CHOLERA. 105 



frequently extra-cellular during the early stages of an 

 attack of urethritis, and, though to a less extent, during 

 its involution, whilst cases sometimes occur in which 

 a considerable number of the cocci lie free during the 

 whole course of the disease. 



CHOLERA. 



The diagnosis of cholera can only be made on clinical 

 grounds alone during an epidemic, as other diseases 

 present almost identical symptoms and course. The 

 importance of making a correct diagnosis arises less 

 from the interests of the patient than from those of the 

 general public ; if the case is one of true Asiatic cholera 

 the sanitary authorities must be notified and the fullest 

 precautions taken to prevent the spread of the disease. 

 In all suspicious cases a quantity of the rice-water 

 stools (in a bottle sterilised by boiling or by dry heat 

 and securely packed} should be forwarded at once to a 

 public laboratory. Meanwhile the diagnosis may be 

 established with a fair amount of certainty by the 

 following simple tests : 



1. Take a platinum loopful of the dejecta and spread 

 it in a thin film on a clean slide ; dry, fix, and stain 

 with carbol-fuchsin for three minutes ; wash, dry, and 

 mount. 



2. Prepare another film and stain by Gram's method. 



EXAMINATION OF THE FILMS. 



The spirillum of Asiatic cholera is about half as long 

 as a tubercle bacillus, or rather longer, and much 



