440 The Philippine Journal of Science 1923 



cholera which is lacking in other infectious diseases. Indeed, 

 these symptoms have a greater similarity to those of high 

 intestinal obstruction than to another enteric infection. Not 

 only may the above symptoms of profound intoxication be in 

 evidence in acute ileus but there is also a great loss of fluid 

 through the intestine ; much of it may be vomited, and at autopsy, 

 especially in paralysis of the intestine, it may fill and distend 

 the small bowel, particularly the upper portions. 



Whipple (2) has been able, by alcoholic precipitation, to isolate 

 from the fluid in experimentally closed duodenal loops a toxic 

 substance which, injected intravenously into dogs in small 

 amount, produces profound collapse and other symptoms of 

 duodenal obstruction. 



It has been possible, by precipitating with alcohol filtered 

 watery stools and intestinal fluid from cases of cholera, to 

 demonstrate the presence of a similar poisonous substance pro- 

 ducing, when injected intravenously or intraperitoneally into 

 dogs, a train of symptoms and pathological changes identical 

 with those caused experimentally by poison from closed duodenal 

 loops. It was to be expected, with the excretion of quantities 

 of fluid in cholera, that whatever dissolved poisonous material 

 might exist would be considerably diluted, and this is the case 

 with the toxic material which has been demonstrated. The 

 degree of toxicity was first estimated by intravenous injection 

 of intestinal fluid removed at autopsy from the ileum three hours 

 post mortem. 



EXPERIMENT 1 



November 29. Four hundred cubic centimeters of watery 

 mucus-containing fluid were removed from the ileum three hours 

 after death from a case of typical cholera, bacteriologically posi- 

 tive, dead two days after onset. Within one hour fluid was 

 placed in ice box at 5° C. 



November 30, 3 p. m. Ten hours later 150 cubic centimeters 

 were placed in a flask in boiling water for a half hour. Precip- 

 itate removed by centrifugalization. Supernatant fluid acid- 

 ified weakly to litmus with acetic acid, boiled, and the light 

 flocculent precipitate removed by centrifuging. 



At 3 p. m. 100 cubic centimeters of the clear brownish fluid 

 were injected intravenously, under morphia and ether anaes- 

 thesia, into an adult dog weighing 8 kilograms. There was a 

 gradual fall in blood pressure and an increased pulse rate, but 

 ■ diarrhoea. The animal died during the night, 



