176 



Messrs. Roy, Brown, and Sherrington. 



The pleomorphism of the comma bacillus which Ferran described 

 in his article in the " Zeitschr. f. Klin. Med." of last year, and the 

 method of inoculation for protection against cholera, largely employed 

 in Spain, attracted our attention while in that country. We had an 

 opportunity of examining with the microscope the cultures sent, at 

 the request of the Government, from Ferran's laboratory, to be em- 

 ployed in inoculating troops. These cultures were under the care of 

 agents duly authorised by Ferran. We found them to contain several 

 forms of bacilli and micrococci, but we did not discover either comma 

 bacilli or any of the peronospora-like bodies described by Ferran to be 

 present in his protective inoculation fluid. We need only say further 

 that the facts which came to our knowledge regarding the protective 

 power of Ferran's inoculations are by no means in accordance with the 

 statements made by that observer. The inoculation of such fluids as 

 we saw in the hands of Ferran's agents must expose the recipient 

 to serious peril of septicemic infection. The theory, moreover, on 

 which Ferran's system is based, e.g., that one attack of cholera pro- 

 tects against a second attack of the same disease, is entirely opposed 

 to the facts which came under our notice in Spain. As, however, we 

 did not personally meet with Dr. Ferran, we have no right to affirm 

 that the cultivations when they left his hands were impure ; we believe 

 indeed that the small swellings described by him in cultivating the 

 comma bacillus under certain conditions — and which are found in the 

 course of the spirillum — rest upon correct enough observations. They 

 have been seen by others, and are apparently degenerative changes. 

 Large peronospora forms described by Ferran we knew of no reason 

 to accept as being possible modifications of the comma bacillus. 



With regard to the macro- and micro-scopic morbid changes to be 

 found in fatal cholera cases, our observations are completely in accord 

 with the classical description given by Strauss, Nocard, Roux, and 

 Thuiller. With regard to the comma bacillus, the observations of 

 Strauss, in which he was unable to satisfy himself of the causal rela- 

 tion between the comma bacillus of Koch and Asiatic cholera are also 

 fully accordant with our own investigations. 



Although specially commissioned to investigate the relation be- 

 tween Koch's comma bacillus and Asiatic cholera, we naturally turned 

 our attention to the pathology of the disease as well as to its etiology. 



That the hypersecretion from the mucous membrane of the stomach 

 and intestines in cases of cholera is not due to catarrh, i3 abundantly 

 shown both by the chemical characters of the dejecta of cholera and 

 by the absence in the mucous membrane, on examination after death, 

 of the anatomical changes which occur in catarrh. That it is 

 not due to any irritant present in the contents of the intestine 

 we think may safely be concluded from the absence of necrosis 

 (ulceration), as well as the absence of any well-marked inflammatory 



