﻿NOTES ON THE DIAGNOSIS OF ASIATIC CHOLERA AT AUTOPSY 



By B. C. Crowell 



(From the Department of Pathology and Bacteriology, University of 



the Philippines, and the Biological Laboratory, 



Bureau of Science, Manila, P. I.) 



Without attempting to review the entire pathological anatomy 

 of Asiatic cholera, it may be of advantage to note some facts 

 obtained in our recent experience with 92 cases of the disease, 

 which may be useful in diagnosis at the autopsy table. 



The autopsies were performed largely as a diagnostic measure 

 to assist the Bureau of Health in locating cases of the disease. 

 This naturally entailed the examination of a much larger number 

 of bodies than appears in this series. Ninety-one and three- 

 tenths per cent of the series occurred in Filipinos, the remainder 

 occurring in Japanese, Chinese, Americans, and Spaniards. Sixty 

 of the cases were males and 32 females. The ages ranged from 

 17 days to 99 years, the greatest number occurring between the 

 ages of 21 and 25 years. 



The work of the pathologist has gone hand-in-hand with that 

 of the bacteriologist in the recent epidemic, and a loop of small 

 intestine has been submitted to the bacteriologist from every 

 autopsy that has been performed during the period of prevalence 

 of the disease. 



As this disease does not exist without the presence of the 

 cholera vibrio, the bacteriologist is naturally considered the court 

 of last appeal in the diagnosis of the disease. In the present 

 series, the number of cases in which there has been disagreement 

 between the pathologist and the bacteriologist were comparatively 

 so few, that these cases have been very instructive, and have 

 served to emphasize certain facts which should be more widely 

 recognized. 



The autopsy findings in cases of Asiatic cholera vary according 

 to (1) the stage of the disease at which the patient died, (2) 

 whether or not the patient had received treatment, and (3) the 

 presence of other associated diseases. The disease is notably 

 so severe in its action that a large number of persons previously 

 of great bodily strength and vigor succumb to its influence. On 

 the other hand, cholera is also one of the severe intercurrent in- 



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