NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
Scientific Memoirs by
or less even columnar outline, quite distinct from the evenly tapering one in
tubes of species ε, and the broadly crateriform and inferiorly tubular one present
in cultivations ofζ .
It grows rapidly in neutralised Agar-agar media, both superficially and inter-
sticially. The surface-growth is thick, and during the summer and autumn was
almost invariably extremely adhesive and ropey. (Vide Table I.) In non-neu-
tralised Agar-agar media it grows with relative rapidity on the surface of the
medium, evident growth being visible around the mouth of the needle-track within
twenty-four hours from the period of inoculation when the cultivation is conducted
at temperatures between 16° and 2 1°C. The stratum which ultimately forms is
characterised by a special tendency to develop localised prominences. As in
the case of almost all the other species, there is never any sign of intersticial
growth along the course of the needle-track.
It is very unwilling to grow on potatoes. Indeed, although very many
cul- ivations have been attempted they have either failed entirely or the growth has
never advanced beyond the formation of thin, limited, colorless,whitish pale pinkish
ochre expansions, which were incapable of surviving transference to other potatoes.
When first obtained, it showed an almost complete absence of power to
cause those decompositions in broth which are necessary to secure the develop-
ment of purple coloration on the addition of acids. This power was, however,
gradually acquired during the course of successive cultivations in Agar-agar
media, and well pronounced color now manifests itself invariably in broth-cultiva-
tions which have been kept for twenty-four hours at temperatures of 35° to 37°C.
Clearing almost invariably takes place relatively slowly in the acidified fluid, so
that in the majority of cases it is still distinctly clouded twenty-four hours after
the addition of the acids. The formation of a distinct pellicle often appears
rather late in the course of cultivation and the fluid is ordinarily particularly
thickly clouded (vide TableII).
The distinctive features in this case are —
1. The specially short, thick, often micrococcoid form of the elements.
2. The phenomena of liquefaction in gelatine in tube-cultivations.
3. The incapacity for free growth on potatoes.
VIII.—SPECIES θ.—Notes regarding the case of cholera from which the
Comma-Bacilli were obtained_
William Hogan; European seaman ; age 58.
Admitted into the General Hospital on the 13th June, eighteen days after
arrival in the port of Calcutta, and died six hours subsequent to admission.
Symptoms :—Vomiting, purging, suppression of urine, excessive depression.
of cutaneous temperature, and cramps.
Characters of the evacuation from which the Commas were obtained.— It
consisted of a watery, highly alkaline, pale yellowish grey fluid, and a deposit
24.
Medical Officers of the Army of India,
of gelatinous, yellowish grey flocculi. The smell was strong ands offensive.
Cover-glass preparations showed that the flocculi were practically pure cultiv-
ations of Commas and pale, slender spirilla, and plate-cultivations , yielded an
almost pure growth of colonies composed of beautiful, highly-curved Commas.
When grown in common gelatine and neutralised Agar-agar media the
elements of this species are typical well-curved Commas, almost always of
smaller size and slenderer than those in corresponding cultivations of species
β and ε. When derived from cultivations in non-neutralised Agar-agar they
are of very small size and either straight or only very slightly curved.
Growth takes place readily in common gelatine media and is attended by
relatively rapid liquefaction, the process throughout, nearly, if not quite, equal-
ling in rate that which takes place in case of cultivations of species β , and at the
outset being often more rapid than it is in them. The form which the channel
corresponding to the needle-track takes is that of a broad, rapidly tapering
funnel.
In neutralised Agar-agar growth also occurs .rapidly both on the surface
and intersticially, and the thick surface-stratum which ultimately forms is almost
invariably very adhesive or ropey, the character having been present at the
same time as it was in the cultivations of species ε
and n, but not having
ceased to manifest itself as in them on the onset of the cold season (vide
Table I). The growth in non-neutralised Agar-agar is relatively rapid and a
distinct stratum forms over the surface of them edium more rapidly than in the
case of species β. Intersticial growth is absent, and, as has been noted above,
the elements in the superficial stratum exhibit conspicuous departure in form
from that normal to the species when cultivated in neutralised or feebly alkaline
media.
