THE CHOLERA SPIRILLUM. 403 



as regards the uniformity of the characters of the comma 

 bacillus. 



Within recent years, and especially during the epidemic 

 in Europe in 1892-93, spirilla have been cultivated from 

 cases of cholera in a great many different localities, and 

 though this extensive investigation has revealed the invari- 

 able presence in true cholera of organisms resembling 

 more or less closely Koch's spirillum, certain difficulties 

 have arisen. For it has been found that the cultures 

 obtained from different places have shown considerable 

 variations in their characters, and, further, spirilla which 

 closely resemble Koch's cholera spirillum have been culti- 

 vated from sources other than cases of true cholera. There 

 has therefore been much controversy, on the one hand, as 

 to the signification of these variations whether they con- 

 stitute different species, or whether they are to be regarded 

 merely as indicating varieties of the same species and on 

 the other hand as to the means of distinguishing the cholera 

 spirillum from other species which resemble it. 



We shall first give an account of the characters of the 

 cholera spirillum, with the evidence for its causal relation- 

 ship to the disease, and afterwards discuss some of the 

 questions just referred to. It may, however, be stated 

 here that no other organism of any kind has been dis- 

 covered which has even the faintest claim to be the cause 

 of the disease. 



In considering the bacteriology of cholera it is to be 

 borne in mind that in this disease, in addition to the evi- 

 dence of great intestinal irritation, accompanied by profuse 

 watery discharge, and often by vomiting, there are also 

 symptoms of general systemic disturbance which cannot be 

 accounted for merely by the withdrawal of water and certain 

 substances from the system. Such symptoms include the 

 profound general prostration, cramps in the muscles, extreme 

 cardiac depression, the cold and clammy condition of the 

 surface, the subnormal temperature, suppression of urine, 

 etc. These taken in their entirety are indications of a 

 general poisoning in which the circulatory and thermo- 



