropriately descriptive, a suggested name for this entity is "Hydrox fecalis."

Stephen Sulkes, M.D.
Monroe Developmental Disabilities
Rochester, N.Y.

Where a petition alleged that the plaintiff was an unmarried white lady, and that while in attendance as a guest of the defendant at a circus performance given by the defendant, and while seated in one of the seats provided by the defendant for the defendant’s guests at the circus, a horse, which was going through a dancing performance immediately in front of where the plaintiff was sitting, was by the defendant’s servant, who was riding upon the horse, caused to back towards the plaintiff, and while in this situation the horse evacuated his bowels into her lap, that this occurred in full view of many people, some of whom were the defendant’s employees, and all of whom laughed at the occurrence, that as a result thereof the plaintiff was caused much embarrassment, mortification, and mental pain and suffering, to her damage in a certain amount, that the damage alleged was due entirely to the defendant’s negligence and without any fault on the part of the plaintiff, the petition set out a cause of action and was good as against a general demurrer.

There is a well known account of an old Inuit man who refused to move into a settlement. Over the objections of his family, he made plans to stay on the ice. To stop him, they took away all of his tools. So in the midst of a winter gale, he stepped out of their igloo, defecated, and honed the feces into a frozen blade, which he sharpened with a spray of saliva. With the knife he killed a dog. Using its rib cage as a sled and its hide to harness another dog, he disappeared into the darkness.

In order to procure the necessary raw materials for knife production, one of us went on a diet with high protein and fatty acids, which is consistent with an arctic diet, for eight days.