NA TURE 



557 



THURSDAY, OCTOBER 9, li 



THE CHOLERA POISON 



"THE reporter of the French Commission appointed to 

 investigate the mode of action of the cholera poison 

 and its method of propagation, as judged of from the 

 behaviour of the disease during the epidemic in tire 

 southern provinces of France, has made public the con- 

 clusions which have been arrived at. It will be remem- 

 bered that the French Commission which studied the 

 same subject in Egypt last summer differed from the 

 German one in regarding the blood as containing the 

 specific organism of the disease, a contention which found 

 no support in this country when the medical societies had 

 had an opportunity of examining microscopically the 

 preparations which were supposed to afford proof of it. 

 Dr. Koch, chief of the German Commission, on the con- 

 trary, declared that the French statement was due to an 

 error of observation, and maintained that the comma 

 bacillus which he had discovered in the coats and con- 

 tents of the intestines formed the specific germ of the 

 disease. The French Commission of 18S4 now return to 

 the subject by still maintaining that the blood contains 

 the poison, and that the initial lesion of cholera takes 

 place in the blood. In proof of this they describe the 

 changes which the blood cells undergo during the process 

 of cholera ; they regard certain modifications, such as 

 result from the entire loss of elasticity of the globules, as 

 one of the most certain signs of the patient's impending 

 death ; they maintain that by the hourly examination of 

 the blood of cholera patients the progress of the malady 

 can be mathematically followed ; they assert that cholera, 

 as such, is transmissible to the rabbit as the result of the 

 injection into its veins of the blood of a cholera patient 

 at the algid period ; and lastly, they maintain that the 

 microbe specially described by Dr. Koch has no such 

 specific properties as have been claimed for it. 



So far the two sets of observations are diametrically 

 opposed to each other, and neither of them finds much sup- 

 port from the investigations of Drs. Lewis and Cunningham 

 in India. The French contention that cholera is trans- 

 missible to one of the lower animals is at variance with 

 all previous trustworthy experiments, and until the details 

 of the method of operating and of the symptoms induced 

 are made public, it would be premature to accept the 

 conclusion at which the Commission have arrived at as 

 in any way proven. But, on the other hand, time is not 

 lending support to the contention of the German Com- 

 mission, and it is asserted that the early labours of Dr. 

 Klein in Calcutta have confirmed the view which he has 

 all along held, that the announcement of the discovery of 

 a specific cholera organism in the comma microbe is, at 

 least, premature. Fortunately, many observers are now 

 at work in the field of cholera micro-pathology, and the 

 opportunities which have been, and still are, afforded for 

 such work both in Europe and in India are exceptionally 

 favourable. The interests of science will be best observed 

 by waiting for the results of the labours now in progress, 

 and by the exercise of caution in accepting any views 

 which are based on any isolated series of experiments. 

 But whatever be the result, Dr. Koch and the German 

 Vol. xxx. — No. 780 



Commission must be regarded as having given fresh life 

 to a scientific question the interest in which had for some 

 time past been flagging, and to them must be given the 

 credit of having secured in Dr. Klein's work at Calcutta 

 the establishment of an English laboratory for the eluci- 

 dation of a subject which this country should always 

 regard as peculiarly its own, in view of the fact that 

 among its possessions is the country which has always 

 been regarded as the home of cholera. 



THE SANITARY INSTITUTE AT DUBUN 

 THE Sanitary Institute of Great Britain succeeds, by 

 its annual migrations from town to town, in securing 

 a widely-diffused interest in matters relating to public 

 health, and there are but few large towns in the United 

 Kingdom that stand in greater need of some such stimu- 

 lus than Dublin, where, under the presidency of the 

 veteran sanitary engineer, Sir Robert Rawlinson, C.B., 

 the Institute has met this autumn. Within the past 

 twelve years we have made great strides in organising a 

 sanitary administration in this country, every portion of 

 which is subject to the control of a sanitary authority 

 having at least two executive officers — the medical officer 

 of health, who is intended to be a skilled adviser as to 

 the principles which should be held in view in action 

 taken for the promotion of health ; and an inspector of 

 nuisances, whose functions relate in the main to the 

 periodic inspection of his district with a view of the re- 

 moval of such conditions as are likely to cause injury to 

 health, or nuisance. In Ireland a somewhat similar 

 organisation has also been established, and, as in this 

 country, the working of the system is subject to the con- 

 trol of a central body known as the Local Government 

 Board. But to judge from a paper read before the Insti- 

 tute by Dr. Edgar Finn, there is a wide difference between 

 the efficiency of the two systems, and it is certain that, 

 whether judged by the progress that has actually been 

 made or by the amount of money that has been raised by 

 way of loan for the execution of sanitary works in Eng- 

 land and in Ireland, the latter country must be regarded 

 as comparing very unfavourably with the former. 



According to Dr. Edgar Finn, this is partly due to the 

 fact that the Irish Local Government Board is in itself 

 unmindful of using the ordinary means at its disposal for 

 enforcing the proper carrying out of the provisions of the 

 Act under which it is constituted, partly to the circum- 

 stance that in the large mass of the sanitary districts the 

 Boards of Guardians who have been constituted the 

 sanitary authorities take but little interest in their sanitary 

 duties, but mainly to the faults inherent to the system 

 under which the medical officers of health are appointed 

 in the rural districts. In Ireland the dispensary or poor- 

 law medical officers are appointed to act as rural 

 medical officers of health, and Dr. Finn points out that 

 the miserable addition of from 10/. to 15/. to their other 

 salaries does little more than suffice to induce them to 

 hold their tongues, and to take no official notice of the 

 conditions of dirt and unwholesomeness with which they 

 come into contact. And not only so, but it is alleged 

 that such officers cannot possibly be unfettered and inde- 

 pendent in their action, for they are generally the medical 

 attendants of the Guardians whom they serve, and who 



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