It does not grow readily on potatoes, but, when fairly established, gives
rise to thin, very moist expansions of a dirty ochreous pink color, composed of
small slender Commas like those normally characteristic of the species when
occurring in connection with other media. Successful cultivations, even when
the growth has attained considerable extension, are either odourless or have a
mere faint mawkish smell, and any thorough acclimatisation to the medium
does not, as a rule, appear to occur, as attempts at transfer to other potatoes
very generally fail. It is noteworthy that this should be the case here, and with
species α. and γ, in which also the elements composing the growth on potatoes
exhibit little appreciable deviation in form from the normal type, while in cases
like those of species β,ε andζ , w h e r e t h o r o u g h a c c l i m a t i s a t i o n o c c u r s , i t i s
associated with a conspicuous alteration in form.
Cultivations in broth present no very distinctive phenomena (vide Table
II). Like those of all the other species save 8 they give a distinct purple
-re-action when treated with acids within twenty-four hours of their commence-
ment where they have been maintained at temperatures of from 35° to 37°C. In
25
26
Scientific Memoirs by
regard to clearing after the addition of acids they hold a rather intermediate posi-
tion, having less tendency to rapid clearing than those of species α. andβ, and
decidedly greater tendency to it than those of species γ, ε , and η.
The distinctive features in this case are-
1. The morphological characters of the elements, their small size and relative
slenderness.
2. The very conspicuous modification in form which they present when grown on
non-neutralised as compared with neutralised or feebly alkaline Agar-agar
media.
3. The characters of the growth on potatoes which are quite distinct from those
present in similar cultivations of any of the other species.
IX.—SPECIES ι.—Notes regarding the case of cholera from which the
species was obtained.
Khedu Chandra Biswas; Native Christian; age 60.
Admitted into the Medical College Hospital on the 24th November 1890,
and discharged on the 30th November.
Symptoms.—Purging, vomiting, depression of temperature, and cramps.
Suppression of urine was present only for a brief period.
Characters of the evacuation from which the Commas were obtained.— It
consisted of a yellowish grey, alkaline, watery fluid and abundant gelatin-
ous flocculi. The smell was strong and offensive. Cover-glass preparations
showed it to be full of isolated Commas and vibrionic filaments of various sizes,
some of the vibrionic forms being of unusually large size. The primary plate-
cultivation yielded a pure growth of large colonies of Commas and had a pecu-
liar musty odour. All the colonies appeared to be composed of the same kind
of Commas. This is very readily recognisable, as a distinct species as its culti-
vations in almost all media present striking peculiarities even to casual observ-
ation. Morphologically it is distinguished by the excessively small size of its
elements, which in cultivations on ordinary gelatine, neutralised Agar-agar or
potatoes are commatous, whilst in cultivations in non-neutralised Agar-agar
they take the form of minute oval bodies which are very frequently associated
in pairs. In any medium they are normally very aggregant, large numbers of
them adhering persistently to one another in dense clumps when the growth is
diffused in fluid.
The growth in common gelatine is very distinct from that of any other
species. Liquefaction takes place with very great slowness as compared with
the rate at which it occurs in the case of any of the other liquefying species.
There is no special tendency to greater rapidity of liquefaction at the surface,
and hence the liquefied area presents itself as a mere narrow tube at periods at
which in all the other species conspicuous craters and tapering or wide colum-
nar areas of liquefaction are present.
Scientific Memoirs by
the close of twenty-four hours' inoculation. It is the nature of the pellicle, how-
ever, which forms the most strikingly distinctive feature. It makes its appearance
comparatively rapidly, but very rarely takes the form of a continuous stratum,
being represented either by a narrow ring around the margins of the fluid, or by
isolated flocculi. The material of which it is composed is in any case opaquely
white and very friable and sinks to the bottom of the tube on the slightest
agitation. The latter property is no doubt the reason why complete pellicles
are so seldom to be met with, as in many cases where an annular one is present
a considerable flocculent deposit may be recognised at the bottom of the fluid,
which is apparently due to the rupture of the surface-stratum and the subsidence
of the central portion, leaving the peripheral ones adherent to the sides of the
tube. This tendency to subsidence of the pellicle is peculiar to this species of
all those which are capable of liquefying gelatine and of intersticial growth in
Agar-agar, but, as previously mentioned in describing the properties of that
species, it is present in the case of the pellicles of broth-cultivations of species δ .
