CHOLERA. I05 
frequently extra-cellular during the early stages of an 
attack of urethritis, and, though to a less extent, during 
its involution, whilst cases sometimes occur in which 
a considerable number of the cocci lie free during the 
whole course of the disease. 
CHOLERA. 
The diagnosis of cholera can only be made on clinical 
grounds alone during an epidemic, as other diseases 
present almost identical symptoms and course. The 
importance of making a correct diagnosis arises less 
from the interests of the patient than from those of the 
general public; if the case is one of true Asiatic cholera 
the sanitary authorities must be notified and the fullest 
precautions taken to prevent the spread of the disease. 
In all suspicious cases a quantity of the rice-water 
stools (in a bottle sterilised by boiling or by dry heat 
and securely packed) should be forwarded at once to a 
public laboratory. Meanwhile the diagnosis may be 
established with a fair amount of certainty by the 
following simple tests :— 
1. Take a platinum loopful of the dejecta and spread 
it in a thin film on a clean slide; dry, fix, and stain 
with carbol-fuchsin for three minutes; wash, dry, and 
mount. 
2. Prepare another film and stain by Gram’s method. 
EXAMINATION OF THE FILMs. 
The spirillum of Asiatic cholera is about half as long 
as a tubercle bacillus, or rather longer, and much 
