Medical Officers of the Army of India.
13
rise to choleraic symptoms? and second:—Are commas alone efficient
agents in determining the epidemic diffusion of the disease? That they really
are quite distinct ones is, however, evident even to casual consideration, and it
is further clear that the latter question is the one of really practical import.
Had it been unequivocally and finally shown that, as the result of laboratory
experiments, choleraic symptoms were induced under the influence of the action
of Comma-Bacilli or their products on the animal organism, a great advance
in our knowledge of the disease would have been made. There could, under such
circumstances, be no more discussion of the question whether the presence of
commas were causative of, or consequential to, the presence of the choleraic
state, but this alone would, so far, be merely a scientific gain. Did cases of
choleraic poisoning only occur in the same isolated fashion as those of poisoning
by the higher fungi do, their practical importance would be inappreciable. It is
of scientific interest to us to know that certain species of the higher fungi are
poisonous, and it would be of scientific interest to us to know that Comma-Bacilli
were so also, and that they produced certain definite effects on the animal
organism. But the great practical interest in regard to cholera depends entirely
on the fact that cases do not only occur isolatedly but in epidemic fashion, so
that, even had it been definitely established that the symptoms of the disease
were due to the presence of commas, very little practical gain would have been
attained.
Assuming, as a matter of hypothesis, that those observers are in the right
who maintain that Comma-Bacilli do give rise to choleraic symptoms, let us now
endeavour to ascertain what evidence there is in regard to the part which they
play in determining epidemic diffusion of the disease. The experiments on the
influence of the Bacilli on the animal organism are separable into two classes,—
1st, those in which choleraic symptoms are said to be developed only under the
influence of certain adjuvant measures; and, 2nd, those in which they are stated to
occur independently, and simply as the result of the access of the Bacilli to the
organism. Koch's experiments may be taken as an example of those of the first
class, and Hueppe's experiments with "Arthrospores," of those of the second.
According to Koch the introduction of commas into the digestive canal of animals
is, under normal conditions, followed by no result, because from their extreme
susceptibility to the action of acids they are killed by the gastric juice, and do
not therefore reach their normal site of development in the small intestine in
a state to do any mischief. Adjuvant means have, therefore, to be employed,
consisting in establishing temporary alkalinity in the stomach and injecting
opium and alcohol into the peritoneal cavity, and only when this has been done
is the access of the parasite to the digestive track by the normal path followed
by morbid effects. From this it would appear that in the presence of normal
healthy conditions on the part of the recipient organisms the Comma-Bacilli
are incapable of doing any harm, and that it is only with the concurrent presence