ASIATIC CHOLERA. 367 



that Koch's comma-bacilli are not constantly found ; and that 

 the eomma-hacilh obtained from typical cholera cases show a 



great variation in cultivation, and cannot be distinguished from 

 comma-bacilH from other sources. 



Cunningham asserts that ^'\(/^% 



comma-bacUli resembling Koch's ^'"^"fj^^^ « 



are found in the intestine in '^r^,^^^^/0''*>J'*,ji'ni 



health. Sternberg, on the other ^^>^'£.V^"^^ 'li** 



hand, made a number of examina- ■^sT-- 

 tions of the evacuations of yellow 



„ ,. , n n 1,1 -1- FlR.156, — COMMA-BAOILLIOFTHBMOUTH, 



fever patients and healthy indi- ^ ^qq fj_^^ Ebmengbm). 



viduals, and failed to find any 



micro-organism resembling the cholera spirillum. 



Various comma-baciUi have been isolated from different sources 

 and compared with Koch's comma-bacUlus. Comma-bacilli have been 



found in the mouth by Lewis ; 



.VJ, in cholera nostras by Finkler and 



^■i'^^i Prior ; in cheese by Deneke ; 



>''''/ /'r' "v V. i'^ ^*y infusion and sewage by 



~ f-^i w '^ofisd'Co^ Weibel ; in the intestines of fowls 



by Gamaleia, and in water by 

 ,-=:#*• '-"'i " SanarelU. 



V*' ^ Whether the comma-bacillus 



Fig. 157.— Finklek's Comma-bacilli ; is the cause of cholera or 

 FKOM Cholbba nostbas, X 700 not, its detection is an aid in 

 (Fluggb). diagnosis. If we are dealing 



with a case alleged to be one of Asiatic cholera, and a micro- 

 organism is found in the intestinal evacuations, which can be 

 differentiated from the comma-bacUlus described by Finkler in 

 cholera nostras, and identified 



with the comma-bacillus de- 2" "-. ' 



scribed by Koch, we are justified ^ "^;;^ _^-jl -.,' 



in regarding the case as one of -^'^i ""'s^r' ^ 2 



Asiatic cholera. But we cannot ~Si\''i~ -''^if :^ 



diagnose Koch's comma-bacUlus, ' "■ ^ ''-~ ' --^^ 



with certainty, vinless we know '-~ 



the source of the culture. The j,^^ 158.— Dbnbkb's Comma-bacilli, 

 clinical symptoms of cholera in fbom Chbbsb, x 700 (Flugge). 



man, and especially the presence 



of rice-water stools, must be taken into account, together with 

 the biological, morphological, and chemical characteristics of 

 the baciUi which are found to be present. There are several 



