ENGLISH CHOLERA. 291 



organism long before the death of the patient, which is 

 often attributable to their action rather than to that of the 

 Bacillus icteroides. 



ENGLISH CHOLERA {Cholera nostras)— AUTVWNAL 

 AND INFANTILE DIARRHCEA. 



English cholera or Cholera nostras — Occurrence — Similarity to true 

 cholera — Exciting organisms appear to be B. coli and Proteus 

 vulgaris, which appear to assume a specific character — Klein's 

 researches — Bacillus enteritid/is sporogenes — Diarrhoea as the result 

 of meat poisoning — Infantile diarrhoea — Eesearches of Esoherioh, 

 Macfadyen, Vaughan and others — Green diarrhoea. 



Every year a certain number of cases of autuinnal diarrhoea 

 occur in various parts of the country, .which are so severe 

 in character as to be cUnically indistinguishable from true 

 Asiatic cholera. English cholera, or ' cholera nostras,' is 

 the name usually given to these cases. The cases tend to 

 occur sparsely, and as isolated cases spread over the 

 country, instead of as in the case of true Asiatic cholera, 

 in groups in particular localities. 



A large number of cases of this character have been 

 examined during the last two or three years by Dr. Klein, 

 under the auspices of the Local Government Board (see 

 Local Governvient Board Report, 1895-96). As the result 

 of the examination of the dejecta of these cases, he has 

 found the B. coli communis and the Proteus vulgaris 

 profusely abundant. The former chiefly predominated, 

 and sometimes it appeared in almost pure growth, and, 

 what is more, the cover-glass specimens showed the bacilli 

 in question distributed through the intestinal flakes in the 

 ' fish-in-stream ' arrangement which has been hitherto con- 

 sidered peculiar to Koch's comma, and so absolutely 

 diagnostic of true cholera. 



19—2 



