576 Asiatic Cholera 



ated and necrotic, its epithelium separating in small shreds or 

 flakes. The evacuations of watery exudate rich in these shreds con- 

 stitute the characteristic "rice-water discharges" of the disease. 

 As the disease progresses, the denudation of tissue results in the 

 formation of good-sized ulcerations. Perforations and deep ulcer- 

 ations are rare. Pseudo-membranous formations not infrequently 

 occur upon the abraded and ulcerated surfaces. The other mucous 

 membranes of the alimentary apparatus become congested and 

 abraded; the parenchyma of the liver, kidneys, and other organs 

 become markedly degenerated, so that the urine becomes highly 

 albuminous and very scanty in consequence of the anhydremia. 

 The cardio-vascular, nervous, and respiratory systems present no 

 characteristic changes. 



So far as is known, cholera is a disease of human beings only, 

 and never occurs spontaneously in the lower animals. 



Intraperitoneal injection of the virulent cultures produces fatal 

 peritonitis in guinea-pigs. 



Supposing that the lower animals were immune against cholera 

 because of the acidity of the gastric juice, Nicati and Rietsch,* 

 Van Ermengem, and Kochf have suggested methods by which 

 the micro-organisms can be introduced directly into the intestine. 

 The first-named investigators ligated the common bile-duct of guinea- 

 pigs, and then injected the spirilla into the duodenum with a hypo- 

 dermic needle, with the result that the animals usually died, some- 

 times with choleraic symptoms. The excessively grave nature of 

 the operation upon such a small and delicately constituted animal as 

 a guinea-pig, however, greatly lessens the value of the experiment. 

 Koch's method of infection by the mouth is much more satisfactory. 

 By injecting laudanum into the abdominal cavity of guinea-pigs 

 the peristaltic movements of the intestine can be checked. The 

 amount necessary for the purpose is large and amounts to about 

 I gram for each 200 grams of body-weight. It completely nar- 

 cotizes the animals for a short time (one to two hours), but they re- 

 cover without injury. The contents of the stomach are neutralized 

 after administering the opium, by introducing 5 cc. of a 5 per 

 cent, aqueous solution of sodium carbonate through a pharyngeal 

 catheter. With the gastric contents thus alkalinized and the peris- 

 talsis paralyzed, a bouillon culture of the cholera spirillum is intro- 

 duced through the stomach- tube. The animal recovers from the 

 manipulation, but shows an indisposition to eat, is soon observed to 

 be weak in the posterior extremities, subsequently is paralyzed, and 

 dies within forty-eight hours. The autopsy shows the intestine 

 congested and filled with a watery fluid rich in spirilla — an appear- 

 ance which Frankel declares to be exactly that of cholera. In 

 man, as well as in these artificially infected animals, the spirilla are 



* "Deutsch. med. Wochenschrift," 1884. 

 t Ibid., 1885. 



