138 DISEASES OF SWINE 



crater-like, ulcerated base. This gradually heals, and the destroyed 

 gland tissue is replaced by white fibrous tissue, leaving a shiny scar 

 or cicatrix. This is the appearance in the healed cholera cases, a 

 small punched-out scar marking the location of the former ulcer. 



The Colon. — We will next have a look at the large bowel or 

 colon, and also the cecum. The cecum is the sac-like beginning of 

 the large bowel into which the ileum opens, the opening being 

 guarded by the ileocecal valve, which has already been described. 



In the cecum we frequently find an extensive inflammation, with 

 marked reddening of the mucous membrane lining this portion of 

 the bowel. Here, also, we may find ulcers, some of those found 

 in this portion of the bowel being quite large, and often will show 

 a well-marked elevated surface and button-like appearance. 



The colon in some cases is little affected, if at all. On the other 

 hand, many cases show a most violent inflammation of this por- 

 tion of the large bowel. In manj^ cases the inflammation here is 

 so severe that the bowel appears almost gangrenous, and all the 

 coats seem involved in the inflammation. 



Some authors seem to convey the impression that ulcers in the 

 colon are unusual in cholera. I have found this decidedly not the 

 case. Many of the most pronounced ulcers I have ever seen were in 

 the large bowel, and I have found them here in many cases in which 

 there were no ulcers to be found either in the small bowel or on the 

 ileocecal valve. 



As regards the severity of the inflammation of the large bowel, 

 I have noted it as an ahiiost constant finding that when the large 

 bowel is involved it is apparently much more severe in tj^pe than 

 that of the small intestine. In many cases the congestion of the 

 large bowel is so marked that the organ is very dark red or almost 

 black in color when taken from the abdomen, and it requires no 

 opening of the bowel to reveal the character and extent of the le- 

 sions. The ulcers also in this part of the intestinal tract seem to 

 have a marked tendency to burrow deeply and involve the 

 mucous, submucous, and muscular coats more extensively than 

 those which are found in the small intestine. 



For some reason, however, there is often no corresponding 

 severity of the sjanptoms of the disease as related to the extent of 

 the pathologic changes. Cases which cUnicallj'' have been appa- 



