416 SPIRILLUM CHOLERA ASIATICS. 



in acute tin- the intensity and duration of the process. In some 



complicated 



cases of cag es running a very acute course there was only slight 



cholera. swelling and rosy red coloration of the mucous mem- 



brane of the small intestine ; and the contents of the 

 intestine were colourless like rice-water, or better, like 

 gruel. In these cases the comma bacilli were usually 

 present in very large numbers in the intestinal contents, 

 In more pro- often almost in pure cultivation. If the morbid process 

 3es ' had lasted longer the mucous membrane showed some- 

 what more marked alterations ; more especially there 

 was a patchy redness, which was particularly noticeable 

 at the margins of the follicles and of Peyer's patches. 

 At the same time it was found that the comma bacilli 

 had penetrated into the mucous membrane ; in sections 

 the comma bacilli were found in the tube-like glands, 

 and had to some extent penetrated between the epi- 

 thelium and the basal membrane. Nearer the surface 

 other bacteria were also frequently present, usually 

 thicker or finer bacilli which had passed more or less 

 deeply into the mucous membrane; but this had evi- 

 dently occurred after the entrance of the comma bacilli, 

 which always lay most deeply, and which had, as it were, 

 In typhoid prepared the way for the other bacteria. In a third cate- 

 gory of the cases all sorts of secondary alterations had 

 occurred in consequence of the longer duration of the 

 disease ; the lower portion of the small intestine was of 

 a dark brownish red colour, the mucous membrane 

 showed superficial haemorrhages, and at times it had 

 undergone a superficial necrosis, and was covered with 

 diphtheritic deposits. In correspondence with this, the 

 intestinal contents were no longer colourless, but con- 

 sisted of a bloody stinking fluid, and in it the comma 

 bacilli were often difficult to recognise on account of 

 the presence of numerous other kinds of bacteria. 

 Methods em- l n a il these cases Koch found that the following was the 

 demonstration best method for discovering the bacilli. For their 

 demonstration he employed either fresh dejecta, where 

 possible those of a soupy character ; or the contents of 

 the ileum obtained on post-mortem examination ; or 

 clothes which had been soiled with dejecta. Koch has 



