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The publication of Mr Norman Longmate’s book King Cholera in November 1966 served as a reminder of the terrible scourge which afflicted this country on no less than four separate occasions during the nineteenth century. While this volume was, no doubt—as the ‘blurb’ on its dust-jacket affirms—‘an important contribution to social history’, so far as the part which the Church played during those critical years, the half was not told in its pages. In this short paper it will be my task to try to repair this omission in regard to just one of the four major outbreaks of the disease in England, the last in fact, that of the year 1866; and to say something of the response made by churchmen and women to the cholera outbreak of a century ago.

Suitable mesenteric glands were selected from virus hogs, the glands carefully dissected out of mesentery, covered with 10 times their weight of absolute alcohol, and placed at 37 C. over night. The alcohol was then decanted off, the glands thoroughly ground with sterile sand, and the alcohol again added to the ground glands. The preparation was then placed at 37 C. for 8 days and thoroughly shaken each day. At the end of this period the preparation was filtered through an ordinary, white, folded filter paper. The filtrate, which measured 670 c.c, was evaporated by the aid of an electric fan to a somewhat pasty, deeply yellow mass. This mass was partly dissolved in 225 c.c. of ether and set aside to sediment. The ether was decanted from the sediment and allowed to evaporate to a volume of 15 c.c. To this 15 c.c. were added 75 c.c. (5 times its volume) of acetone. A heavy, flocculent precipitate immediately formed, which was allowed to settle, whereupon the supernatant liquid was decanted. Twenty-five cubic centimeters of methylic alcohol were added to the precipitate. The methylic alcohol dissolved a portion of the precipitate, leaving, however, a deeply yellow, sticky mass undissolved. After sedimentation the methylic alcohol, decanted and diluted 1:10 with normal salt solution (1.5 c.c), was used as antigen in amounts varying from 0.01 c.c. to 0.03 c.c. with, in each case, 0.05 c.c. immune serum, 0.045 c.c. complement, 0.1 c.c. hemolysin, and 0.5 c.c. red blood corpuscles. The antigen, immune serum, and complement were mixed and placed at 37 C. for 1 hour, whereupon the hemolysin and corpuscles were added and the whole placed at 37 C. for 2 hours. Complete hemolysis followed in every case. The test for complement absorption was negative. This test was repeated with 10 times the dose of antigen used in the first test, and the result was again negative.

A controlled comparison of furazolidone and tetracycline in the treatment of cholera indicates that, in either dosage used, furazolidone reduced total stool volume by 50% and duration of diarrhoea by 40%. These results are comparable to those achieved with tetracycline, which was given in presently recommended dosage. Both furazolidone and tetracycline significantly reduced the rate of stool output within 18 to 24 hours of starting antibiotic treatment. Furazolidone was significantly less effective than tetracycline in rapidly and consistently terminating vibrio excretion. One convalescent carrier of cholera vibrios was identified among control patients; none was identified among patients treated with either tetracycline or furazolidone. All Vibrio cholerae strains tested were sensitive to tetracycline and furazolidone, but larger concentrations of the latter were required to achieve inhibition of growth. It is concluded that tetracycline remains the antibiotic of choice in cholera but that furazolidone would be a useful adjunct to cholera therapy when tetracycline is unobtainable or if strains of V. cholerae with clinically significant resistance to tetracycline should be encountered.