vi.] VALUE OF CHOLERAIC COMMA-BACILLI. 117 



In another series, in which to 300 ccm. of fecal mixture one 

 cubic centimeter of the same choleraic culture was added, 

 out of twelve gelatine plates only in one was there a colony 

 of the comma-bacilli detected. In a third series to 300 ccm. 

 of faecal mixture 2 ccm. of the pure culture of choleraic 

 comma-bacilli were added; of a series of twelve gelatine 

 plates, two plates showed colonies of choleraic comma-bacilli; 

 one had one colony, one had three out of about thirty 

 colonies of other bacteria. It is evident from this that 

 although crowds of undoubted choleraic comma-bacilli may 

 be present, they are not easy of demonstration if they are 

 present only in comparatively small numbers amongst a 

 great majority of other quickly-growing bacteria. 1 And that 

 this actually obtains in a certain percentage of cases of true 

 Asiatic cholera no one who has had large experience can 

 doubt. I will readily admit that plate-cultivation in a number 

 of cases, particularly those with typical rice-water stools and 

 mucus-flakes, yields positive results if the mucus-flakes are 

 usad ; but it is well known to all who have had to deal with 

 cholera epidemics that such cases are not by any means 

 common in the early stages of an epidemic, and it is precisely 

 at those stages, when no other symptom besides diarrhoea is 

 present to guide us, and when the bowel discharges are 

 simply fluid faecal matter, that the detection of the choleraic 

 comma-bacilli would be of the greatest importance. Later 

 on, when the cases have become more numerous, and the 

 symptoms more pronounced and typical of cholera, the 



1 Kitisato shows (Zeitschrift f. Hygiene, v. 3, p. 487) that the comma- 

 bacilli when kept in a mixture of faecal matter undergo death : the 

 more rapid, the greater the comparative amount of faecal matter and the 

 more delayed the examination. This inimical influence of faecal matter 

 on the comma-bacilli does not affect our argument, since in our cases 

 the examination was proceeded with immediately after the mixture was 

 made. But it helps to explain the disappearance of the comma-bacilli 

 from the stools of cholera patients in the later stages of the disease, 

 pointed out by Koch (loc. cit.) and easily confirmed. 



