ASIATIC CHOLERA. 367 



that Koch's comma-bacilli are not constantly found ; and that 

 the comma -bacilli obtained from typical cholera cases show a 

 great variation in cultivation, and cannot be distinguished from 

 comma-bacilli from other sources. 

 Cunningham asserts that 

 comma-bacilli resembling Koch's 

 are found in the intestine in * 



health. Sternberg, on the other 

 hand, made a number of examina- 

 tions of the evacuations of yellow 



, , ,,, . ,. FIG. 156. COMMA-BACILLI OF THE MOUTH, 

 fever patients and healthy mdi- x m (VAN ERMENGEM) . 



viduals, and failed to find any 



micro-organism resembling the cholera spirillum. 



Various comma-bacilli have been isolated from different sources 

 and compared with Koch's comma -bacillus. Comma-bacilli have been 



found in the mouth by Lewis ; 



in cholera nostras by Finkler and 

 J^yf 



Prior ; in cheese by Deneke ; 



' l)/( /r' V. ^ i 11 na y infusion and sewage by 



Weibel ; in the intestines of fowls 

 by Gamaleia, and in water by 

 Sanarelli. 



Whether the comma-bacillus 



FIG. 157. FINKLER'S COMMA-BACILLI ; is the cause of cholera or 

 FROM CHOLERA NOSTRAS, x 700 no t ? its detection is an aid in 

 (FLUGGE). ,. . T ,. , ,. 



diagnosis. It we are dealing 



with a case alleged to be one of Asiatic cholera, and a micro- 

 organism is found in the intestinal evacuations, which can be 

 differentiated from the comma-bacillus described by Finkler in 

 cholera nostras, and identified 



with the comma-bacillus de- -^ . 



scribed by Koch, we are justified ^> ^ \ 



in regarding the case as one of " * p"* ^v'Z.i' * "* 



Asiatic cholera. But we cannot ^~^* ^ ^~* 



diagnose Koch's comma -bacillus, '^^NfV* f ^X 



with certainty, unless we know 



the source of the culture. The FJG m _ DENEKE > s COMMA-BACILLI, 

 clinical symptoms of cholera in FRO M CHEESE, x 700 (FLUGGE). 



man, and especially the presence 



of rice-water stools, must be taken into account, together with 

 the biological, morphological, and chemical characteristics of 

 the bacilli which are found to be present. There are several 



