6i6 Asiatic Cholera 



are deeply congested, almost velvety in appearance, and contain 

 liquid fecal matter. The patient suffers from diarrhea, by which 

 the feces are hurried on and become extremely thin from the ad- 

 mixture of a copious watery exudate. As the feces are hurried out 

 more and more of the aqueous exudate accumulates, until the intes- 

 tine seems to contain only watery fluid. The sohtary glands and 

 Peyer's patches are found enlarged and the mucosa becomes macer- 

 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 ulcera- 

 tions 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 hver, 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. 



Zeatogoroff* found that the cholera spirilla could remain alive in 

 the intestinal canals of those recovered from the disease as long as 

 93 days. Their duration he supposed to depend upon associated 

 organisms by which it might or might not be extinguished. In Heu 

 of the observations of Kuleschaf that disease of the biliary passages 

 were occasioned sequelae of cholera, and that the spirilla could long 

 remain in the gall-bladder, it seems as though a new supply of the 

 spirilla might at frequent intervals enter the intestinal contents. 



This makes it not improbable that there are "cholera carriers" 

 just as there are "typhoid carriers" among convalescents. 



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

 and never occurs spontaneously in the lower animals. 



Supposing that the lower animals were immune against cholera 

 because of the -acidity of the gastric juice, Nicati and Rietsch,t 

 Van Ermengem, and Koch§ 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 



* "Centralbl. f. Bakt. u. Parasitenk," Originale, 1911, LVin, 14. 

 t "Centralbl. f. Bakt. u. Parasitenk," Originale, 1909, l, p. 417. 

 t "Deutsch. med. Wochenschrift," 1884. 

 § Ibid., 1885. 



