viii.] THE INFECTIVENESS OF CHOLERA. 145 



the superficial layers of the mucous membrane of the ileum 

 and of the Peyer's glands cannot be demonstrated in a 

 number of typical acute cases. All that can be said, 

 therefore, is this in some cases the comma-bacilli are 

 found numerously present in the mucus-flakes of the 

 ileum (i.e. in dead tissue), in other equally acute and typical 

 cases they are there present only sparingly amongst crowds 

 of other bacteria ; further, when they are present in large num- 

 bers in the rice-water discharges, i.e. when the chemical poison 

 is being elaborated in large quantities, the disease has already 

 well set in, and in this state the intestine is pouring 

 out quantities of fluid and therefore cannot be said to be 

 capable of absorption. From these considerations it seems 

 to me to follow that the presence of numerous comma-bacilli 

 in the contents of the cholera-intestine is a result of the 

 peculiar pathological state of the intestine, just as was the 

 case in the above-mentioned successful experiments on 

 guinea pigs. Supposing, as has been suggested on a former 

 page, that the comma-bacilli are already present in the 

 normal human intestine, but being subject to unfavourable 

 conditions remain very limited in numbers ; it may be that 

 in cholera the conditions having become favourable we 

 should find them greatly increased in numbers! True, no one 

 has as yet shown that in the normal human intestine comma- 

 bacilli identical with Koch's comma-bacilli do exist, but 

 then few observers have as yet systematically examined the 

 different species of bacteria that do exist in the normal 

 intestine. Koch and others say that they have by plate- 

 cultivations carefully examined the normal contents of the 

 human intestine and have never found them, but it 

 must be remembered that they failed to find any comma- 

 bacilli, and yet we now know that Finkler's comma-bacilli do 

 occur normally. I do not mean hereby to imply that these 



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