2o6 DISEASES DUE TO BACTERIA 



her servant ^^■ho drank water taken to them from the I3roa(l Street well, 

 for Avhich they had a special Hking. 



The Hamburg and Akona instance is well known. Both towns 

 used water from the river Elbe for drinking purposes. The former 

 townspeople did not filter their water; an epidemic of cholera broke 

 out, and there were 8,000 deaths, or i3"4 per cent, of the population. 



The latter people filtered their water, and during the epidemic they 

 only had 328 deaths, 2*1 per cent, of the population. 



(4) Milk is especially dangerous, as it affords a good growing 

 medium. 



(5) Carriers are extremely dangerous; though not obviously ill 

 themselves, they carry and give out virulent comma bacilli in their 

 faecal excretions. 



(6) The bacillus vibrio has been found upon and within the bodies 

 of flies, hence these should be considered an important means of trans- 

 mission. Ants, too, should be looked upon with suspicion. 



(7) Green vegetables eaten raw, such as lettuces, watercress and 

 tomatoes are liable to become infected. In the East vegetable gardens 

 are often contaminated with human faecal matter. 



For details of the organism, see p. 621. 



PATHOLOGY. 



The vibrio has a local habitat, living and growing in the small 

 intestinal mucosa, epithelial cells, glands and lumen giving off in all 

 probability an endocellular toxin w^hich, when set free and absorbed, 

 causes the general symptoms. This toxin causes the blood elements 

 to enter the blood thus : First water, then inorganic salts, especiallv 

 sodium chloride, later phosphates and potassium salts, and still later 

 organic substances. This produces a great concentration of blood 

 (T073-1078) and an increase of hb. and red cells to 8,000,000 per c.mm., 

 also of white cells up to 60,000 c.mm. 



The alkalinity of the blood is decreased and the coagulative power 

 altered. 



This concentration of the blood causes a fall in the blood pressure, 

 shown by the feeble compressible pulse (50-80 mm. of Hg). 



The result of this low blood pressure is that the urine is scanty, 

 high sp. gr., albumin, casts and much indican. 



Perhaps the blood pours out bactericidal substances. 



POST MORTEM. 



Rigor mortis marked and early. Rise of temperature and muscular 

 movements after death not uncommon. Tissues dry. Blood thick^ 

 may be tarry. 



Stomach empty, vessels injected. 



