88 The Philippine Journal of Science isi? 



ularity not only makes it impossible to detect all carriers in any 

 general bacteriologic survey, but it renders difficult the problem 

 of how long a carrier should be hospitalized or regarded as a 

 potential source of infection. Schobl states that the adminis- 

 tration of bile may facilitate the search for cholera carriers 

 among quarantined persons. 



Of 189 carriers detected in Bilibid Prison in 1914, 5 developed 

 the disease in from four to eighteen days after having been 

 detected as carriers. In order to detect carriers who might 

 otherwise escape in the routine examination at the cholera hos- 

 pital in Manila, a follow-up system has been adopted. Cholera 

 carriers and cases are discharged from the hospital after 3 suc- 

 cessive negative examinations of the faeces at 2-day intervals. 

 All cholera carriers and recovered cholera cases are followed to 

 their homes and examined weekly for a period of two months. 

 If they are found positive, they are returned to the hospital. 

 About 27 cases were so returned in eight weeks. 



The development of antibodies against the cholera vibrio in 

 cases of cholera appears to be rather inconstant. Agglutinins for 

 the cholera vibrio have been found in the blood of cholera patients 

 by Achard and Bensaude,(i) Haller,(23) Karwacki,(26) Schir- 

 now,(4i) Kopp,(28) Svenson,(43) Oya,(35) Greig,(i7) and many 

 others. Even when agglutinins are present, they are not in great 

 abundance, as the titer of the serum is in the majority of the 

 cases below 1 : 500. Kolle and others have shown that normal 

 sera may agglutinate the cholera vibrio in dilutions up to 1 : 20. 

 At any rate, the reaction is of limited diagnostic importance 

 in cases of cholera, for it is usually absent in fatal cases, and 

 the agglutinins do not appear to any extent in the blood until 

 convalescence has commenced. (17) Greig thinks that the re- 

 action may be of value in the prognosis of cholera cases, in as 

 much as he found that agglutinins appeared earlier and in 

 greater amounts in nonfatal cases. He also thinks that the re- 

 action may be a valuable preliminary test in the detection of 

 convalescent cholera-carrier cases. 



Another point of undetermined importance in dealing with 

 the cholera epidemics is the significance to be attached to the 

 finding of choleralike vibrios in the stoqls or tissues of persons 

 under examination. Opinions on this question are not as yet 

 unanimous for lack of positive evidence. These vibrios may 

 have all the characters of the true cholera vibrios save that they 

 are not agglutinated by high-titer cholera-agglutinating serum 

 and do not, when injected intravenously into rabbits, produce 



