Savannah morning news. [volume] (Savannah) 1868-1887, 1884-08-28
DR.. KOCH'S CHOLERA LORE
MORE OF HIS DISCOVERIES
GIVEN TO THE PUBLIC.

CIV In TO THE PUBLIC,
bis Tracing of the Propagation of the
Disease of fTnestimable Value to Science
The ''Medical News" Sounds the Note
of Warming that This Country is Not
Yet Beyond Danger,
PHILADELPHIA, Aug. 2I.-An impor-
tant conference upon the cholera has just
been held in Berlin at the Office of the I'm
perial Board of Health, an abstract Of the
proceedings of which1s now appearing in
the Medical NelcS, of this city.
DR.. Koch exhibited microscopic specimens
of the cholera bacillus, and he demonstrated
the method of its preparation and cultiva-
tion. Regarding his recent investigations,
he stated that microscOpical examinations
of the intestine and its contents revealed
considerable invasion of bacteria, occurring
partly within the tubular glands, partly be-
tween the eplthelium and basement men,
brane, and In some parts deeper still. Then
he found cases in which, besides the bacteria
of one definite and constant form, there were
others also accumulated within and around
the tubular glands of various sizes, some short
ana thick, others very fine, and he soon con-
cluded that he had to deal here with the pri-
mary invasion of the pathOgenic bacilli which,
as 1t were, prepared tissues for the entrance
OF non n-pathOgenic forms. Just as he had OBJ
Intestinal mucosa and in typhoid ulcers.
THE BACTERIA.
He then proceeded to describe the charac-
ters of his bacteria. 1t is smaller than the
tubercle bacillus, being only about half or at
most two-thlrds the size of the latter, but
much more plump, thicker and slightly
curved. As rule the curve is no more than
that of a comma, but some times it assumes
q aselnI-SIrGGIar shape'ano ne mas seen II form
ing double curve like an 5. These two
variations from normal being suggestive of a
junction of two individual bacilli. In cul-
ture there always appears a remarkably
free development of comma shaped bacilli.
These bacilli often grow out to form long
threads. not in the manner of anthrax bacill,
nor with simple undulating form, but as
suming the shape of delicate long spirals, the
corkscrew shape reminding one very forcibly
of the spirOchalt of relapsing fever. Indeed,
it would be difficult to distinguish the two if
placed side by side. On account of this de-
velopmental change he doubted if the cholera
organism should be ranked with the bacilli.
1t is rather transitional form between the
bacillus and spirilum. Possibly it Is true
spirlllum, portions OF which appear in comma
shape much as nother spirilla, e. g.: spirilla
undue, which do not Always form complete
spirals, but consist only of more or less curved
rods.
WHEN THEY THRIVE.
The comma bacilli thrive best at a tempera-
ture between 81 Fahrenheit and lO4 Fahren-
helt, but they are not very sensitive TO low
temperatures. their growth not being pre-
vented until 6215 or Sc degrees is reached. In
this respect they agree with anthrax bacilli.
DR.. Koch made an experiment to ascertain I
whether very low temperature not merely
checked their development but killed them,
and subjected the comma bacilli to a tempera-
ture of IA degrees Fahrenheit. They were
then completely frozen, but yet retained
vitality, growing in gelatine afterwards. DIR.
Koch found that the addition of an aqueous
solution of iodine in 1000 to meat infusion
In the proportion OF in 10 did not in the least
interfere with the growth of bacilli in that
medium. He did not pursue this line of IN
quiry, seeing that in practice larger quantities
of iodine than that could not be given. Alco-
hol first checks the development Of the comma
bacilli when il is mixed with nutriment fluid
in the proportion of in 10, a degree of con-
centratiOn which renders 1t impracticable
for treatment. Common salt was added
to the extent of per cent. without influenc-
ing the growth of the bacilli. Sulphate of
iron in the proportion of per cent. checks
this growth; probably by precipitating al
buminates from the fluids, and possibly also
by its acid reaction.
NO SPECIFIC DISINFECTING ACTION,
Certainly it does not seem to have any spe-
cific disnfecting action-i. e., IN DESTROYING
the bacIll. Among other substances which
prevent the growth of the comma bacilli NAV
be mentioned: Alum, in solutions of strength
of in 100; camphOr, in 800; carbolic acid,
in 400; oil of peppermint, in 1900; sulphate
of copper, l in 2,500-a remedy much employed
But how much would really be needed
merely to hinder the growth of bacilli in the
intestine?
