ii.] DISTRIBUTION OF COMMA-BACILLI. 37 



An important line of research is hereby opened up, namely 

 to enquire to what extent in the human subject do the 

 bacteria normally present in the cavity of the intestine 

 penetrate into the wall of the intestine ? It must be clear 

 from the above that statements as to the occurrence of one 

 or other species of bacteria in the tissue of a diseased 

 intestine, e.g. in typhoid fever, cannot claim that significance 

 which has hitherto been attributed to them. In typhoid 

 fever the disorganisation of the intestinal wall is very 

 profound, and lasts days and weeks ; there is no reason why 

 bacteria, particularly motile bacilli, such as the so-called 

 typhoid bacilli are, should not penetrate deep into the 

 intestinal wall and thence into the mesenteric glands, 

 particularly into the foci of inflammation and necrosis 

 always present in these glands in typhoid fever, and even 

 further into the necrotic foci of the spleen. And the same 

 applies to the choleraic intestine ; in some cases, particularly 

 those remaining for some hours in articulo merits, or kept 

 for some time after death before examination is made, the 

 motile comma-bacilli and other motile bacilli of the internal 

 cavity can penetrate into the tissue of the intestine, par- 

 ticularly as the mucous membrane is in a profound state of 

 disorganisation, and, as has been noticed and described by 

 various observers, also into more distant localities, e.g. the 

 liver and gali-bladder. 



(d) As I have mentioned under (b), I cannot confirm the 

 statement of Koch that the purer and the more typical and 

 acute a case of cholera, the more does the lower part of the 

 ileum contain an almost pure cultivation of the comma- 

 bacilli. Although I have found in some typical acute cases 

 that the mucus-flakes of the contents of the lower ileum 

 contained comma-bacilli in large numbers and continuous 

 masses, I have seen others where these comma-bacilli were 



