CHOLERA VIBRIO 5()o 
Asiatic cholera may present at (iiii'erent times a \-ariety of clinical 
symptoms which for convenience may be grouped as follows: 
1 . Ambulatory Cholera : The symptoms are either very mild or they 
may be unnoticed. Such cases are potentially or actually vibrio car- 
riers. The diagnosis flepends upon the isolation of the specific \ibrio 
from the feces. 
2. Cholerine: Diarrhea, with or without choleraic abdominal 
cramps; the diarrhea may be transitory or pass into typical cholera, 
with the characteristic rice-water stools and other symptoms of typical 
Asiatic cholera. The patient soon enters upon convalescence. This 
group contains both those individuals who harbor true cholera vibrios 
and those from whom various cholera-like vibrios may be isolated. It 
is very probable that the term "Paracholera"^ may be appropriately 
applied to those choleroid cases which harbor cholera-like vibrios. 
Fig. 76.— Cholera vibrios, showing flagella. 
3. Cholera Gra\is, the typical disease, characterized by a sudden 
onset after an incubation period of a very few hours to three or four 
days, vomiting and purging of serous material, extremely painful 
cramps, rice-water stools and collapse. 
4. Cholera Sicca: The patient very rapidly enters into a state of 
collapse and dies before typical symptoms of diarrhea and vomiting 
appear. Death may occur within a few hours after infection. Post- 
mortem examination of cultures from the intestinal contents will 
establish the diagnosis. 
Morphology.— The typical cholera vibrio is a distinctly curved rod, 
the cur\ature being in three planes of space. It measures 0.5 to 0.6 
micron in diameter by 1 to 'A microns in length, occurring singly or 
in pairs, less commonly in longer spiral chains of several elements. 
Pairs of organisms frequently appear as S-shaped spirilla, the curva- 
' Castellani: Jour. Trop. Med. and Hyg., 1915, 18, No. 8. Chalmers and Water- 
field: Ibid., 1916, 19, No. 14. Greig: Indian Jour. Med. Research, 1917, 5, Nos. 1 
and 2. 
