14 The Philippine Journal of Science 1913 
it was recommended as enrichment medium. During the acute 
_attack of cholera the proximal part of the small intestine usually 
contains cholera vibrios in pure culture, and frequently cholera 
vibrios are found in the stomach contents if vomiting sets in. 
Two out of three vomits collected from known cholera cases 
examined by me contained numerous cholera vibrios. 
It is evident that once the lively motile cholera vibrios reach 
the gall bladder they grow practically without competition. 
Kolle and Schiirmann’ state that the numerous examinations 
of cholera cadavers made in India showed that the cholera 
vibrios are restricted to the intestines while the internal organs 
are free from vibrios. Their statement is based on the findings 
which were published in extenso in the official report of Pro- 
fessor Gaftky. 
Greig ?° believes that the infection of the bile passages is 
of hematogenous origin. He found cholera vibrios in a focus 
in the lungs. 
Kulescha 1! admits that under certain conditions cholera vi- 
brios invade the gall bladder through the bile passages, but he 
upholds the theory that the vibrios reach the gall bladder 
through the blood stream on the following ground: he found 
necrotic foci (emboli) in the liver of cholera cadavers and suc- 
ceeded in isolating the cholera vibrios therefrom. As a support 
of the theory of the hematogenous origin of the infection of 
the gall passages by cholera vibrios, this author quotes the 
findings of Sewastjaneff, who found 5 cases of vibrionuria, one 
of them being of four days’ duration, and also the case of Lief- 
schiitz-Jakowleff who isolated the cholera vibrio from a stillborn 
child whose mother suffered with cholera. Kulescha made 
numerous examinations of urine in cholera patients under strict 
aseptic precautions and failed to find the cholera vibrio. Ina 
preliminary note Greig ** reports 8 positive findings of cholera 
vibrios in the urine (55 examinations). Several cases analogous 
to that of Liefschiitz-Jakowleff came under my observation 
during the outbreak. The results of these examinations are 
summarized in Table II. 
* Cited from Kolle und Wassermann, Handbuch der pathogenen Micro- 
organismen. Gustav Fischer, Jena. 
See footnote 2. 
™ See footnote 4. 
% See footnote 2. 
