NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
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to stain well, whilst a certain number stained very deeply, and at the, same time
showed an alteration in their form, becoming fusiform and thicker than their
neighbours, so that the entire filaments appeared like pale threads, with deeply
colored beads strung upon them at intervals. So completely, however, did the
idea that Choleraic Comma-Bacilli were necessarily Koch's bacilli prevail that
the obvious suggestion conveyed by the phenomena escaped notice ; they
were noted as remarkable, but passed over as the result of inappreciable differ-
ences in external conditions, telling on organisms of one and the same species.
So much so was this the case that, even when, during the summer of 1889, a
specimen of choleraic materials presented itself which was certainly crowded with
distinct and healthy looking Comma-Bacilli, incultivable in any ordinary media,
the phenomenon was assumed to have been due to something having proved
fatal to' them ere they were subjected to experiment.
As in so many other cases, the discovery of the multiplicity of species did
not result from investigations primarily directed to settle the question, but in the
course of an enquiry into the old question of the invariable association of
Koch's Comma-Bacilli, with choleraic materials. As it had been ascertained
during the course of the previous year that at certain times large numbers of
cases presenting essentially choleraic symptoms may be admitted into the hos-
pitals of Calcutta, and be there diagnosed and treated as cases of cholera without
the contents of the intestines showing any trace of the presence of Comma-
Bacilli, it appeared to be desirable once more to investigate the subject closely,
with a view to determine, if possible, whether the phenomenon were due to error
in diagnosis or to inconstancy of the association of Comma-Bacilli with the
disease. Arrangements were accordingly made to secure materials from all cases
regarded as genuine cases of cholera in three of the principal hospitals in
Calcutta. The hospitals serving as the source of supply were the General
Hospital, the Medical College Hospital, and the Sealdah Pauper Hospital, the
first serving as an, index to the conditions present in the case of the disease
as affecting Europeans, and the two latter doing the same in regard to the native
p o p u l a t i o n .
There seems to be no reasonable ground to doubt that the cases from
which the materials yielding the various species of Commas, to be described pre-
sently, were obtained were genuine cases of cholera—they were diagnosed as such
by physicians of long experience of the disease, the symptoms were characteristic,
and the mortality was in a ratio of 62.5 per cent. Details in regard to each case
are recorded farther on, and from them it will be seen that they were derived from
the native population of Calcutta, from European sailors who had recently arrived
in Calcutta, and from Europeans who had for prolonged periods been resident in
India.
Very shortly after the experiments had been begun, it was noticed tnat
cultivations of the Commas derived from materials supplied by the . Medical College
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others were admitted into the Medical College Hospital on the 24th and 26th
of November, and each furnished a new and distinct species.
The total number of cases which furnished the materials for special investi-
gation during the course of the year was sixteen, and they have yielded no less
than ten distinct species of Comma-Bacilli, the distinctive characters of which
must next be considered. In proceeding to give detailed descriptions of the
different species I do not propose, in the meantime, to designate them by specific
terms, but merely to distinguish them from one another by lettering.
I.—SPECIES a.—Notes regarding the cases of Cholera from which the
species was obtained.
I.—uditTewari; Hindu, age 28.
Admitted into the Medical College Hospital on the 21 st January, and died
the same day.
Symptoms.—Vomiting, purging, suppression of urine, &c.
Characters of the evacuation from which the Comma-Bacilli were obtained.—
It consisted of a clear, watery, alkaline fluid, and abundance of white, tenacious
flocculi. The smell was mawkish and characteristic. Cover glass preparations
of the flocculi showed them to be practically almost pure cultivations of Comma-
Bacilli, and plate cultivations yielded very abundant colonies of similar bodies.
2.-Ramrup Chakravarti, Hindu, age 25.
Admitted into the Medical College Hospital on the loth February, and dis-
charged some time later.
Symptoms :—Vomiting, purging, suppression of urine, &c.
