NATE RE 
617 
THURSDAY, OCTOBER 29, 1885 
THE ANTI-CHOLERA INOCULATIONS OF 
DR. FERRAN 
(ey the spring and summer of the present year the public 
in Europe—lay and medical—have been greatly 
agitated by the exploits of a Spanish medical gentleman, 
who, during the cholera epidemic then raging in Spain, 
claimed to have discovered a means of preventing cholera. 
He was hailed as a great benefactor, and if his deeds had 
been equal to his professions, he would no doubt fully 
deserve to rank with Jenner, the greatest benefactor to 
mankind. But fortunately the medical world, at any rate 
the scientific medical world outside Spain, is not guided 
by the allegations of enthusiasts nor by wonder-doctors 
either. A Don Quixote, who discerns in a windmill 
giants, in a flock of sheep a squadron of the enemy’s 
soldiers, may present points of interest to the psychologist: 
to the disciple of physiology and pathology he demon- 
strates an aberration of the visual nerve centres. I shall 
show that Dr. Ferran comes very near in rank, not to 
Jenner, but to his own illustrious countryman, the Knight 
of La Mancha. 
The method of Ferran is practically this :—Ferran says 
that by a peculiar mysterious method of cultivation— 
which for a long while he was not going to divulge—he 
has succeeded in attenuating the action of the comma 
bacillus of Koch. In these cultivations the comma 
bacillus after very complex morphological changes, un- 
necessary to detail here, forms spores. Such cultures 
introduced in sufficient quantities into the subcutaneous 
tissue of animals (guinea-pigs) or man produce a disease 
which is a mild and abortive form of cholera ; it manifests 
itself in local inflammation, and a general constitutional 
disturbance, febrile rise of the body temperature, head- 
ache, nausea, and sickness, and even diarrhcea. After a 
few days the person inoculated returns to his normal 
state. Persons once, twice, or thrice inoculated answer, 
or ought to answer, each inoculation with the said consti- 
tutional disturbance. Statistics collected by Ferran and 
his adherents in the places where these inoculations were 
practised, notably in Alcira, in and about Valencia, 
prove, so it is said, that the number of cholera cases and 
of deaths from cholera decreased in a conspicuous degree 
after these inoculations had been commenced, and also 
that those persons that had been inoculated remained 
almost impervious to cholera, while others not so 
inoculated fell victims to the plague in large numbers. 
In these assertions and practices several important 
questions are involved, each of which demands a direct 
answer, which ought to be favourable to this theory of 
Dr. Ferran. 
First: Is the so-called cholera-bacillus, or Koch’s 
comma-bacillus, found in the intestinal discharges of 
cholera patients, the vera causa of cholera ? 
Second: Does this so-called cholera-bacillus form 
spores, which when introduced into the living tissue 
germinate into the comma bacilli: in the subcutaneous 
tissue capable of producing only an abortive and mild 
form, but in the alimentary canal producing severe and 
malignant cholera ? 
VOL. XXXII.—NO. 835 
Third: Do the cultivations of Dr. Ferran, when inocu- 
lated into the subcutaneous tissue, set up a disturbance 
which can be considered as an abortive form of cholera ? 
Fourth: Are persons so inoculated really protected or 
almost protected against an attack of real cholera; and 
do the statistics collected by Ferran and his adherents 
prove this ? 
(1) The first of these questions, it is obvious, forms the 
basis of the whole theory; for if the comma bacillus 
of Koch is not the real cause of cholera all the rest of 
Ferran’s assertions, as far as cholera is concerned, fall to 
the ground. The claims of the comma bacillus of Koch 
to be accepted as the true cause of cholera, rests on very 
insufficient evidence: the epidemiological evidence as to 
the spread of cholera being dependent on soil and season, 
the anatomical evidence as to the comma bacilli being 
limited to the cavity of the cholera intestine, they being 
absent from the tissues and the blood, the misproportion 
existing between the number of comma bacilli present in 
the alimentary cavity, and between the severity and 
acuteness of the disease in many cases, and a number of 
other facts not necessary to mention here, prove to my 
mind that the comma bacillus is not the real cause of 
cholera. Add to this that Emerich of Munich vindicates 
this claim to be the real cause of cholera, not to the 
comma bacilli of Koch, but to small straight bacilli, 
probably identical with those seen and described by the 
English cholera Commission in India as constantly 
present in the alimentary canal of cholera patients, 
and for which bacilli I did not and cannot claim any real 
infective power; and further, that Emerich’s view is backed 
up by no less an authority than Von Pettenkoffer himself. 
There is then at present an interesting contest going on 
between two rival bacilli: one, having Berlin for the 
head-quarters of its advocates, may be called the northern 
bacillus ; the other, in Munich, may be called the southern 
bacillus. As to the actual facts, it seems to me the ques- 
tion is not whose claim is stronger, but whose claim is 
weaker. 
(2) All except Ferran, acquainted practically with the 
comma bacillus in pure cultivations (Koch, Van Ermen- 
gem, myself, Mr. Watson Cheyne, Finkler, Emerich, 
Buchner, Klebs, and many others) are agreed that the 
comma bacillus in artificial cultivations never forms 
spores ; having multiplied until all the nutritive materia] 
in the cultivation is exhausted, a period arrives when 
the comma bacilli degenerate and die; some undergo 
this long before the point of exhaustion is reached, 
others retain their vitality longer, but after weeks and 
months death has involved all the comma bacilli present 
in the cultivation. [An impurity accidentally present in 
the culture would effect this death of the comma bacilli 
in a much shorter period; in fact, in many instances, 
they would not have much chance of primarily reaching 
any considerable number. ] 
When this period has been reached, the culture be- 
comes incapable of starting a new culture; and wc 
versi: by this means the point of death of the 
bacilli present in the culture can be tested and 
accurately determined. I have a large number of tubes 
of pure cultivations of the comma bacilli, the nutritive 
medium being broth, or peptone and broth, or gela- 
tine peptone and broth, or gelatine peptone and 
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