On the Pathology of Cholera Asiatiea. 



lib 



either with that described by Finkler and Prior as having been ob- 

 tained from cases of Cholera nostras, or with those other forms of 

 curved bacilli which have been found in the mouths of healthy per- 

 sons, decayed teeth, cheese, &c. That it is pathogenic scarcely admits 

 of doubt, in view of 'the evidence given by Koch and V. Ermengem. 

 The view, however, that it is to be looked upon as the direct cause of 

 cholera is, we think, incompatible with the results we obtained, as re- 

 ferred to above. Many points of similarity between Koch's and 

 Finkler and Prior's comma bacillus, and the relation between the 

 latter and Cholera nostras, have led us to consider the possibility of the 

 former of the two being the cause of the so-called premonitory diar- 

 rhoea which is so frequently, if not constantly found accompanying 

 epidemics of Asiatic cholera. The frequency with which the comma 

 bacillus of Koch is to be found in cases of cholera makes it, we 

 think, almost certain that it has some relation to the disease in ques- 

 tion. That the so-called premonitory diarrhoea of cholera cannot be 

 looked upon as a mild form of Asiatic cholera we feel convinced from 

 our own observations in Spain. At the same time we think it must be 

 looked upon as a predisposing cause of Asiatic cholera. It seems to us 

 by no means improbable that Koch's comma bacillus may be the cause 

 of this so-called premonitory diarrhoea, and that its frequent presence 

 in fatal cholera cases may be due to true cholera having supervened. 

 Unfortunately while in Spain our researches were not sufficiently com- 

 plete to enable us to decide that Koch's comma bacillus could not be 

 looked upon as the direct cause of cholera, and our attention, there- 

 fore, was not directed to the question of its being found in the 

 dejecta of persons suffering from the so-called premonitory diar- 

 rhoea. This is a question which we believe well worthy of further 

 investigation. 



As to the straight bacilli obtained by Emmerich from the blood and 

 organs of fatal cholera cases, our results, by use of similar methods to 

 those employed by Emmerich, do not enable us to confirm those of 

 that observer. The cultivating media in which we placed drops of 

 blood, or portions of the kidney, liver, and other organs from cholera 

 cases, remained sterile. We cannot, therefore, accept the bacillus of 

 Emmerich, as the cause of Cholera Asiatiea, and see no difficulty in 

 explaining the pathogenic effects which he observed on introduction 

 of his bacillus into certain of the lower animals as being due to a 

 form of Septicaemia. 



The straight bacillus described by Klein in his Report of the 

 Indian Cholera Commission, is much smaller than that found by 

 Emmerich ; and we know of no reason for believing the two to be 

 identical. As Klein has not claimed for the bacillus found by him 

 any causal relation to cholera, we need only say here that we have not 

 been able to recognise it in any of our preparations. 



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