Characters of the evacuation from which the Comma Bacilli were obtained.—
It consisted of a transparent, greyish, alkaline, watery fluid, and abundant, large,
ragged, white flocculi. The smell was mawkish and characteristic.Cover-glass
preparations showed it to be an almost pure cultivation of large, deeply-staining
Comma Bacilli, and plate cultivations yielded an abundant growth of colonies
of them.
3.—Rajpati Upadhya, Hindu.
Admitted into the Medical College Hospital on the 14th February, and died
very early on the morning of the 17th February.
Symptoms.— Vomiting, purging and suppression of urine.
Characters of the evacuation from which the Comma Bacilli were obtained.—
It consisted of a watery, grey, alkaline fluid, and abundant, white, powdery
deposit. The smell was offensive. Cover-glass preparations showed it to be full of
schizomycetes of various kinds, Comma-Bacilli being present in small numbers
only. Plate cultivations yielded a few colonies only, all of them seemingly of
one kind, and consisting of Comma-Bacilli.
4.—kheta Mohun Statpati, Hindu, age 30.
Admitted into the Medical College Hospital on the 19th February, and died
on the 21st February.
Medical Officers of the Army of India.
the same constancy as in the case of cultivations in the solid media. The pel-
licle, which ultimately forms on the surface of the fluid, is soft and homogeneous,
and almost never shows any tendency towards the membranousness, dryness
and wrinkling so conspicuous in those of certain other species. The pheno-
mena presenting themselves in tubes, which have been treated with nitric and
sulphuric acids, so as to develope the so-called cholera-purple due to the simul-
taneous presence of indol and nitrites, are very characteristic in those cases
where both acids are employed. The fluid is then distinguished from that in
similarly treated cultivations of any of the other species, by the constancy with
which it becomes quite limpid within twenty-four hours, due to complete deposit of
the cloudiness originally present in it. This character comes out most clearly as
a distinctive feature in cases where the tubes have been under cultivation at
temperatures of 35° to
37°
C. for periods of seventy-two hours or more. After the
lapse of twenty-four hours from the time when the acids were added to the fluid,
this is found almost invariably to be quite limpid, whilst those in corresponding
tubes of the other species present various degrees of haziness or cloudiness. The
fluid, also, is ordinarily at this time characterised by having a more or less decided
brown tinge, which is not, as a rule, present in the case of the other species (vide
Table II) . It is only where both acids are added that this distinctive clearing
occurs with certainty, the addition of either of them alone leading to the develop-
ment of a purple color, but the fluid usually remaining persistently cloudy.
II.—SPECIES β.—Notes regarding the cases of Cholera from which
this species was obtained.
1.—Thomas Langan; European sailor; age 36.
Admitted into the General Hospital on the morning of the 8th January 1890,
and died on. the 9th. He had been for twelve days in the port of Calcutta ere
he was taken ill.
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Symptoms.—V omiting, purging, suppression of urine, depression of cuta-
neous temperature, and cramps.
Characters of the evacuation from which the Comma-Bacilli were obtained.—
It consisted of a grey fluid, full of fine particles, but devoid of large flocculi.
The re-action was at first alkaline, but became faintly acid on drying. The
odour was offensive. Cover-glass preparations showed a variety of curved and
straight Bacilli, and a very large number of very slender, faintly-stained vibrionic
filaments. Plate-cultivations yielded an abundant and apparently pure growth
of colonies of Comma-Bacilli, with a very characteristic mawkish odour.
2.—Joseph Morphy; European sailor; age 41.
He had been for three weeks in the port of Calcutta, and was admitted into
the General Hospital on the 26th January 189o, and died on the following day.
Symptoms.—Vomiting, purging, suppression of urine, depression of cuta-
neous temperature, and cramps.
Characters of the evacuation from which the Comma-Bacilli were obtained.—
It consisted of a grey, neutral, watery fluid, containing a very few small flocculi.
