CHOLERA 61 



cause a fatal peritonitis. Many saprophytic organisms will act in the 

 same way and quite as promptly. It is safe to say that all attempts 

 to induce genuine and distinctive Asiatic cholera in the lower animals, 

 made up to the present time, have failed, and that we know no animal 

 susceptible to this disease under either natural or experimental con- 

 ditions. To man alone belongs the function of serving as host, pre- 

 server and distributor of the comma bacillus. Without man to supply 

 warmth, shelter, food and transportation, the cholera bacillus would 

 soon disappear from the face of the earth. 



Every man who goes into battle is not killed; likewise not every 

 man who swallows the cholera bacillus becomes infected and of the 

 infected all do not die. The cholera bacillus is highly susceptible to 

 acids, and the acidity of the stomach is a protective agency. But the 

 acidity of the stomach is widely variable among people and scarcely 

 less so in the individual from time to time. Infected drink, taken when 

 the stomach is empty and non-acid, is likely to carry its infection on 

 into the alkaline intestinal content. Bacilli protected by masses of 

 food, difficult of digestion, may also pass through. In the midst of 

 cholera epidemics, many harbor the bacillus and distribute it in their 

 stools without being at all affected by it Others are only slightly ill 

 and there is every degree of gravity up to those in which the disease 

 is fatal within a few hours. 



In typical cases of cholera the bacillus does not find its way through 

 the intestinal walls. It multiplies so abundantly in the intestinal con- 

 tent that it starves out all other bacteria and after death there is a 

 pure culture in the intestine. It not only grows abundantly, but its 

 cells speedily die and in doing so the poison contained in their struc- 

 ture is liberated, exerts its local effects on the intestinal walls, is 

 absorbed and produces the symptoms of the disease, and death. In 

 fact, cholera as an infection is limited to the alimentary canal; as an 

 intoxication it kills. 



In acute cholera the bacillus is found only in the intestine and gall- 

 bladder after death. All other organs and tissues are sterile. The 

 intestine is converted into a great culture flask from which the chemi- 

 cal poison, elaborated by the bacterial growth, diffuses into the blood, 

 while the water from the blood diffuses into the flask. This results 

 in the condensation of the circulating blood, the drying out of the 



