SPIRILLUM CHOLERA ASIATICS 137 



by polluted water, although food infected with bacteria 

 may, of course, transmit it. Water is contaminated by 

 dejecta of cholera patients, and the vibrio leaves the 

 patient in no way but with feces (or vomiting of intes- 

 tinal contents, a rare occurrence). Large numbers of 

 vibrios are present in the feces early in the attack. Later 

 they rapidly decrease, but do not disappear from the 

 gut and feces, and may continue to come away in small 

 numbers for many months. In such cases they natu- 

 rally pollute anything with which the dejecta come in 

 contact. They do not live long in nature, however, and 

 regulations can be made to kill them. Flies having 

 soiled themselves upon cholera excreta may carry the 

 germs. Vegetables may be soiled from water. Personal 

 contact and handling of clothes from patients have the 

 same value in transmission of cholera as for typhoid 

 fever. As the organisms leave the body only with the 

 feces, measures should be taken to disinfect them, and 

 anything likely to be soiled with them. The feces 

 should be received into 5 per cent, carbolic acid solu- 

 tion. The buttocks and anus should be wiped with 

 1 to 1000 bichloride solution. Clothes or bedding, 

 glasses, utensils, and other objects should be soaked 

 in these solutions. Boiling when possible is advisable. 

 A disinfecting hand lotion should be constantly used 

 by the attendants. It is necessary to continue disin- 

 fection of stools for varying periods after an attack, 

 since bacteria lurk in the depths of the intestinal 

 mucosa, and are excreted long after the acute symp- 

 toms have disappeared. 



Cholera is diagnosticated bacteriologically by culti- 

 vation of the stools. The organisms are present in 



