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THE CHOLERAS 



the existence of a clinical entity differing from true cholera mainly in 

 the fact that the causal organism is not the cholera vibrio. 



etiology. — The organisms which have been isolated from cases 

 of paracholera are : — 



Vibrio kegallensis vel paracholerce Castellani in Ceylon. 



Vibrio freseris Lamas in Spain. 



Vibrio gindha Pfeiffer, by Chalmers and Waterfield, in 1916, 

 in the Anglo-Egyptian Sudan. 



Orticoni's vibrio in Marseilles in 1911. 



Symptomatology— Clinically the symptoms resemble those of 

 Asiatic cholera, and as such the cases are generally diagnosed. The 

 motions are generally of the rice-water type, but are sometimes 

 slightly greenish, therein differing from true cholera. 



Treatment.- — This is the same as for cholera. 



PSEUDOCHOLERA. 



Synonyms. — Choleraic diarrhoea, so-called ptomaine poisoning, Serous 

 diarrhoea, Trench diarrhoea. 



Definition. — -Pseudocholera is an acute attack of serous diarrhoea 

 which resembles cholera and paracholera in its symptoms, but differs 

 therefrom in being due to various causes, none of which is a vibrio. 



Remarks. — Cases of profuse serous diarrhoea associated with 

 algidity, muscular cramps, and in general showing symptoms 

 resembling cholera or paracholera, are not rare, in our experience, 

 in tropical and subtropical lands and war zones. 



etiology — The causal agents are very various^ — e.g., food poison- 

 ing, generally caused by bacilli of the aertrycke type; serous 

 diarrhoea, caused by bacilli of the dysentery group ; atypical subter- 

 tian malaria ; certain poisons. We will now consider the symp- 

 tomatology of these varieties. 



Food-Poisoning Pseudocholera. 



This form of pseudocholera is generally due to 5. aertrycke. The 

 cases are of mild or moderate severity, and are often termed 

 ' ptomaine poisoning.' The onset is acute, with severe abdominal 

 pain, furred tongue, and diarrhoea. The motions do not contain 

 blood or mucus, nor are they usually of the nature of rice-water, but 

 in the more severe cases the stools are choleraic and there may be 

 algidity and cramp. 



Bacillus aertrycke can be differentiated from B. paratyphpsus B by means 

 of Castellani's absorption test. Broughton Alcock has described several 

 varieties of B. aertrycke which can be distinguished by this method. For its 

 biochemical characters see table of intestinal bacteria, p. 944. 



Dysenteric Pseudocholera. 



Castellani some years ago showed that the type of choleraic 

 diarrhoea, called serous diarrhoea, was often due to bacilli of the 



