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XXVIII] an injected appearance. On opening the bowel it is found to contain a larger or smaller amount of the characteristic rice-water material, occasionally blood. The mucous membrane of the stomach and intestine is generally pinkish from congestion, or there may be irregularly congested or arborescent patches of injection here and there throughout its extent. In addition, there may be seen smaller or larger points of ecchymosis in or under the mucous membrane. The changes in the alimentary canal are most marked at the lower end of the ileum, where Peyer's patches and the solitary glands may be seen to be congested and swollen. In some instances the bowel is pale throughout; in many the mucous membrane has a sodden, pulpy appearance from exfoliation of epithelium— possibly a post-mortem change; occasionally, especially towards the lower end of the ileum, a croupous exudation is met with. Greig has shown that the gall-bladder and biliary passages are frequently invaded by the cholera vibrio, and in a proportion of instances are, consequently, more or less inflamed. He also found that in a proportion of cases (8 in 55) the vibrio is present in the urine. The mesenteric glands are congested. The superficial veins of the kidneys are full; the medullary portion is much congested, the cortical portion less so; the tubules are filled with granular matter; the epithelium is cloudy, granular, or fatty, and, at a later stage, may be shed. The bladder is empty and contracted. Nothing special is to be noted in the nervous system.

If death have occurred during the stage of reaction, the tissues are moist; the venous system is less congested; the lungs are probably congested and œdematous, perhaps inflamed. Very probably there are evidences of extensive enteritis.

Microscopical examination of the contents of the bowel during the acute stage of the disease discovers, in most instances, the comma bacillus. Usually it is in great abundance; occasionally in what is almost a pure culture. Sections of the intestine show the bacillus lying on and between the epithelial cells of