618 Asiatic Cholera 



in an epidemic of exceptional virulence. This makes it probable 

 that a protective effect could be obtained even for long periods ol 

 time if larger doses of a stronger vaccine were used. 



"4. The best results seem to be obtained from application of middle 

 doses of both anticholera vaccines, the second one being kept at the 

 highest possible degree of virulence obtainable. 



"5. The most prolonged observations on the effect of middle doses 

 were made in Calcutta, where the mortality from the eleventh up to 

 the four hundred and fifty-ninth day after vaccination was, among 

 the inoculated, 17.24 times smaller, and the number of cases 19.27 

 times smaller than among the not inoculated." 



Pawlowsky and others have found the dog susceptible to 

 cholera, and have utilized it in the preparation of an anti- 

 toxic serum. The dogs were first immunized against 

 attenuated cultures, then against more and more virulent 

 cultures, until a serum was obtained whose value was 

 estimated at i : 130.000 upon experimental animals. 



Freymuth * and others have endeavored to secure favor- 

 able results from the injection of blood-serum from con- 

 valescent patients into the diseased. One recovery out 

 of three cases treated is recorded. 



In all these preliminaries the foreshadowing of a future 

 therapeusis must be evident, but as yet nothing satis- 

 factory has been achieved. 



One of the chief errors made in the experimental prepara- 

 tion of anticholera serums is that efforts have been directed 

 toward endowing the blood with the power of resisting 

 and destroying the bacteria that rarely, if ever, reach it. 

 The two essentials to be aimed at are an antitoxin to neu- 

 tralize the depressing effects of the toxalbumin, and some 

 means of destroying the bacteria in the intestine. 



The cholera spirillum is one of a considerable-sized group 

 of closely related organisms, from some of which it is dif- 

 ferentiated with difficulty. 



Sanitation. The first appearance of cholera may depend 

 upon the introduction of the micro-organisms upon fomites, 

 hence to avoid epidemics it is necessary to disinfect all such 

 coming from cholera infected localities. Especially are food- 

 stuffs and particularly raw vegetables and fruits to be con- 

 sidered. All such should either be avoided or only eaten after 

 cooking. 



So soon as cholera asserts itself, the chief danger lies in the 

 probable contamination of the water-supply. To prevent 

 this the utmost effort must be made to locate all cases and see 



* "Deutsche med. Wochenschrift," 1893, No. 43. 



