called typhoid stage of cholera) which may
greatly retard recovery, and under which the patient may sink at a
period even as late as two or three weeks from the commencement of the
illness.

Many other complications are apt to arise during the progress of
convalescence from cholera, such as diphtheritic and local inflammatory
affections, all of which are attended with grave danger.

When the attack of cholera is of milder character in all its stages than
that above described, it has been named _Cholerine_, but the term is an
arbitrary one and the disease is essentially cholera.

The bodies of persons dying of cholera are found to remain long warm,
and the temperature may even rise after death. Peculiar muscular
contractions have been observed to take place after death, so that the
position of the limbs may become altered. The soft textures of the body
are found to be dry and hard, and the muscles of a dark brown
appearance. The blood is of dark colour and tarry consistence. The upper
portion of the small intestines is generally found distended with the
rice-water discharges, the mucous membrane is swollen, and there is a
remarkable loss of its natural epithelium. The kidneys are usually in a
state of acute congestion. This form of cholera belongs originally to
Asia, more particularly to India, where, as well as in the Indian
archipelago, epidemics are known to have occurred at various times for
several centuries.

Much light has been thrown upon Asiatic cholera by Western experience;
and the study of the disease by modern methods has resulted in important
additions to our previous knowledge of its nature, causation, mode of
dissemination and prevention.

Causation

The cause is a micro-organism identified by Koch in 1883 (see PARASITIC
DISEASES). For some years it was called the "comma bacillus," from its
supposed resemblance in shape to a comma, but it was subsequently found
to be a vibrio or spirillum, not a bacillus. The discovery was received
with much scepticism in some quarters, and the claim of Koch's vibrio to
be the true cause of cholera was long disputed, but is now universally
acknowledged. Few micro-organisms have been more elaborately
investigated, but very little is known of its natural history, and its
epidemiological behaviour is still surrounded by obscurity. At an
important discussion on the subject, held at the International Hygienic
Congress in 1894, Professor Gruber of Vienna declared tha