Medical Officers of the Army of India.
cells and debris, and might certainly, with far more accuracy than is usually
the case of those in common choleraic materials, be described as representing
a pure cultivation, not, however, of Comma-Bacilli, but of very peculiar, short,
straight, thick oval rods. These were present in immense numbers, spe
- c i a l l y i n d e n s e g r o u p s w h i c h c l o s e l y e n c i r c l e d t h e n u c l e i o f t h e e p i t h e l i a l c e l l s .
Plate-cultivations yielded an abundant and seemingly quite pure growth of
colonies, which were confined to the surface of the medium and consisted of
elements presenting the same characters as those in the flocculi. So long as only
one species of Comma-Bacilli had been recognised as associated with choleraic
materials, cases of this nature might with some show of reason be rejected as
not being true cases of cholera; but this is no longer so when we are acquainted
with the existence of numerous species of choleraic Commas, for, if cholera be
associated with numerous distinct Comma-Bacilli, there is no rational ground
for denying the possibility that in certain cases these may be replaced by
other forms of schizomycete organisms. The occurrence of such anomalous
cases, together with a consideration of the fact that we have no evidence of the
multiplication of Comma-Bacilli within the intestinal tract antecedent to the ma-
nifestation of active symptoms of the disease, and of the manifest improbability
of any appreciable absorption of intestinal contents taking place during its earlier
stages, appear to be sufficient to indicate that neither Koch's species, nor the
group of Comma-Bacilli as a whole, are capable of acting'as the essential primary
cause of cholera.
Taking all the facts into consideration, there would almost appear to be
grounds for formulating a theory of the following nature in regard to the relation
of the various species of Comma-Bacilli and other schizomycete organisms
abounding in choleraic materials to the disease. None of them have been shown to
be capable of originating the disease, and they are all merely normal inhabitants
of the intestinal tract which have undergone abnormal multiplication as the
result of the important modifications which the contents of the tract undergo
during its primary stages. The intestinal canal is constantly peopled by an in
-
finite variety of schizomycete organisms, among which, in many instances, Com-
- m a s a n d o t h e r v i b r i o n i c e l e m e n t s a r e r e a d i l y r e c o g n i s a b l e . A l l o f t h e m m u s t
necessarily be subject to a continuous struggle for existence, the conditions being
such that, under ordinary circumstances, certain species, such as the common cho-
leraic Comma-Bacilli, are repressed and rendered incapable of multiplying to any
considerable extent. On the profound alteration in the conditions incident on the
onset of cholera, certain of the species of schizomycetes which happen at the
time to be inmates of the intestinal tract encounter conditions specially favorable
to them, and consequently undergo excessive multiplication. The number of
species to which the altered conditions are specially favorable is different in
different instances, and the results will necessarily vary accordingly, so that in
certain cases relatively pure cultivations of one or other species will occur,
37