62 CHOLERA 



tissues, the suppression of urine, perspiration, saliva and even of the 

 tears. The cholera poison, irritating the intestinal wall, increases 

 peristalsis until it becomes most painful and leads to the ejection of 

 large volumes of rice-water stools. The constant nausea and vomiting 

 render even drinking quite impossible. Through mouth and anus the 

 culture flask is discharged while it is constantly replenished by the 

 withdrawal of water from the blood and tissue. In the acute form, 

 a few hours suffice to dry out the tissues so thoroughly that death 

 results. 



Several cases of laboratory infection with the cholera bacillus have 

 been reported. The first of these occurred in Koch's laboratory in 

 1884. A careless worker infected himself. Dr. Oergel of Hamburg 

 died from accidental infection with the cholera bacillus. Some half- 

 dozen additional laboratory infections have been reported. Besides 

 these accidental infections, several have intentionally swallowed cul- 

 tures. The most notable instance of this kind were the Munich pro- 

 fessors, Pettenkoffer and Emerich. They alkalized their stomachs and 

 then drank the dilute cultures. The former suffered only a severe 

 diarrhea, but the other passed into the algid stage with suppression 

 of urine and barely escaped with his life. A similar instance occurred 

 in Paris under the observation of Metschnikoff. It has been observed 

 in these cases that the period of incubation is short, from twenty-four 

 to forty-eight hours. 



The cholera poison, on which much work, ending in diverse and 

 even contradictory conclusions, has been done, is probably the protein 

 poison found in all proteins. Ordinarily this poison is without effect 

 when given by mouth on account of the slowness with which it passes 

 the intestinal wall, but with the lumen of the intestine filled with an 

 abundant cholera culture, the walls are so injured that the poison is 

 rapidly absorbed. The cholera poison is not more active than that 

 obtainable from other bacteria, both pathogenic and non-pathogenic, 

 also from other proteins both vegetable and animal. 



Sources of Infection. Every case of cholera means that some one 

 has swallowed bacilli which have come from the stools of some one 

 else. The route may have been quite short and direct or may have 

 been long and circuitous. The bacilli bred in the intestine of one indi- 



