lera
in Egypt last year to study the disease before it reached European soil
was taken advantage of by various governments, who sent expeditions for
the purpose. He had the honor to take part in one of these, and in
accepting it he well knew the difficulties of the task before him, for
hardly anything was known about the cholera poison, or where it should be
sought; whether it was to be found only in the intestinal canal, or in the
blood, or elsewhere. Nor was it known whether it was of bacterial nature,
or fungoid, or an animal parasite--e.g., an amoeba. But other difficulties
appeared in an unexpected direction. From the accounts given in text-books
he had imagined that the cholera intestine would show very slight changes,
and would be filled with a clear "rice-water" fluid. He had not fully
recollected the conditions met with in post-mortem examinations had
formerly made, and was therefore at first surprised to meet with quite a
different state of things. For he soon found that in a large majority of
cases remarkably severe lesions were present in the intestines. In other
cases the changes were slighter, and eventually he met with some which, to
a certain extent, corresponded with the type described in text-books. But
it was some time, and after many inspections, before he was enabled to
correctly interpret the varied changes met with. In spite of a most
careful examination of all other organs and of the Mood, nothing was found
to establish the presence of an infective material, and attention was
finally concentrated on the intestinal conditions.

There were cases in which the lower segment of the small intestine, most
marked immediately above the ileocaecal valve, extending thence upward, was
of a dark reddish-brown color, the mucous membrane being covered with
superficial haemorrhages. In many cases the mucous membrane appeared to be
superficially necrosed, and covered with diphtheritic patches. The
intestinal contents in such cases were not colorless, but consisted of a
sanguinolent, ichorous, putrid fluid. Other cases showed a gradual
transition to a less marked change. The redness was less intense, and was
in patches, while in others the injection was limited to the margins of
the follicular and Peyerian glands, giving an appearance which is quite
peculiar to cholera. In comparatively few cases were the changes so slight
as to consist in a somewhat swollen and opaque condition of the
superficial layers of the muc