OF CHOLERA AND COMMAS. sll 
free of any tubercle bacilli, contained, besides other putre- 
factive organisms, also comma-bacilli, and in this case they 
were so distinct that there was no difficulty in identifying 
them, and they were as numerous as in many cholera stools 
that we have examined. In the stool of a case of diarrhea of 
a child suffering from chronic peritonitis (February, 1882) there 
are present in specimens stained with Spiller’s purple numbers 
of comma-bacilli which it is impossible to distinguish from 
choleraic comma-bacilli; in size, shape, and general aspect 
they appear identical. On the whole, then, we maintain, 
contrary to Koch’s emphatic statement, that the comma-bacilli 
occur also in cases of intestinal disease other than cholera” 
(page 7). 
16. Both before and since this report was written evidence 
of a like character has been adduced, but it is to be borne in 
mind that, in at least some instances, such, for example, as the 
comma-shaped organisms which have been found associated 
with the cases of so-called “‘ cholera nostras ” in Bonn, it has 
been stated that “although in size and form they resemble 
those of cholera, they are, neverthelsss, not identical with 
them.” Drs. Klein and Gibbes draw attention to the fact, 
which had been recently pointed out, that comma-shaped 
bacilli, similar in appearance to those found in cholera, are 
ordinarily present in certain parts of the alimentary tract in 
health; and, as will be seen by a reference to our ‘ Proceed- 
ings,’ there is reason to assume that these comma-shaped 
organisms present themselves under two, if not three, forms in 
the mouth alone. It has latterly been shown by Miller that 
at least one of these forms can be cultivated, though isolating 
it in the first instance appears to have been a difficult task ; 
and we are informed that Dr. Klein (apparently since the sub- 
mission of the report) has succeeded in cultivating either this 
or one of the other forms of mouth-commas, and has, moreover, 
demonstrated that its action on the media in which it grows is 
identical with that of the comma-bacillus as derived directly 
from a case of cholera. That the two forms are absolutely 
identical does not, however, appear to have been definitely 