When first obtained this species had hardly any capacity for effecting the
alterations in the medium connected with the development of purple on the addi-
tion of acids, tubes of twenty-four and forty-eight hours' incubation showing hardly
any perceptible traces of the color, but, in connection with continued cultivation
in gelatine and Agar-agar media, a considerable increase in power has taken place
and the tubes now show well-marked color within twenty-four hours after inocula-
tion. There can be no doubt that in certain cases, such as this and that of spe-
cies η, continuous cultivation under particular conditions may most importantly
modify the phenomena of the color re-action, and that, therefore, the latter are, as
Ali Cohen has pointed out,* only really of diagnostic value when manifested in
connection with schizomycetes which have for prolonged periods been subject to
like conditions of environment.
If acidulated tubes be examined twenty-four hours after the addition of the
acid, the deposits of pellicular material will generally be found to have risen to
the surface in considerable amount in the form of ragged white masses.
The distinctive characters of this species are—
1.Very minute size of the elements.
2. Peculiar form of the elements when grown in non-neutralised Agar-agar media.
3. Excessively slow liquefaction of gelatine.
4. Limited and slow surface-growth and conspicuous intersticial growth in non-
neutralised Agar-agar media.
5. A growth on potatoes of strong Indian yellow color and composed of very minute
Commas.
6. The formation of a peculiar, very friable and subsident pellicle in broth-cultiva
- tions.
28
Medical Officers of the Army of India.
X.—SPECIES K.—Notes regarding the case from which the species
was obtained.
*" Zur Frage von der Cholera-reaction " (Fortschritte der Medicin, 1888, No. 6.)
Sadaya Nayah ; Hindu ; age. 5o.
Admitted into the Medical,College Hospital at 8 P. M. on the 26th Novem-
ber 189o, and died at 3-45 P.M. on the 27th November.
Symptoms. —Profound collapse, vomiting, purging, extreme depression of
cutaneous temperature, and cramps.
Characters of the evacuation from which the Commas were obtained.— It
consisted, of a large quantity of greyish, watery, faintly acid fluid and very
abundant powdery flocculi. The smell was mawkish and the fluid gave strong
purple on the addition of nitric acid to it. Cover-glass preparations showed
schizomycetes of different kinds, among which were numerous Commas of vari-
ous sizes. Plate-cultivation yielded abundant colonies, apparently all of one kind
and composed of Commas. The smell resembled that of the evacuation.
The elements in this species are relatively thick and well curved. They
so far resemble those of species ß and Є, but are usually considerably larger, and
have a very strong tendency to vacuolation. They retain the same character with
great constancy in all the media in which they are capable of growing freely, and
there is no appreciable change of form in those which are grown in acid media.
They grow freely and rapidly in common gelatine, liquefying it rapidly, but
.not quite so rapidly as species ß and θ do. The process in the earlier stages
gives rise to an evenly tapering funnel of liquid in the basis.
Growth also occurs rapidly in neutralised Agar-agar both superficially
and intersticially. The superficial growth is characterised by the relative activity
with which it advances at moderate temperatures. It ultimately forms a
smooth, thick, shining, moist stratum of great adhesiveness or ropiness. Growth
occurs rapidly in non-neutralised Agar-agar, a conspicuous white patch being
usually recognisable around the orifice of the needle-track within twenty four hours
of the inoculation. This spreads with comparative slowness, but is of consider-
able thickness and is distinguished by its sharply defined, somewhat elevated
margin, and by its density and opacity, and often by having an ochreous tinge
centrally. Intersticial growth often occurs to some extent around the upper
part of the needle-track, but not by any means so conspicuously as it does in
the case of the previous species.
It is very unwilling to grow on potatoes. Numerous attempts have been
made to secure successful cultivations, but in two cases only did any growth
occur, and in these it took the form of a mere, thin colorless expansion. This
consisted of Commas mainly of very large size and either isolated or united in
vibrionic filaments of considerable length. Many of them were irregularly swollen
and were evidently more or less in a condition of involution, but at the same
time they stained very deeply. The characters of the .growth are quite unlike
29
Medical Officers of the Army of India.