The smell was offensive. Cover-glass preparations showed an abundance of
Comma-Bacilli, and large numbers of slender, faintly-stained spirilla. Plate-culti-
vations gave an excessively abundant, and seemingly pure growth of colonies of
Comma-Bacilli, with a strong mawkish smell.
3.—David Steer; European sailor; age 56.
He was admitted into the General Hospital on the 19th of May 1890, on ac-
count of inguinal hernia, and was attacked by cholera two days later. He was
very ill for about seventy-two hours and then gradually recovered.
Symptoms.—Vomiting, purging, suppression of urine, depression of temper-
ature, and cramps.
Characters of the evacuation from which the Comma-Bacilli were obtained.—
It consisted of a whitish, neutral, watery fluid and a scanty sediment of white,
powdery material. The smell was offensive, and strong. Cover-glass prepara-
tions showed it to be crowded with Comma-Bacilli, and plate cultivations
yielded an abundant and apparently pure growth of similar bodies.
4. — J. WILLIAMS; European; resi dent i n Indi a for 30 years.
Admitted into the General Hospital on the 17th November 1890, and dis-
charged on the 21st November.
Symptoms :—Vomiting, purging, suppression of urine, and cramps of the
extremities.
Characters of the evacuation from which the Comma-Bacilli were obtained.
—
It consisted of an alkaline, grey, watery fluid, and abundant gelatinous flocculi,
of greyish-white color, Cover-glass preparations showed an abundance of
Commas in the fluid and flocculi, and plate-cultivations gave a growth of short,
thick, well-curved Commas.
10
Medical Officers of the Army of India.
5. The growth on potatoes is quite distinctive, and unlike that present in the case of
any other species.
6. The pellicle in broth-cultivations has a great tendency to become membranous,
and rough or wrinkled, and the fluid, when treated with acids, has a marked tendency to
copious and persistent gaseous evolution.
III. SPECIES y.—Notes regarding the cases of Cholera from which
the species was obtained.
1.—Motty; Hindu; adult.
Admitted into the Sealdah Pauper Hospital on the 26th January 189o, and
died on the 30th January.
Symptoms.—Vomiting, purging, suppression of urine, depression of cuta
- neous temperature, and cramps.
Charcalers of the evacuation from which the Comma-Bacilli were obtained.—
It consisted of a reddish brown, alkaline, watery fluid, and an abundant deposit
of grey, powdery material. The smell was strong and offensive. Cover-glass
preparations showed few distinct Commas, but very large numbers of minute,
straight Bacilli, in many cases forming dense aggregates around the persistent
nuclei present in the substance of the small flocculi. Plate cultivations yielded
only a very limited number of colonies, all seemingly of one kind, and composed
of well formed Commas.
2.-Siboo; Hindu ; adult.
Admitted into the Sealdah Pauper Hospital on the 1st February 1890, and
died on the morning of the 2nd February.
Symptoms.— Purging, suppression of urine, depression of cutaneous tern-
perature, and cramps.
Characters of the evacuation from which the Comma-Bacilli were obtain-
ed.— It consisted of a grey, alkaline, watery fluid, and a copious, white, powdery
deposit. The smell was offensive. Plate-cultivations yielded very abundant
crops of colonies, the majority of which were composed of Commas.
3.—Shama; Hindu; adult.
Admitted into the Sealdah Pauper Hospital on the 10th February 1890, and
ultimately recovered.
Symptoms.—Vomiting, purging, suppression of urine, and slight cramps.
Characters of the evacuation from which the Comma-Bacilli were obtanied.—
It consisted -of a greyish, faintly acid watery fluid and numerous fine, white flocculi.
The smell was offensive. Cover-glass preparations showed multitudes of small
straight Bacilli and micrococci, and also very minute, pale Commas. Plate-
cultivations yielded limited numbers of relatively large, superficial and inter-
- s t i t i a l c o l o n i e s , a l l s e e m i n g l y c o m p o s e d o f C o m m a s .
In almost all cases the morphological characters of the elements in this
species are very distinct from those present in either of the preceding ones.
