NA TURE 



401 



D 



THURSDAY, FEBRUARY 28, 1884 



THE GERMAN CHOLERA COMMISSION 

 R. KOCH, as chief of the German Cholera Commis- 



sion, has just issued his fifth report. When we 

 commented on his first report, which was transmitted from 

 Alexandria on September 17, 1S83, we drew special atten- 

 tion to the discovery by that expert of certain bacilli 

 which were found to swarm in the discharges and coat- 

 ings of the intestines of cholera patients, which were 

 certainly not due to post-mortem changes, and which 

 were absent from the intestines of bodies dead from 

 diseases other than cholera. Dr. Ko:h believed that 

 these bacilli, which much resembled those found in cases 

 of glanders, stood in some special relation to the opera- 

 tion of cholera, but he was not prepared to say whether 

 inva'-ion of the bacteria was the primary cause of cholera, 

 or whether it was merely an effect of the cholera infection. 

 At that time the epidemic in Egypt had reached its de- 

 cline, the period which of all others is the least satisfiictory 

 for etiological investigation ; and hence, apart from some 

 further record confirming the existence of the same bacilli 

 in other cholera bodies which had since been examined, 

 the reports which Dr. Koch has transmitted to his 

 Government between his first one and the one now under 

 consideration have not dealt with any scientific dis- 

 covery. But since November last the Commission have 

 pursued their investigations in India, the city of Calcutta 

 having been decided on as the head-quarters of their 

 mission of inquiry ; and it is to the results there obtained 

 that Dr. Koch's last report relates. In the meantime, 

 however. Dr. Straus had reported on behalf of the French 

 Commission, and had expressed his belief that the bacilli 

 discovered by Dr. Koch did not bear the relation to 

 cholera which the German Commission attributed to 

 them ; and that, unlike Dr. Koch, who had found nothing 

 noteworthy in the blood of cholera patients, he had dis- 

 covered in that fluid a definite micro-organism, which he 

 believed he had succeeded in cultivating in the laboratory. 

 At this stage the subject is again taken up by Dr. Koch, 

 who now gives an account of the further labours of his 

 Commission. Under conditions of the most favourable 

 sort, experiments have been renewed in Calcutta with an 

 unbroken series of cholera patients and cholera bodies, 

 and at the outset it is stated that microscopical examina- 

 tion has in all cases confirmed the existence, both in 

 the choleraic discharges and in the cholera intestines, 

 of the same bacilli as those which had been found in 

 Egypt. And further, that which had not been pos- 

 sible in Ale.xandria, namely, the isolation and cultiva- 

 tion in pure media of these special bacilli, is stated to 

 have been successful in Calcutta, with the result that 

 they have been found to exhibit under cultivation cer- 

 tain characteristic peculiarities as to shape and mode 

 of growth which enable the Commission to distinguish 

 them with certainty from other bacilli. The Commission, 

 too, have sought, as far as possible, to exclude sources of 

 error, and hence they have subjected the bodies of patients 

 dying from diseases other than cholera to careful micro- 

 pathological examination, with the result that they are 

 able to say that it has not been possible to find bacilli 



Vol. XXIX.— No. 748 



similar to the cholera bacilli in any of the bodies of 

 persons who had died of pneumonia, dysentery, phthisis, 

 and kidney disease. Nor has it been possible to detect 

 these bacilli in the intestinal contents of animals and in 

 other substances commonly abounding with bacteria. 



The inoculation of the lower animals with cholera dis- 

 charges and other cholera material had, in Egypt, led' 

 only to negative results ; and even if nothing further had 

 been adduced as to this, we should in no way have re- 

 regarded failure in this respect as invalidating any infer- 

 ences that may be drawn by Dr. Koch and his fellow- 

 workers as to the speciality of this bacillus, because it has 

 been found impossible to transmit many of the specific 

 infectious diseases of man to any other animal. We now 

 learn, however, that several experiments made on animals 

 have given results which allow of the hope of furthei 

 success. Reviewing their more recent work, in this and 

 other respects, the Commission are evidently hopeful of 

 establishing an etiological relation between the bacilli in 

 question and the cholera process, and this quite irre- 

 spective of success being attained in the reproduction of 

 the disease in the lower animals. A telegram of more 

 recent date than the report itself announces that Drs. 

 Koch, Fischer, and Gaffky have discovered the same 

 bacillus in a water-tank. If this be confirmed, it will be 

 of value as proving that water, which, when polluted with 

 excreta, has so often been alleged to be one of the prin- 

 cipal means of conveying the cholera poison, is a medium 

 favourable to the transmission of the "germ" from 

 person to person, and the announcement comes aptly in 

 connection with a report in which the German Commis- 

 sion announce that a diminution in the annual mortality 

 from cholera in Calcutta from lOT per 1000 inhabitants 

 before 1870, to 3 per 1000 since that date, is regarded 

 by nearly all the physicians in that city as being solely due 

 to the introduction of a water-supply of excellent quality. 



Referring to the report of the French Commission, Dr. 

 Koch declines to accept the conclusions of Dr. Straus as 

 to the existence in the blood of organisms which are 

 peculiar to cholera, and he expresses the belief that the 

 alleged organisms are nothing but certain small, roundish 

 blood-plates, which, not absent even in health, undergo a 

 peculiar increase in the case of cholera patients, and which 

 were referred to as far back as 1872 by Dr. D. Cunning- 

 ham in his " Microscopical and Physiological Researches 

 into the Nature of the Agents producing Cholera." 



Whilst desiring to follow in the steps of Dr. Koch in 

 observing an attitude of caution as to the meaning of the 

 researches of the German Commission, we cannot but 

 feel that the tendency of the reports as yet issued is 

 favourable to the doctrine that cholera is associated 

 with a specific organic contagion. A connection has 

 already been established between specific disease on 

 the one hand, and the staff-shaped bacilli of splenic 

 fever, the spirillum of relapsing fever, and the micro- 

 zymes of vaccinia and of sheep-pox on the other ; 

 and though it may still be doubtful whether these 

 bodies should be regarded as actual generators of 

 the diseases with which they are associated, or as mere 

 carriers of infection, yet the advance which is being made 

 is in the direction of the doctrine of the particulate nature 

 of contagion. We may have to wait before there is 

 sufficient evidence to warrant the application of this doc- 



