CHAPTER XXXII. 

 VIBRIO CHOLERA ASIATICS. 



Introduction 



Section I. The experimental disease, p. 489. 



1. Choleraic peritonitis, p. 489. 2. Choleraic septicaemia, p. 489. 3. Intestinal 

 cholera in animals and man, p. 489. 



Section II. Morphology and cultural characteristics, p. 491. 



Section III. Biological properties, p. 493. 



1. Vitality and virulence, p. 493. 2 Bio-chemical reactions, p. 494. 3 Toxin, 

 p. 494. 4. Vaccination, p. 496. 5. Serum therapy, p. 498. 6. Bactericidal pro- 

 perties ; Agglutination, p. 499. 7. Complement fixation, p. 500. 



Section IV. Detection, isolation and identification of the vibrio, p. 500. 

 1. Detection, p. 500. 2. Isolation, p. 501. 3. Identification, p. 502. 



The vibrio of Finkler-Prior, p. 502. 

 The vibrio of Deneke, p. 503. 

 Vibrio metchnikowi, p. 503. 



THE infecting agent in asiatic cholera is a vibrio discovered by Koch and 

 often known as the comma bacillus. The vibrio is found in the intestinal 

 contents and in the dejecta of patients suffering from the disease : it remains 

 localized in the intestine and the symptoms of cholera are due to the absorption 

 of toxin. 



[The present conception of the distribution of the cholera vibrio in the 

 tissues of man must however be revised in view of the recent observations of 

 Kulescha and of Greig. Kulescha was the first apparently to show that 

 the cholera vibrio could gain access to the gall-bladder and set up patho- 

 logical changes in the biliary passages and Greig was able to isolate the vibrio 

 from the bile of about one-third (81 out of 271) of the fatal cases of cholera 

 coming under his observation at Puri in India. Moreover the finding by 

 Zlatogoroff of the vibrio in the stool of a person one year after recovery 

 leads to the suspicion that the organism may live in the gall-bladder for 

 long periods and be excreted via the alimentary canal from time to time 

 thus giving rise to " carriers " as in the case of enteric fever and other 

 diseases.] 



The cholera vibrio is essentially a pleomorphic organism ; there are many 

 varieties which differ more or less from the vibrio originally described by Koch. 

 If it be added that it is not uncommon to find in water and in the excreta of 

 healthy persons, vibrios morphologically similar to if not identical with the 

 cholera vibrio, it will be understood how difficult and inexpedient a diagnosis 

 of cholera may be in the absence of large epidemics. 



