90 PHYSIC 



where the indispensable element of water becomes con- 

 taminated and where its choice is limited. Drinking water 

 thus becomes the principal representative of the media 

 by which such organisms are conveyed within the bodies 

 of their victims, and its most lethal microbic organism is 

 the comma-bacillus, or cholera germ. The manner and 

 methods of its attack have been described so fully that a 

 great literature is now claimed by it, and yet it cannot be 

 said that it is satisfactorily understood thus its geographi- 

 cally determined varieties are sometimes not founded on 

 generic differences of bacterial organisms, but on climatic 

 and other influences affecting the growth, virulence, and 

 septic qualities of, in all respects, identical organisms. 

 We, therefore, sometimes find that a local outbreak of 

 British cholera, or summer diarrhoea, is in no way dis- 

 tinguishable from Asiatic cholera in the fatality of its 

 influence, the character of its materies morbi, and the 

 symptoms to which it gives rise. 



In illustration of the truth of this statement I would 

 adduce the following personal experiences in which my 

 own services as Medical Officer of Health were completed 

 by those of Professor Klein, Bacteriologist, and Dr. 

 Bulstrode, Inspector of the Local Government Board. 



The findings of Professor Klein, after an examination 

 of the excreta of the first and last cases, were to the effect 

 that the bacillary organisms discovered were "indistin- 

 guishable from those of Asiatic cholera." 



This outbreak proves that the disease can be self- 

 renewed in the same individual by the preservation of 

 septic cultures from a patient's own excreta. Moreover, 

 from this point of view we may be warranted in inferring 

 that the dried residue of choleraic diarrhoea might be 

 spread atmospherically, might remain dormant for a period, 

 or until the required conditions of heat and moisture being 

 renewed a re-growth is effected, by which the disease may 

 again be spread. 



This is the experience referred to which I take the 

 liberty of quoting from my final report on the subject to 

 the Local Government Board. 



