Medical Officers of the Army of India.
35
pointing in the same direction. Klein has recorded cases in which, both as the
result of experimental interference in lower animals and as a concomitant of
intestinal disturbance in the human subject attending errors of diet, the intestinal
contents have come to be peopled by innumerable comma-bacili,* and similar
phenomena present themselves in Calcutta in connection with cases which are
certainly not of a choleraic nature in any sense. The authorities of the Presi-
dency Jail in Calcutta are much troubled by the habit which many prisoners, who
are desirous of shirking labour, have of inducing a peculiar species of diarrhœa
which is unattended by any general illness, and in which the discharges have a
very peculiar character quite unlike that of those accompanying any natural
form of intestinal disturbance ordinarily occurring in the locality. Numerous
samples of the material have been submitted to me for microscopical examination,
in the hope that they might throw some light on the procedure which is adopted
in order to produce this result. The discharges which I have examined have
invariably consisted of a watery, often nearly transparent, fluid containing large,
almost colourless, very flocculent masses of highly gelatinous and tenacious
consistence, consisting mainly of amorphous matter and fragments of débris of
uncertain nature. The schizomycete organisms which are present are ordinarily
few in number and of various forms, but in one instance beautiful comma-bacilli
were present in such extreme abundance and accompanied by so few other
schizomycetes that many portions of the material might be roughly described
as representing a pure cultivation of them. Here we have an instance of an
abnormal condition of the intestinal contents, which certainly was neither of a
choleraic nature nor necessarily caused by comma-bacilli, but which was at
the same time accompanied by excessive multiplication of such organisms. In
this case, as in many other similar ones, whilst the bacilli presented close
morphological resemblances to those occurring in association with cases of
cholera, they differed conspicuously from the latter in being entirely incultiv-
able in ordinary agar-agar and common gelatine nutritive media.
The concurrence of numerous comma-bacilli with abnormal conditions of the
contents of the intestinal tract of non-choleraic nature is certainly not an in-
frequent phenomenon ; but, as a rule, the resemblance between the choleraic and
non-choleraic organisms is purely morphological, as in the instance just cited.
This, however, is not always the case, as has been clearly proved by Prior and
Finkler's discovery and by various other observations, such as those of Lesage
and Winter.† In these cases not only does the presence of an abnormal condition
of the intestinal contents coincide with the development of abundant comma-
bacilli in them, but the latter present physiological, as well as morphological
similarities to those occurring in connection with cholera. One very striking case
* The Bacteria in Asiatic Cholera by E. Klein, M.D., F.R.S., MacMillan & Co., 1889.
†Lesage :—" Sur l e chol éra i nfant i l e et l e chol éra nost ras. " ( La Semai ne Méd. , No. 15, 1890.)
Winter :" Contributions à l'étude du poison cholérique." ( Bulletin Méd. , No. 29, 18 90 .)
F 2