86 The Philippine Journal of Science i9i7 



Rietsch,(32) Tizzoni and Cattani,(44) Rapchevski,(38) Rekowski 

 and Dzierzgowski,(39) Sawtschenko,(40) Girode,(8) Bruloff,(3) 

 Defressine and Cazeneuve, (5) Kulescha, (29) Greig,(9) and 

 Schobl. (42) The last three authors have especially emphasized 

 the importance of these findings. 



In 430 autopsies on cholera cases Kulescha (29) found chole- 

 cystitis forty-two times (10 per cent). In 1908, in 109 cholera 

 cases, he found the vibrio in the gall bladder forty-nine times 

 (46 per cent), and in 1909, in 50 cases, he found it thirty-eight 

 times (76 per cent). Bruloff(3) found the vibrio in the bile 

 of 76 per cent of the cases examined. In 1913 Greig(9) examined 

 the bile in 271 fatal cases of cholera and cultivated the cholera 

 vibrio from 80 of these cases (29.5 per cent). He found naked- 

 eye changes in the gall bladder in 12 of this series (4.4 per cent) 

 and in 10 of the 235 cases (4 per cent) in the post-mortem rec- 

 ords at the Medical College, Calcutta. Schobl(42) found cholera 

 vibrios in the bile of 17 of 39 cholera cases examined (43.5 per 

 cent) . 



In our own series the cholera vibrio was isolated from the 

 bile in 137 of 212 cholera cases (65.2 per cent) and from the 

 bile when the intestinal contents were negative in 12 cases (5.7 

 per cent) . In 32 cases of cholera carriers detected post mortem 

 we found the cholera vibrio, in the bile in 24 cases (75 per cent) 

 and in the bile when the intestinal contents were negative in 

 14 cases (43.7 per cent). 



This finding of ours appears to be important. The fact of 

 the presence of the vibrio in the bile in so large a proportion 

 (65.2 per cent) of cholera cases confirms and extends the work 

 of others. The fact of finding the vibrio in the bile in so many 

 cholera cases (12) when it could not be isolated from the intestine 

 emphasizes the importance of examining the bile as well as the 

 intestinal contents of all suspected cholera cases. This impor- 

 tance is still further emphasized by our finding the vibrio in the 

 bile in 75 per cent of cholera carriers and in the bile alone in 

 43.7 per cent of 32 carriers. 



The detection of cholera carriers after death by such examina- 

 tions is to be expected in view of the large number of such 

 individuals known to exist where cholera is extant. The presence 

 of the vibrio in the bile in a larger proportion of cholera carriers 

 than in the intestine renders the routine examination of the bile as 

 well as the intestine in all cases where cholera is extant of greater 

 importance. The possibility of detecting carriers in this way, 

 who might otherwise have escaped attention, before the outbreak 