Modifications of a similar nature, capable to a greater or less degree of
hereditary transmission, and tending, therefore, towards the establishment of
definite varieties, have been already recorded by Hansen,*Fritsch†, and Cartwright
Wood,‡ as occurring in connection with cultivations of Saccharomyces, Vibrio
Proteus and Koch's Bacillus.
Such phenomena are specially noteworthy when taken in connection with
that of the constant, or at all events usual, association of Comma-Bacilli, unknown
from any other source, with choleraic materials. They indicate that the nature
of the medium and other external conditions are influential in giving rise to
important and more or less persistent alterations in the morphological and
physiological properties of schizomycete organisms. But, if this be so, the
association of certain species of Comma-Bacilli with choleraic materials may
quite conceivably be sometimes due to the active agency of the choleraic con-
ditions in directly modifying the properties of species of schizomycete organisms
normally present within the intestinal tract, but, under ordinary circumstances,
not presenting the character of Commas. It has been distinctly recognised by
certain observers that the association may be due to the fact that the choleraic
condition of the interior of the intestinal tract specially favors certain normal
commatous schizomycete elements in the struggle or existence, and Klein has
even furnished experimental proof that' similar conditions when artificially produc
- ed actually do so, but it may well be that they do more than this, and give rise to
morphological and physiological modifications of a more or less persistent character
in which elements, not ordinarily presenting such characters, assume those of
Comma-Bacilli. Neutralised Agar-agar media do not probably differ more in
composition from potatoes than the contents of the choleraic intestines do from
those of normal ones, and results similar to those often following transfer from
one medium to another, which may be observed when dealing with cultivations
in the two former media, may well be capable of occurring when a substitu-
tion of the normal for the choleraic medium takes place in situ within the
intestinal tract, more especially as a mere alteration in medium does not occur,
but apparently also a considerable alteration in temperature. In cases of pro-
found choleraic collapse, with extreme depression of external temperature, the
rectal temperature is not unfrequently 104º Fahrenheit, and if this may be taken
as indicative of a general rise in intestinal temperature, it implies the presence
of conditions which, as we have already seen, § are specially favorable to the
occurrence of changes in form, at all events, under the influence of which non-
commatous elements take on commatous characters.
*" Production de varietes chez les Saccharomyces," Annales de Micrographie, 1890.
† "Untersuchungen uber Variationserscheinungen bei Vibrio Proteus." Notice in Centr. f. Bacte-
riologie u. Parasitenkunde. vol. 5, page 342.
‡ "Enzyme Action in Lower Organisms," Pros. R. S. E., December 16th, 1889.
§ Vide supra, p. 31.
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Scientific Memoirs by Medical Officers of the Army in India.
whilst in others several species will multiply simultaneously and mixed cultiva-
tions arise. During the course of their development all the species must tend to
develope decomposition-products of various kinds, and these may, of course, differ
greatly from one another in properties, some being quite innocuous, and others
toxic in various degrees should they undergo absorption. Absorption must, how-
ever, be almost entirely in abeyance during the earlier stages of the choleraic
condition, and it is only when these have been passed that it can come into play
to any appreciable extent, When it has been re-established the results which fol-
low will necessarily vary with the nature of the materials absorbed. Where these
are innocuous, no appreciable effects will occur, but where they are toxic they will
give rise to the symptoms which so often manifest themselves in the later stages
of cholera, and hence, whilst quite incapable of originating the disease, the in-
testinal schizomycetes may have a very important effect in relation to its
mortality. One of the most striking phenomena of cholera is the great variation
in regard to mortality of cases which at the outset appear to be of equal se-
verity, and in which all the primary phenomena are equally well marked, the vari-
ation presenting itself both in regard to distinct local epidemics, to different
periods of one and the same epidemic, and casually to individual cases. In
certain cases, too, there is an absence of any marked septicaemic phenomena,
and those which recover pass on at once from a condition of collapse to one of
convalescence, whilst in a large number of instances septicmic symptoms of
varying intensity characterise the later stages of the disease. Not less con-
spicuous is the strangely conflicting nature of the evidence in regard to the
value of certain remedies, such, for example, as salol, in treatment. Now,
all these phenomena are quite incomprehensible on any theory, such as that
of Koch, in which cholera is ascribed to the action of a single species, but
are quite explicable on one which, whilst denying that the primary cause of
cholera is represented by any species of intestinal schizomycetes which has
yet been discovered, affirms that those whose development is favored by the
existence of the choleraic condition may exert an important influence on the
ultimate outcome of individual cases of the disease.