They are, as a rule, of considerable size, relatively slender, only slightly curved,
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and pointed. They do not show the coarse, blunt appearance and aggregant
tendency of those in species a , nor are they short, thick and well-curved like
those in species β (vide Plate I, Fig. 3). They are actively motile in suitable
fluids. When grown in neutralised common gelatine they liquefy the medium
more rapidly than those of species a, but not so rapidly as those of β . Dur
- i n g t h e e a r l i e r s t a g e s o f c u l t i v a t i o n t h e l i q u e f i e d a r e a i n t h e b a s i s h a s a v e r y
marked tendency to assume a peculiar calicyform outline, unlike that presented
by it in cultivations of any of the other species.
On neutralised Agar-agar media they grow rapidly, both over the surface and
intersticially around the track, of the needle. The surface stratum is neither
so constantly smooth and polished as that in species a, nor so frequently
rough and wrinkled as that in β. Like them, it is either quite incoherent or only
slightly adhesive (vide Table I). The growth in non-neutralised Agar-agar media
is very much slower than in the case of species β. It appears later than in the
case of that of any other species, save a, and, like the growth in that case, forms
at first a barely perceptible film. Intersticial growth is entirely absent.
It is not by any means so easy to cultivate successfully on potatoes as
species β.
In those cases in which it does grow freely, it forms rather thin
brown expansions, with irregular margins, and lineated surface, resembling
crustacious lichen-thalli more than anything else, and with a mawkish odour
(vide Plate II, Fig. 3). The growth consists of well-formed Commas. It has
never as yet been successfully transferred from one potato to another, even
when the primary growth appeared to be really vigorous, and in no instance have
any modifications of form in the elements, corresponding to those accompanying
thorough acclimatisation to potatoes in the previous species, been observed.
Cultivations in broth show no very distinctive features in their natural con
- d i t i o n . W h e n t r e a t e d w i t h n i t r i c a n d s u l p h u r i c a c i d s w i t h i n 2 4 h o u r s o f t h e t i m e
at which they were inoculated, the fluids show well-developed purple. They are
distinguished from those in the two previous species by having hardly any tendency
to rapid clearing, so that in most cases they are distinctly clouded 24 hours
after the addition of the acids, and in hardly any truly limpid ( vide Table II).
The principal distinctive features in this species are
—
1st.—The morphological character of the elements.
2nd. —The slow growth in non-neutralised Agar-agar.
3rd.—The brown, thalloid growth on potatoes.
4th .—The absence of any tendency to rapid and complete clearing in broth-cultiva
- tions treated with acids.
IV.—SPECIES δ.-Notes regarding the case of Cholera from which.
this species was obtained.
J. Longman; European; age 23.
The patient was a resident of India, in the employ of the East Indian Rail
- way. He was admitted into the General Hospital on the 5th April, on account
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consists almost entirely of comparatively small, straight rods, but at a later
stage large, well curved and often beaded commas are present in considerable
numbers. The smell is faint, peculiar, not unpleasant and somewhat like that of
decaying apples. The growth is certainly and rapidly—within five or six days—
followed by alterations in the isolant solution of the moist chamber, where this
consists of. a diluted spirituous solution of corrosive sublimate; a dry film and
copious, precipitate of bright canary yellow occurring in it.. Similar changes in
the isolant fluid in potato cultivations of some of the other species sometimes
manifest themselves, but never with the rapidity and constancy with which they
occur in connection with this species.
.
The growth in broth is much slower than that, occurring in similar cultivations
of the other species, (vide Table II). After twenty-four hours' exposure to tem-
peratures ranging from 35º to 37°C., the fluid is almost always quite limpid, and in
some cases no appreciable signs of growth are present. In others a pellicle has
f o r m e d - t o a g r e a t e r o r l e s s e x t e n t , u s u a l l y i n t h e f o r m o f i s o l a t e d w h i t e f l o c c u l i
of small size, and occasionally as a thick continuous stratum. In any case the
exposed material of the pellicle tends to subside to the bottom of the fluid when
exposed to the slightest agitation. Distinct clouding of the fluid does not set in
for several days, and is only pronounced at periods when the initial clouding in
corresponding cultivations of the other species has begun to diminish in density.
