XIV, 5 Johnston: The Cholera-carrier Problem 463 
Greig,(2) working in India, has made an intensive study of 
these choleralike vibrios, and he classifies them according to 
their serological reactions with each other. He makes arbitrary 
division into six groups. During the past year thirty strains of 
nonagglutinating vibrios have been studied at the Bureau of 
Science. These strains were obtained from cholera cases, from 
carriers, and from presumably normal individuals who were 
contacts of cases of cholera. After obtaining a strain in pure cul- 
ture, 0.1 cubic centimeter of a suspension of a twenty-four hour 
culture was injected into the gall bladders of a number of guinea 
pigs under strict asepsis. The animals were sacrificed from ten 
to twelve days subsequent to injection, and the contents of the 
gall bladder were used to inoculate peptone tubes; direct 
plates on Dieudonné were made also. The supply of animals 
being short it was decided to use bile, and transfers were made 
every three days. After forty such transfers eight of these pre- 
viously nonagglutinable strains gave prompt agglutination in 1 to 
500 dilution. Of these eight strains five held the acquired prop- 
erty for approximately three months. Three lost it after two 
months, and none held it for longer than four months. ‘These 
facts were reported at the time as showing that the property of 
agglutination might be acquired, but my belief now is that these 
strains were true cholera that had lost the ageglutinability. 
TREATMENT 
In Bilibid the carriers were given urotropin and, following 
Schobl’s experiments with ox bile in guinea pigs, 0.65 cubic centi- 
meter of ox bile three times a day for two days; after an interval 
of five days the treatment was repeated. Those cases negative 
after the treatment were released from quarantine. The prison 
authorities at first, I believe, used sodium tauro cholate; but, the 
supply of this soon becoming exhausted, I suggested the use of 
inspissated beef bile. It was not supposed that the bile would 
cure the carrier condition, but that it would cause more vibrios 
to enter the intestinal tract from the gall bladder. The following 
is quoted from the Report of the Philippine Health Service for 
1916: (5) 
Results—From 185 cases prior to the use of ox gall, 15 or 8 per cent 
became repeaters within 2 months. The first ox-gall period produced the 
following result: 
Of 155 treated September 8, 9, 14 and 15, 5 were reported positive 
September 9, and 6 September 17; 84 of these 155 were discharged to 
brigades September 20, of whom 10 were returned positive on September 
22; thus producing a total of 21 positives or 13.5 per cent of the 155 
treated. 
