142 THE BACTERIA IN ASIATIC CHOLERA. [CH. 



that had got access to it ; or stranger still, that in ail these 

 persons the intestine is in a state of disease, thus favouring 

 the settling and multiplication of the comma-bacilli ? I think 

 all who have witnessed an epidemic of cholera will agree 

 that such an assumption is out of the question. If such were 

 the conditions under which infection takes place, I am sure 

 cholera would be an extremely rare disease. For even 

 assuming that the comma-bacilli had got entrance into the 

 stomach, say before breakfast, when the stomach is sup- 

 posed to be perfectly empty, and its reaction supposed to 

 be neutral or alkaline, they would pass unscathed and in a 

 living state into the small intestine ; but in order to multiply 

 in appreciable numbers the intestine itself would have to be 

 in a state of disease, otherwise they could not multiply in it. 

 Such conditions would unquestionably reduce cholera cases 

 to an insignificant number. The fact, repeatedly observed 

 during the epidemics of 1884-1886 in Spain and Italy and 

 France, that in a population of 10,000 or 12,000 inhabitants, 

 in the course of two to three weeks 1,200 to 1,500 people 

 were struck down with cholera, disposes of the above 

 assumption. It is true, and it has been observed over and 

 over again, that when cholera appears in a locality it attacks 

 at first and with obvious predilection those persons whose 

 digestive organs, or whose general health for the matter of 

 that, are weakened or in a state of disease ; but this is 

 known to be the case in other infectious maladies also, the 

 unhealthy being as a rule more susceptible to infection than 

 the strong. But when an epidemic has well set in, no such 

 exemption of the strong and vigorous is noticeable ; pro- 

 vided the active contagium is present and has in this state 

 access to their system, it does not matter what their general 

 condition or that of their digestive organs is, they are struck 

 down by the plague. And in this respect there is no line 



