VIBRIO CHOLERA. 361 



developing algid stage, muscular weakness, sleep, falling 

 of temperature to 30, death in sixteen to eighteen hours. 

 Yet it must be emphasized that various proteins (from 

 Bact. prodigiosum, Bact. coli), when introduced into the 

 peritoneal cavity of guinea-pigs, produce the same symp- 

 toms (Hiippe, Klein, and others); also Voges obtained 

 similar results with papain. Regarding the theory of 

 Emmerich and Tsuboi (Munch, med. Wochenschr., 1893, 

 473, 497), that cholera is a poisoning by nitrite origi- 

 nating in the intestine, see page 94. 



Distribution. 



(a) Outside the body: Recently they have been found 

 not infrequently in water (wells, tap- water, rivers, har- 

 bors, canals), which had been contaminated with dejecta 

 from cholera cases, yet their presence is only valuable if 

 the differential diagnosis from the ' l water bacteria resem- 

 bling cholera ' ' is carried out with great caution. (Com- 

 pare p. 373, etc. ) 



(6) In the healthy body : Not infrequently, in times of 

 cholera, cholera vibriones have been found in healthy 

 persons without any pathologic symptoms (" Cholerage- 

 sunde"). For example, Abel and Claussen, upon re- 

 peated examination, found cholera vibriones present at 

 some time in 14 out of 17 healthy persons who were mem- 

 bers of 7 families in which there were cases of cholera; in 

 many, for as long as fourteen days. Negative days inter- 

 vened between the ones when positive results were ob- 

 tained. In Hamburg 28 such cases of "cholera in health " 

 with absolutely normal feces were demonstrated. 



(c) In diseased human organism : Found only in cases 

 of cholera, and in no other disease. The principal location 

 is in the intestinal contents, especially in the mucous floc- 

 culi of the rice-water stool. There the cholera vibrio is often 

 in pure culture; usually at the height of the attack they 

 are present in large numbers, and generally decrease after 

 four to fourteen days. In fresh cholera cases the organism 

 is not usually found in the organs, except in the intestinal 

 glands, where sometimes the epithelial layer is broken 

 through. In exceptional cases, however, both in man and 

 experimental animals, the vibrios are also found in the 

 internal organs, as lungs, liver, kidney, spleen, and most 



