The diagnostics and treatment of tropical diseasesStitt, E. R. (Edward Rhodes)
Science
The diagnostics and treatment of tropical diseases
Stitt, E. R. (Edward Rhodes)
Tropical medicine
It is true that the digestive action which true cholera has on
the red cells of the medium may give the appearance of a zone of
haemolysis. Therefore, for the demonstration of this haemolytic
action of noncholera spirilla, fluid blood media should be used.
The El Tor spirillum, isolated from Egyptian pilgrims without
symptoms of cholera, is haemolytic, but gives the immunity
reactions of the true cholera vibrios which are not haemolytic.
Gelatine is liquefied and the stab shows an air bubble liquefaction
at the summit of the stab. On gelatine plates a powdered glass
center with an encircling zone of liquefaction was formerly
considered characteristic of cholera, but at the present time
gelatine cultures have been almost abandoned in practical work.
As a rule animals cannot be infected by feeding them cholera
material unless the acidity of the gastric juice be neutralized
and intestinal peristalsis checked by opium (procedure of Koch).
Injected intraperitoneally, the cholera vibrio produces a fatal
peritonitis. Recently monkeys have been infected after purgation
with sulphate of soda and administration of bicarbonate of soda.
They died in from one to forty-eight hours with symptoms of cholera.
There have been instances where cholera has been caused in laboratory
workers by the accidental ingestion of cholera cultures, thus Orgel
was infected from sucking up peritoneal fluid in doing Pfeiffer tests
for bacteriolysis and died.
Emmerich and Pettenkofer swallowed cholera cultures, the former
experiencing a severe attack of cholera and the latter a diarrhoea
in which cholera spirilla were present. On the other hand similar
experiments have resulted negatively but this is what should be
expected from the epidemiological facts as to carriers.
The virulence of the cholera vibrio can be exalted by passage
through guinea pigs—successive culturing of the peritoneal exudate
of intraperitoneally infected animals alternating with culture
media growth inoculations. Such a fixed virus, the virulence of
which cannot be exalted, is the material used by Haffkine in
his cholera vaccine. The toxicity of cholera is supposed to be
due to an endotoxin which is set free when the vibrios undergo
disintegration when lying between the basement membrane and
epithelial lining of Lieberkühn’s glands. Others think the vibrios
may enter the blood stream, there to be immediately disintegrated
with toxin production. The usual idea, however, is that the cholera
spirilla never invade the blood stream—they are confined to the
alimentary canal. Macfadyen obtained the endotoxin by grinding the
frozen spirilla. This toxin was destroyed by a temperature of 60°C.
Public-domain text, read in full here on John Shaqi.
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