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 mucous membrane, with delicate rosy-red
injection, and some prominence of the solitary follicles and Peyer's
patches. In such cases the intestinal contents were colorless, but
resembling meal-soup rather than rice-water. In only a solitary instance
were the contents watery and mucoid. Microscopical examination of the
intestine and its contents revealed, especially in the cases where the
margins of Peyer's patches were reddened, a considerable invasion of
bacteria, occurring partly within the tubular glands, partly between the
epithelium and basement membrane, and in some parts deeper still. Then he
found cases in which, besides bacteria of one definite and constant form,
there were others also accumulated within and around the tubular glands,
of various size, some short and thick, others very fine; and be soon
concluded that he had to do here with a primary invasion of pathogenic
bacilli, which, as it were, prepared the tissues for the entrance of the
non-pathogenic forms, just as he had observed, in the necrotic,
diphtheritic changes in the intestinal mucosa and in typhoid ulcers.
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