12 The Philippine Journal of Science 1915 
Pfeiffer * mentions only 2 cases of from forty-eight to forty- 
nine days’ duration; Stiihlern-Zeidler,? 1 case of ninety days; 
Jakowleff * gives 1 case of fifty-six days; and Creel,® 1 case of 
fifty-eight days’ duration. Our record case was positive for 
forty-eight days with several intermissions. The case was in 
the care of Dr. C. S. Butler, of the United States Navy. 
According to the clinical report, which I obtained through 
the kindness of Doctor Butler, the patient became sick on 
October 5. The feces were still positive on November 23. 
Three negative examinations three days apart followed. 
It is interesting to note that the chronic carriers of the Rus- 
sian authors showed intermittent diarrhea after recovering 
from the acute attack of cholera. It also was noticed that 
chronic carriers exhibited clinical signs of cholecystitis; that is, 
icterus and tenderness in the region of the gall bladder. 
In a recent paper Greig ® tabulated the results of 271 bac- 
teriological examinations of gall bladders taken from deceased 
cholera cases, and emphasized the significance of the already 
known fact that cholera vibrios frequently are found in the 
bile passages of cholera patients and convalescents. His is the 
largest series of examinations on record. Among the 271 ex- 
aminations the cholera vibrio was found eighty times, and 12 
of the 80 gall bladders which harbored cholera vibrios showed 
pathological changes. 
Kulescha’ studied the pathology of bile passages during the 
outbreak of cholera in St. Petersburg in 1908-1909. He found 
in the literature the first report of a necrotic cholecystitis in a 
case of cholera by Pirogoff (1848) and an analogous case by 
Netschaeff (1892). Mentioning the numerous authors who con- 
tributed to the knowledge of the subject, he quotes the results 
of examinations made by M. J. Girode as of particular interest. 
Of 28 cases examined, 14 contained vibrios. There was one 
case of marked cholangitis. Savtschenko found cholecystitis 
twice among 30 cholera autopsies. Kulescha found, among 430 
autopsies performed on cholera cadavers, cholecystitis in 10 per 
cent. The majority were in the first or second week of the 
disease. Cholera vibrios were found in 46 per cent of gall 
bladder examinations in 1908 (109 cases examined) and in 76 
* Cited from Jansen, Klin. Jahrb, (1910). 
*Cited from Kulescha, Klin. Jahrb. (1910). 
® Journ. Am. Med. Assoc. (1912), 187. 
*See footnote 2. 
“See footnote 4. 