Qulnne l in 5000, and corrosive sublimate
in 100000. In contrast with the foregoing
measures for preventing the growth of these
bacill, is the striking fact that they are
readily killed by drying. This fact is proved
by merely driving a small drOD of the mate
rial containing bacilli on the cover of a glass
slide, and then placing this over some OF the
fluid on the glass slide. hus il was found
that although vitality was acknowledgement
ing largely upon the number of bacilli-for a
short time, yet the withdrawal of the nutrient
fluid for an hour, or even less, often sufiiced,
and 1t never happened that the bacilli retained
vitality after deprivation lasting "A hours.
EFFECTS OF THE DRYING.
These results would seem to point TO the
fact that the comma bacillus does not, like
the organisms of the anthrax and vaccinia
pass INTO resting state by drying, and if so
1t is one of the most important facts in The
etiOlOgy of cholera. Much. however, remains
to be done, especially with reDard to the soiled
linen of cholera patients being kept in damp
state. He found that in soiled articles when
dried for a time VARYING from q hOurs
and upwards the comma baciIli were
quite destroyed, nor was the destruction de-
layed by placing the chOleraic eXcreta in or
upon earth dry or moist or mixed with stag
nant water. In gelatine the culture of the
comma hacilli can be cultivated for six
weeks, and also in blood serum milk and
potato, where the anthrax bacilli rapidly
form spores, but resting state of the comma
bacilli has never been met with. very ex-
ceptlonal thing in the case OF bacill. and an
other reason why the organism must be re-
garded rather as spirillum than bacillus, and
the comma bacillus has now been found in
nearly one hundred cases of cholera, occur
ring in constant relation to the cholera
process, being most abundant in the lower
end of the ilium, where the changes are most
intense, and being most pure in acute, un-
complicated cases.
SPECIFIC TO CHOLERA.
On these grounds the comma bacilli NAV
be considered as specific to cholera Many
observations were made in other diseases, and
in subjects who had recently passed through
attacks of cholera, without finding these ba-
cilli in the dejecta in the bowels. The
whole etiology of cholera, so far as it is
taken as regards comma bacil. They
multiply rapidly, soon reach their
term and are supported by other
bacteria. So in the intestine they multiply
set up irritation and diarrhea, and all the
typical symptoms of choleraic seizure under
normal conditions. In animals, at least, ba-
cillI are destroyed in the stomach, and this
harmoniZes with the important part plaved
by predisposition and liability of those to
be attacked who are suffering from gastric or
intestinal catarrh, or who have over-laden
the stomach with undigested food, conditions
which would facilitate the passage of the ba-
cilli unchanged into the intestines. But the
bacillus is limited to the intestines; il is not
found IN the mesenteric glands or in the blood.
HOW IT DESTROYS LIFE.
How then can it destroy life? Probably
from the pTOOuClIO0 OF POISONOUS substances,
such as are produced by bacteria in putrefac-
tion. Presuming that baccilli produce a spe-
clflc poison, DR.. Koch then proceeds to explain
the phenomena of cholera. In conclusion he
advocated the subject Of treatment and re-
minded those who say that such discoveries
do not enable us to cure disease better than
formerly, that the rational treatment of most
diseases, and especially of infectious diseases
cannot be adopted until their cause and ma
ture are known; but even yet the discovery
of the cholera bacillus is important
as furnishing aid in the diagnosis which
would facilitate the detection of the first case
occurring in the district, and the adoption of
measures to prevent It's spread, knowing
also, the nature and properties of the bacI-
lus, and especially the readiness with which il
is killed by drying. The right direction of
prOphylaXis is assured, and the lavish exDen-
diture of dlsinfectants checked, so that there
will.nOt be repetition Of what happened in the
last epitemic when millions OF gallons were
poured into the cutters and sewers without
the slightest need. Even therapeuticallv
knowledge of the comma bacillus may be of
value. \ diagnosis will be possible in mild
cases and in early stages of the disease when
treatment is of the most avail.
THE SPREAD OF THE DISEASE.
The Medical NelgS will publish the fol-
lowing editorially in next SATURDAYS pa
per:
The outlook in France, Italy and -Switzer-
and is not so good az it was week ago. and
the late increase of the cholera at TouIon
would seem TO indicate that the disease has
lost none Of its force in the quarter where it
first made its appearance over two months
ago. It gradually spread throu0hout South