Abstract
1) Morphological observations were made on 21 cholera patients who were autopsied soon after death. Since 19 of the cases were those dying within 41 hours after the onset, the changes with time in the early stage of cholera were studied.
2) Small intestinal mucosal abnormalities are represented by acute inflammatory reactions and subsequent atrophic alteration of villous architecture. In these changes, the increased reproduction of epithelial cells in crypts by inflammatory stimulus seems to play an important role.
3) Increased secretion of excretory glands was seen in goblet cells of the small and large intestines, in Paneth's cells of the intestine, and in goblet cells of the bronchi in cases of aspiration of gastric content. Increased secretion of pancreatic juice and bile was also observed.
4) It is speculated that cholera toxin is absorbed by the intestine or some stimulating substance is produced in the intestine. This is suggested by a) reactions of the mesenteric lymphnodes and spleen, b) fatty changes of the liver and kidney, and c) increased secretion of pancreatic exocrine system.
5) The death may be attributed to cardiac failure and swelling of the brain resulting from dehydration. Respiratory disturbance due to aspiration of gastric content should also be considered. Renal changes in the early stage of the disease are mild and consequent renal failure could have been prevented by proper transfusion.
