5i4 



NA TURE 



[Sept. 25 1884 



microphytes at all, they are either Micrococci, Bacteria, 

 or long-oval, and straight Bacilli. 



In "the Report of the Commission, dated Calcutta, 

 February 2, 1SS4, Dr. Koch, however, announces for the 

 first time that the specific Bacillus of cholera is curved or 

 comma-shaped, and not straight ; so that apparently it 

 had become necessary to abandon the microbe first fixed 

 upon. Assuming that the four specimens from natives of 

 India which had been examined by Dr. Koch were those 

 which passed through my hands, the evidence they 

 furnish seems to be in accordance with this view, as in 

 not one of them have I been able to detect any invasion 

 by unmistakable " commas," though at least one of the 

 specimens may fairly be characterised as abundantly in- 

 filtrated (in the manner described by Dr. Koch) by straight 

 (and as I prefer to call them) putrefactive Bacilli. Judg- 

 ing from my own experience, therefore, any extensive in- 

 filtration of the intestinal mucous membrane in cholera 

 by comma-shaped Bacilli must be exceedingly rare ; and 

 this, 1 believe, is likewise the experience of the members 

 of the late French Cholera Commission, MM. Straus, 

 Roux, and Nocard, whose acquaintance I had the plea- 

 sure of making at M. Pasteur's laboratory on my return 

 through Paris. 



Whilst at Marseilles I had, as already stated, opportu- 

 nities of observing 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 | had^xamined 

 different organisms prevailed 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 111 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 Commis- 

 sion 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 a 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 

 ever)- 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 secre- 

 tions of the mouth and fauces— the very commencement 

 of the alimentary canal— to a careful microscopic ex- 

 amination 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. 1 



There is no difficulty in putting this statement to the 

 test ; and to any one acquainted with the methods 

 ordinarily adopted for staining and mounting fungal 

 organisms of this character, no special directions need be 

 given. The procedure followed by me to demonstrate 

 these " commas " in the saliva is precisely that adopted 

 for finding them in the dejections. A little saliva should 

 be placed on a cover-glass (preferably in the morning 

 before the teeth are brushed) and allowed to dry I 

 thoroughly, either spontaneously or aided by a gentle 

 heat. The dry films thus obtained should be floated for a 

 minute or two with one or other of the ordinary solutions 

 of aniline dyes adopted for such purposes, such, for 

 example, as fuchsine, gentian-violet, or methylene blue. 

 The cover should then be gently rinsed with distilled water, 

 and the film re-dried thoroughly. The preparation may 

 now be mounted in dammar varnish or Canada balsam 

 dissolved in benzol, and should be examined under a 

 i/i2th or 1/16U1 of an inch oil-immersion lens. 



As in choleraic discharges so in the saliva the number 

 of comma-shaped Bacilli will be found to vary greatly in 

 different persons, and at different times in the same 

 person. Sometimes only one or two " commas " will bet 

 seen in the field, at others a dozen may be counted, 

 and, occasionally, little colony-groups of them may be 

 found scattered here and there throughout the slide. 



It may be remarked in passing, and as bearing upon - 

 what has been already said regarding the general absence 

 of comma-shaped Bacteria from the intestinal mucosa 

 itself, that they do not appear to manifest any special 

 tendency for attacking the decaying epithelial scales of 

 the mouth, but that, on the contrary, they are for the most 



Since this Memorandum was submitted. I have observed that Dr. Koch 

 ■s. in his recent address on the subject, that, after his return to Bet 

 longst other things, the 5 



of the mouth for comma- 



persons of much experience in bacterial researches as to whether they had 

 ever seen such organisms, and was told that they had not. _ 1 



It may be of assistance to future observers if I give the dimensions of halt- 

 , of the following:—:.') In the 

 alvine discharges of three cholera-affected persons: (J) in the small intestine 

 of a person who had died of the disease and in whom they existed almost to 

 the exclusion of other organisms ; (c) in a cultivation of them in Agar-Agar ■ 

 jelly ; and (d ) in the secretions of the mouth of three healthy persons, ranging 

 from four to fifty 

 ■aluable 



ing power of : 



The measurements were made (with the , 

 of Mr. Arthur E. Brown. B.Sc. Lond.) under a magnify-: 

 a Powell and Lealand's i/i6th of an inch 0lj-| 

 vith a wide angle condenser, being used. 



W 



dth (in Micro-millimetres ") of Comh 

 Bacilli in Choleraic Material 



,-SHAPED 



Alvine discharg 



8xo- 35 t 



Length and Width (in Micro-millimetres*) 

 Bacilli in Secretions of the Mouth 



ie micro-millimetre Cm>=" 

 haped comma-bacilli. 



:-8xo - 4ot 

 01 millimetp 



