PART I.] " Comma-shaped Bacilli " found in the Mouths of Healthy Persons. 331 



numerous specimens of choleraic excreta, and found that comma-shaped bacilli were, 

 more or less conspicuously, present in all of them, though in some instances 

 more than one slide had to be examined before any could be satisfactorily detected. 

 It may also be mentioned that some of the discharges in which these organisms 

 were present manifested an acid reaction when tested with litmus paper. As Dr. 

 Koch himself remarks, the proportion which the comma-shaped bacilli bear to 

 other organisms in the dejecta varies greatly. In some instances only one or two 

 specimens -are to be found in the field of the microscope, while in others they 

 are very numerous, and Drs. Nicati and Rietsch (who are at present engaged in 

 the study of the disease at Marseilles) were so kind as to show me a specimen 

 of choleraic material they had obtained from the small intestine, in which the 

 " commas " existed almost to the exclusion of all other organisms. This is a 

 condition, however, which, I understand, is exceedingly rare. On the other hand, 

 I have seen samples of choleraic dejecta in which totally different organisms pre- 

 vailed to a like exclusion of others ; and in one instance at Marseilles spirilla of 

 various sizes and forms were the most conspicuous of the micro-organisms present. 

 So far, therefore, the selection of the comma-shaped bacilli as the materies morbi 

 of cholera appears to be entirely arbitrary. 



Dr. Koch and his colleagues have adduced no evidence to show that they are 

 more pernicious than any other microbe ; indeed, as a matter of fact, the sole 

 argument of any weight which has been brought forward in favour of the comma- 

 shaped bacillus being the cause of cholera is the circumstance that it is more or 

 less prevalent in every case of the disease, and that the German Commission had 

 not succeeded in finding it in any other. With regard to the suggestion that the 

 cholera process may in some way favour the growth of these bacilli, and that 

 these are not necessarily the cause of the disease, Dr. Koch remarks in the report 

 from Calcutta above cited, that such a view is untenable, inasmuch as it would 

 have to be assumed " that the alimentary canal of a person stricken with cholera 

 must have already contained these particular bacteria; and, seeing that they have 

 invariably been found in the comparatively large number of cases of the disease 

 both in Egypt and India — two wholly separate countries, — it would be necessary to 

 assume, further, that every individual must harbour them in his system. This, 

 however, cannot be the case, because, as already stated, the comma-like bacilli are 

 never found except in cases of cholera." 



Had Dr. Koch and his colleagues submitted the secretions of the mouth 

 and fauces — the very commencement of the alimentary canal — to a careful microscopic 

 examination of the same kind as that to which they have submitted the alvine 

 discharges, I feel persuaded that such a sentence as the foregoing would not have been 

 written, seeing that comma-like bacilli identical in size, form, and in their reaction 

 with aniline dyes, with those found in choleraic dejecta, are ordinarily present in 

 the mouth of perfectly healthy persons. 



