1885.] 



Relation of Bacteria to Asiatic Cholera. 



155 



the exclusion of other bacteria, and in such great numbers that the 

 lower part of the ileum may be considered to contain almost " a pure 

 cultivation of comma bacilli." 



4. The mucous membrane of the ileum, particularly that of the 

 lower part, around and in the lymphatic glands located here — the 

 solitary and Peyer's lymph-glands — exhibits in typical and rapidly 

 fatal cases characteristic alterations : loosening and detachment of 

 the epithelium of the surface and of that lining the glands of 

 Lieberkiihn ; swelling of the mucous membrane and congestion of 

 its blood-vessels, particularly at the peripheral portions of the 

 lymph glands. These alterations are due to the presence, growth, 

 and multiplication of the comma bacilli in these tissues, and the 

 disease cholera is caused by the production on the part of these 

 comma bacilli, and by the absorption on the part of the system of a 

 special chemical ferment. 



This state of the presence of the comma bacilli in the tissue is best 

 pronounced in the lower part of ileum ; higher up it is more limited, 

 and gradually diminishes, and finally disappears in the upper part of 

 the small intestine. 



5. The blood and other tissues are free of any organisms. 



6. The comma bacilli grow well outside the body at the ordinary 

 temperature of the room, but better still at higher temperatures up 

 to 38° or 40° C. They divide transversely; after division the two 

 offsprings may remain joined end to end with shape of an S, and by 

 further division they may grow into a spiral-like or wavy form. 

 They grow well in the mucus flakes taken from the intestine, and 

 placed on linen kept in a moist cell ; they grow well on potato, in 

 broth, in Agar- Agar jelly, in solid nourishing gelatine mixture 

 (gelatine, peptone, and beef extract). In this latter substance they 

 exhibit a peculiar and definite mode of growth not seen by Koch on 

 any other bacteria. The comma bacilli require for their growth an 

 alkaline medium ; they are killed by acid, by drying, and various 

 antiseptic media. 



7. On account of their constant occurrence in the intestines of 

 patients suffering from Asiatic cholera, on account of their absence in 

 all other diseases of the intestine, and on account of their peculiar 

 mode of growth in nourishing gelatine, Koch vindicates for these 

 comma bacilli not only an important diagnostic value, but also con- 

 siders them as the true cause of cholera. 



8. Since his return to Germany, Kocb has convinced himself of the 

 correctness of the observations of Nicati and Rretsch, who maintain 

 that cholera can be produced in dogs and guinea-pigs by injecting 

 directly into the small intestine of these animals the comma bacilli 

 taken either directly from the choleraic evacuations, or from artificial 

 cultivations. 



