BACTERIOLOGIC INVESTIGATION OF FAECES AND BILE OF 

 CHOLERA CASES AND CHOLERA CARRIERS 



By B. C. Crowell and John A. Johnston 



(From the Department of Pathology and Bacteriology, University of the 



Philippines, and the Biological Laboratory, Bureau of Science, Manila) 



The most important advance in the study of cholera within 

 the past decade has been the recognition of the existence of 

 carriers of the disease. These carriers are individuals who 

 harbor the cholera vibrio while in apparent health ; they are of 

 two kinds — "convalescent carriers," who have recovered from 

 an acute attack of the disease, and "contact carriers," who have 

 never had the disease, but have contracted the infestation from 

 contact with others who harbored the organism. 



Table I shows the cholera cases and the cholera carriers that 

 have been detected in Manila during the last three years. 



Table I. — Cholera cases and cholera carriers in Manila in three years. 



Year. 



Persons 

 exam- 

 ined. 



Carriers detected. 



Cholera 

 cases. 



Cholera 

 deaths. 



Number. 



Per cent. 



1914. 



37,160 



10.440 



243,974 



530 



43 



1,643 



1.42 

 0.41 

 0.67 



490 



66 



1,340 



272 



44 



513 



1915 



1916 





In Bilibid Prison there was a daily average of about 2,700 

 prisoners during 1914. Fifty-two cases of cholera with 6 deaths 

 occurred, and 189 carriers were detected ; of the 189 carriers, 5 

 developed the disease in from four to eighteen days after having 

 been detected as carriers. 



As in typhoid fever the carrier state in cholera has been shown 

 to be intimately, if not causally, related to the existence of gall 

 bladder infection. Until very recently it has been considered 

 that the infection in cholera was limited to the intestinal tract. 

 It is true that as long ago as 1848 Pirogoff (37) described patho- 

 logic conditions in the gall bladder in cholera, but the importance 

 of this was not recognized. 



The next step was the recognition of the presence of the 

 cholera vibrio in the bile in cholera cases, which has been recorded 

 by numerous workers since 1884. Among these workers may 

 be mentioned Doyen, (6) Kelsch and Vaillard,(27) Nicati and 



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