CALCUTTA :
D. D. CUNNINGHAM.
The 16th January 1891.
40
Scientc Memoirs by
TABLE I.—Showing the Characters presented by the surface growth of
Tube-Cul
S e r i e s .
Date.
Age of
cultivation.
1
Species a.
2
Species β.
3
Species γ.
I
July 27th . 6 days
. Shining; polished ; slight-
ly adhesive.
Dry; somewhat rough; not
polished or adhesive.
Shining; polished ; diffluent .
I I
Jnly 31st . 5 days
Thin ; smooth ; shining;
non-adhesive.
Thicker ; dry ; rough and
somewhat wrinkled ; non-
adhesive.
Like that of β. but not so
distinctly wrinkled; non-
adhesive.
III
Aug. 5th . 5 days
. Perfectly smooth ; shining;
somewhat adhesive.
Rough ; dryish; non-adhe-
sive.
Smooth ; shining; very slight-
ly adhesive.
IV
Aug. loth . 5 days
. Thin ; perfectly smooth ;
shining; somewhat adhe-
sive.
Thicker ; rough ; dryish ;
diffluent.
Shining but not quite smooth;
a trace of adhesiveness.
V
Aug. 15th . 5 days
Perfectly smooth ; shining;
slightly adhesive.
Roughened by small pro-
minences; a trace of adhe-
siveness.
Smooth ; slightly dry looking;
a mere ti ace of adhesiveness.
VI
Aug. 20th . 5 days
. Perfectly smooth ; shining;
polished; somewhat adhe-
sive.
Surface covered with slight
elevations ; slightly adhe-
sive.
Covered with slight eleva-
tions; slightly adhesive.
VII
Aug. 25th . 5 days
. Thin ; smooth ; polished ;
shining; somewhat adhe-
sive.
Roughened all over by
slight elevations; slight-
ly adhesive.
Partly smooth, partly rough-
ened; slightly adhesive.
VIII
Aug. 31st . 6 days
. Thin ; smooth ; shining ;
distinctly adhesive.
Thicker ; partially rough ;
slightly adhesive.
Thick; smooth ; slightly
adhesive.
IX
Sept. 5th . 5 days
•
Smooth ; polished ; shin-
ing; very slightly adhe-
sive.
Dry ; roughened over with
minute elevations; in
great part membranous ;
somewhat adhesive.
Nearly smooth ; shining;
slightly adhesive.
X
Sept. l0th . 5 days
•
Thin ; perfectly polished ;
adhesive.
Shining but roughened by
minute elevations; slight-
ly adhesive.
Perfectly polished ; very
slightly adhesive.
XI
Sept. 15th
5 days
. Thin ; perfectly smooth
and polished ; non-adhe-
sive.
Closely roughened all over;
adhesive.
Perfectly smooth ; shining;
adhesive.
XII
Sept. 20th . 5 days
. Smooth ; shining ; polished ;
slightly adhesive.
Rough all over and dry
looking ; very slightly
adhesive.
Half roughened by slight
elevations; diffluent.
XIII
Sept. 25th . 5 days
. Perfectly smooth ; shining;
polished ; slightly adhe-
sive.
Rough and dry looking all
over ; slightly adhesive.
Shining, but not quite
smooth; slightly adhesive.
XIV
Oct. 1st . 6 days
Thin ; white ; perfectly
smooth and polished ;
slightly adhesive.
Entire surface rough and
dry looking ; slightly
adhesive.
Smooth ; white ; shining ;
slightly adhesive.