Addition of nitric and sulphuric acid fails to induce the evolution of purple in
the fluid in tubes of any period of cultivation.
The distinctive features of this species are
–
1.The morphological characters of the elements.
2. Absence of power of liquefying gelatine.
3. Incapacity for anaerobic growth in neutralised Agar-agar media.
4. Rapid growth on non-neutralised Agar-agar media.
5. Peculiar characters of growth on potatoes.
6. Absence of evolution of purple in broth-cultivations when treated.with acids.
V.—SPECIES E :—Notes regarding the case of cholera from which this
species was obtained.
Surya Kumar Kadmakar; Hindu ; age 20.
Admitted into the Medical College Hospital on the 21st June and discharged
on the 28th June.
The case was admitted and treated as one of cholera, but details of the
symptoms are not available owing to the fact that the history sheet has been
lost.
Characters of the evacuation from which the Comma-Bacilli were obtained. —
It consisted of a whitish, alkaline, watery fluid, and a scanty; whitish, powdery
deposit. The smell was offensive. Cover-glass preparations showed schizomy-
cetes of various kinds, among which Commas of small size were present. Plate-
cultivations yielded an abundant crop of colonies. There appeared to be three
18
Medical '0 cers of the Army "of India.
23'
invariably, even from the very first cultivation of the kind which was carried oust,
purely confined to the surface, and although very, many attempts were made by
means of repeated transfers to Agar-agar and broth-media to secure a resumption
of the anaёrobic habit .they always failed completely. In certain cases a certain
amount of resumption of the original form manifested itself in the course of theses
experiments, more or less distinctly commatous elements replacing the straight
ones originally present in the cultivations most : nearly related to the potatoes in
the series of transfers, but the power for intersticial growth in Agar-agar, or of
causing the decompositions in broth necessary for the development of purple
color on the addition of acids was never regained in the slightest degree. Ulti-
mately, when the growth on potatoes hadbegun persistently to show the abnor-
malities in consistence and color described above, transfers to Agar-agar media
became entirely unsuccessful and a condition of pure acclimatisation to potatoes,
like that which persisted so long in the case of species β , appeared to have been
thoroughly established. When transferred to abnormally acid potatoes, the pink
-ish material derived from normal ones soon lost its color and became almost
white, and a thin, rough stratum of gamboge-yellow color, consisting of very
large Commas, solitary and associated in: vibrionic filaments, gradually radiated
from it over the surrounding surface.
Cultivations in broth do not show any features especially distinguishing them
from those of the preceding species (vide Table II). This species is charac-
terised by the following features :—
1 . T h e m o r p h o l o g i c a l c h a r a c t e r s o f i t s e l e m e n t s .
2. The peculiar features presented by cultivations in gelatine, due to excess in ac-
tivity of solution of the medium towards the surface.
3. The appearance of the growths which it forms when cultivated, on, potatoes, and
the persistence with which the elements in these retain the alterations in form
and properties which have been acquired under the influence of the medium in
connection with which they have been developed.
VII.—SPECIES η .
This was obtained from the same evacuation as the two previous species.
The surface colonies in the original plate-cultivation were distinguished from
those belonging to the co-existent species by their relative thickness and promi-
nence, and by their appearing of a pure yellowish tinge when viewed obliquely by
transmitted light. The elements composing them were characterised by their
extreme shortness and thickness, so that in many cases they did not present a
truly commatous outline; but were either piano-convex or almost micrococcoid.
These morphological characters recur more or less distinctly almost invari-
ably in all cultivations, whatever the nature of the substratum be.
Like their original compeers they liquefy gelatine relatively slowly, and as the
process advances with considerable equality all . along the course of the needle
track, the softened area in the basis at early stages of cultivation presents a more