1888 - 89 .] Messrs Macleod and Milles on Asiatic Cholera. 21 
Cholera Commission in Spain frequently failed to demonstrate the 
presence of the comma bacillus, and also that Drs Roy, Graham 
Brown, and Sherrington made their examinations after death, when, 
it is urged, such examination, alone, is not sufficient to determine 
the absence of the organism in a given case, unless this he supple- 
mented by failure to find it in the typical stools passed during life. 
They further observe that, unless the cases were under the observa- 
tion of the members of the Commission during life, they could not 
he certain that they were dealing with the true collapse stage. 
The so-called “rice-water” stool is almost transparent or only 
slightly opalescent when seen in a glass vessel, having no odour, or 
but a faint meaty smell, and containing white flakes containing 
masses of epithelium, which, however, are not present in sufficient 
quantity to render the fluid opaque. This fluid yielded an almost 
pure cultivation of the comma bacillus by the plate method, whilst 
in the non-typical stools several different organisms were found. 
In typical cases it was found that in the intestinal follicles and 
in the spaces formed by the separation of the follicular epithelium 
from the underlying membrane numerous comma bacilli were to 
be demonstrated, and occasionally a few in the tissues near the 
follicles. Klein has arrived at the conclusion, that if the bacilli 
enter the tissues at all during life, it is only during prolonged 
agony before death, and not as a result of the proper activity of the 
bacillus, — but he does not, however, advance sufficient proof of this 
statement. 
The authors found, on examination of a case in which death took 
place ten hours from the apparent onset of the disease (the 'post- 
mortem being made half an hour after death), that the small intes- 
tine was distended and externally was rose-red, the wall having a 
lax appearance as if paralysed, or as if it had been over-distended, 
and had not recovered its contractile power. 
The contents were the clear fluid before referred to as the typical 
stool, the ileum being more particularly distended therewith. The 
mucous membrane was swollen, its epithelium stripped to a consider- 
able extent, and red spots marked the mouths of the follicles. On 
microscopic examination these follicles were seen to be, many of them, 
filled with broken-down epithelium, others with the epithelium 
detached from the underlying membrane, and the epithelium of the 
