180 



On the Pathology of Cholera Asiatica. 



unstained and stained spaces or bodies in the granules and mycelium, 

 which suggest the possibility of spores being present. The deve- 

 lopment of zoosporangia from the terminal granules, such as are 

 described in some forms of the Chytridiacese, we have never seen in 

 our specimens. In every one of our twenty-five cases of Asiatic 

 cholera we have found a parasite having the above- described charac- 

 ters lying in the mucous membrane of the intestine. It is found at 

 various depths of the mucosa, its distance from the free surface, the 

 absence of other micro-organisms, and the precautions taken to pre- 

 vent post-mortem contamination, make it evident that it must have 

 been present there during life. We find, moreover, that the luxuriance 

 of its growth goes, speaking very roughly, hand in hand with the 

 degree of the histological changes in the structure of the mucous 

 membrane, which are found unequally distributed in the mucosa of 

 the small intestine in fatal cholera cases. In some of our cases we 

 have found it in or between the epithelial cells of the tubular glands 

 of the intestine. 



As to its presence in other organs and tissues, we have satisfied our- 

 selves of its presence in the kidney in some of our cases. That it 

 occurs in the blood-vessels in some cases we have also convinced 

 ourselves, and think it possible that the filaments and bodies described 

 by Strauss as growing from the blood corpuscles may have been the 

 micro-organism which is above described. 



The time required for the successful staining of this micro- 

 organism has prevented us as yet from making a systematic examina- 

 tion of the kidney and other organs in all of our cholera cases, so that 

 we are not at present in a position to say in what organs besides 

 the mucous membrane of the small intestine it is frequently or 

 constantly present. We have seen it, however, both in the liver and 

 kidneys, as well as in the intestinal wall. As to the question whether 

 this parasite can be cultivated artificially, our observations are 

 unfortunately very unsatisfactory. While in Spain we made a very 

 large number of cultivations from the contents of the intestine, from 

 the blood and tissues, but found it impossible to investigate the life 

 history of all the micro-parasites which we encountered. Our a priori 

 belief was that the parasitic cause of cholera, if it exist (which we 

 thought exceedingly probable), must belong to the class of the 

 Schizomycetes. Our attention, therefore, was almost exclusively 

 directed to the bacilli, bacteria, and micrococci, which grew in our 

 plate cultivations, other micro-organisms receiving little or no atten- 

 tion. We may, very possibly, have grown the parasite which we 

 afterwards found in the wall of the intestine, passing it over, however, 

 as being a very improbable cause of the disease. It appears to us by 

 no means necessary that this micro-organism will grow readily m the 

 alkaline cultivating media which Koch found best suited for his 



