The patho-physiology of cholera.

Studies conducted by US Navy Medical Research personnel in Cairo in 1947, and subsequently in Dacca, Bangkok, Hong Kong and Manila, have delineated, for the first time, the water and electrolyte losses in this disease, and have demonstrated that the cholera stool approximates an isotonic solution with a low (0.1 g%) protein content. The potassium content approximates 15 mEq/litre and the HCO(3) (-) ion approximates 45 mEq/litre; the sodium and chloride concentrations are proportionately lower than their plasma values. The low protein content and other studies refute the idea that the cholera stool is a transudate. The 1958 studies in Bangkok postulated that the diarrhoea resulted from an inhibition of the active transport of sodium ion from gut lumen to plasma. Subsequently, the presence of such an inhibitor was found in stools of patients with Asiatic cholera (Bangkok and Dacca) and with cholera El Tor (Hong Kong and Manila).