17,1 Brillantes: Disease-carrier Problem 115 
Munson, in 1914, mentions the occurrence of a number of 
intermittent carriers in Bilibid Prison, one of them for over 
seven weeks. In the same institution an individual, after having 
been a case in 1913, was found to be a carrier in 1914. It 
therefore remained to determine the limit of the viability of 
the vibrio in the intestine. The possibility of these individuals 
having harbored the vibrios for the whole time (one of them 
over a year) and being representative of persons responsible for 
the annual outbreaks, was recognized. Treatment with salol was 
apparently of little value, since some carriers receiving it for 
some time developed the disease, and one of them even died. 
In 1915 Schobl reported the examination of thirty-nine gall 
bladders, seventeen of which were positive for vibrios while the 
intestines of the same cases were all positive. All of the forty- 
one specimens of urine from patients and convalescents were 
negative, while the fseces from the same were positive. 
A little later the same author succeeded in producing carriers 
among guinea pigs by inoculation of living cultures of cholera 
vibrios into the gall bladder, stomach, small intestines, and 
serous cavity, and by feeding, although the duration of this 
state was limited to fourteen days. He also determined that 
in these experimental cholera carriers there was an infection 
of the gall bladder caused by the injected cholera vibrios, the 
latter therefore not only surviving there as mere saprophytes. 
He also found that infection may extend to the liver. Cholera 
vibrios were absent from the blood, lungs, and spleen; hence 
the improbable septicaemic character of the infection. The 
excretion of vibrios was irregular, so we see that this cor- 
responds to the occurrence of intermittent human carriers. 
Coulter in 1915, and Crowell and Johnston in 1917, also found 
gall-bladder infections in connection with cholera carriers, as 
well as the presence of cholera vibrios in the bile. As compared 
with the results of the cholera-carrier survey in 1914 there was 
observed in 1915 a marked decrease, the Incidence being only 
0.41 per cent (1.42 per cent in 1914). 
Long, in 1916, stated that it has been demonstrated pretty 
conclusively that when a cholera carrier is given a severe purge, 
or when he (the carrier) ingests food or other substances which 
have the effect of producing a severe purge, the carrier fre- 
quently is converted into an actual case. 
A suggestion of this developed in a recrudescence of the 
cholera outbreak of that year, which came in November and 
December. It developed, on investigation, that at this time 
