﻿REPORT ON CHOLERA IN MANILA. 421 



the human intestine than the injection of these bacteria into the circula- 

 tion, or beneath the skin either of man or animals ever gives rise to. 



Having investigated the agglutinating power of a fresh extract obtained 

 from the intestinal epithelial cells of two rabbits previously inoculated 

 intravenously with the immunizing substances extracted from the cholera 

 organism by autolysis, and having found traces of agglutinins present 

 in these extracts, it occurred to me that it would be advisable to under- 

 take the investigation of the bactericidal value of the rice-water stools 

 obtained from cholera cases and also to examine whether the cells of 

 the intestinal mucosa in rabbits immunized with our cholera prophylactic 

 possessed an increased affinity for cholera receptors. It was also of 

 interest to discover if extracts of these cells from the inoculated rabbits 

 possessed bactericidal properties. This study was undertaken by Dr. 

 Edwards of this laboratory who reported his results at the Third Annual 

 Meeting of the Philippine Islands Medical Association in 1906. Owing 

 to the difficulties encountered in the technique, produced by decomposi- 

 tion of the extracts obtained from the intestinal cells, admixture with 

 other bacteria, etc., he was not able to arrive at any satisfactory conclu- 

 sions in regard to these questions. 



It has been supposed that when cholera organisms are injected 

 intravenously into animals, the immunizing substances are anchored par- 

 ticularly to the cells of the spleen, the bone marrow, and lymph glands, 

 since it was in these organs, according to the investigations of Pfeiffer 

 and Marx, 9 that the specific protective substances seemed particularly 

 to be formed. However, Wassermann and Citron 10 demonstrated that 

 the location of the development of the immunizing substances depends 

 to a large extent upon the point at which the injections of the corre- 

 sponding bacterial antigens were made. Nevertheless, the combining 

 power of intestinal epithelial cells for the receptors of the cholera 

 spirillum has not been definitely determined, 11 although as has been 

 mentioned it seems not unlikely that in the human intestinal infection 

 the epithelial cells of the mucosa may possess receptors with special 

 combining powers for the corresponding cholera antigens and hence 



Ztschr. f. Hyg. u. Infectionskrankh., Leipz. (1898), 27, 272. 



10 Ibid. (1905), 53, 331. 



11 Brieger and his assistant took per os repeatedly from 5 to 15 centimeters 

 of Brieger's vaccine (aqueous extract of typhoid bacilli) but no development of 

 baeteriolysins occurred in their blood.* This experiment throws no light upon 

 the subject since perhaps, the bacterial antigens were changed or destroyed by 

 the gastric and intestinal juices before their imnrunizing power was exerted upon 

 the intestinal cells. 



* Bischoff, H. : Das Typhus-Immunisierungsverfahren nach Brieger. Ztschr. 

 f. Hyg. u. Infectionskrankh., Leipz. (1906), 54, 298. 



