476 CHOLERA 



stools in this case, and Pfeiffer is of the opinion that the organism 

 gained entrance accidentally. These examples will show how differences 

 of opinion, even amongst experts, might arise as to whether a certain 

 spirillum were really the cholera organism or a distinct species resem- 

 bling it. 



A few examples may also be given of organisms cultivated 

 from cases in which cholera-like symptoms were present. ' 



The vibrio of Massowah was cultivated by Pasquale from a case during 

 a small epidemic of cholera. The organism so closely resembles Koch's 

 spirillum that it was accepted by several authorities as the true cholera 

 organism, and, as already stated, Metchnikoff produced by it cholera 

 symptoms in the human subject, and also the cholera-like disease in 

 young rabbits. It possesses four flagella, has a high degree of virulence, 

 producing septicaemia both in guinea-pigs and pigeons, and its colonies 

 in plates differ somewhat from the cholera organism. Moreover, it 

 reacts negatively to Pfeiffer's test. Another organism, the v. Gindha, 

 was cultivated by Pasquale from a well, and was at first accepted by 

 Pfeiffer as the cholera organism, but afterwards rejected, chiefly because 

 it failed to give the specific immunity reaction. It also differs somewhat 

 from the cholera organism in its pathogenic effects, and it fails to give 

 the cholera-red reaction, or gives it very faintly. 



Pestana and Bettencourt also cultivated a species of spirillum from a 

 number of cases during an epidemic in Lisbon an epidemic in which 

 there were symptoms of gastro-enteritis, although only in a few instances 

 did the disease resemble cholera. They also cultivated the same organism 

 from the drinking water. It differs from the cholera organism in the 

 appearance of its colonies and of puncture cultures in gelatin. It has 

 very feeble pathogenic effects, and gives a very faint, or no, cholera-red 

 reaction. To Pfeiffer's test it also reacts negatively. Another spirillum 

 (v. Romanus) was obtained by Celli and Santori from twelve out of forty- 

 four cases where there were the symptoms of mild cholera. This organism 

 does not give the cholera-red reaction, nor is it pathogenic for animals. 

 They look upon it as a "transitory variety" of the cholera organism, 

 though sufficient evidence for this view is not adduced. 



We have mentioned these examples in order to show some of 

 the difficulties which, exist in connection with this subject. It is 

 important to note that, on the one hand, spirilla which have 

 been judged to be of different species from the cholera organism, 

 have been cultivated from cases in which cholera-like symptoms 

 were present ; and, on the other hand, in cases of apparently true 

 cholera considerable variations in the characters of the cholera 

 organisms have been found. Such variations have especially 

 been recorded by Colonel Cunningham in India. It is there- 

 fore quite an open question whether some of the organisms 

 in the former class may not be cholera spirilla which have under- 

 gone variations as a result of the conditions of their growth. 

 The great bulk of evidence, however, goes to show that Asiatic 

 cholera always spreads as an epidemic from places in India where 



