HISTOPATHOLOGY OF THE INTESTINE IN CHOLERA 

 By Ernest W. Goodpasture 



The final diagnosis of cholera rests upon the demonstration 

 of agglutinable vibrios; nevertheless, during an epidemic the 

 pathologist can recognize the disease post mortem in the majority 

 of cases by gross anatomical appearances, although no distinctive 

 single lesion has yet been described. The diagnosis is arrived 

 at by weighing the evidence of a group of changes which are 

 commonly found in typical instances. Crowell(l) has sum- 

 marized these features as follows: An acute catarrhal enteritis 

 associated with cyanotic finger nails, dry tissues, oligaemia; dry 

 and sticky peritoneum with pink serosa of ileum; contracted 

 and empty urinary bladder; shrunken, dry spleen and liver; 

 acute degeneration of parenchymatous organs ; poorly coagulated 

 blood ; absence of formed f aeces ; presence of rice-water intestinal 

 content; and prominence of lymphoid tissue in the ileum. 



The mucous membrane of the small intestine presents no 

 characteristic anatomical change but varies in appearance de- 

 pending on the course of the disease. It is described by Koch (4) 

 as showing in different necropsies all transitions, from a mod- 

 erate swelling and clouding of the superficial layers and rose 

 red color to a more intense swelling and reddening with 

 extensive loss of epithelium and, finally, to a blue-black discol- 

 oration, numerous haemorrhages, superficial necroses, and even 

 diphtheritic changes. 



In a recent small outbreak of cholera in Manila all these 

 variations in appearance of the intestine were encountered at 

 necropsy and an equal diversity in the character of intestinal 

 content, varying from a relatively small amount of greenish, 

 bile^stained, mucus-containing fluid to a voluminous, purplish, 

 blood-stained, watery material with mucus and desquamated 

 epithelium in suspension. In some instances as much as 2 liters 

 of fluid was present in the bowel. The wall of the small intes- 



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