Report on the pathology and etiology of Asiatic cholera / as observed in Spain in the summer of 1885, by C.S. Roy, J. Graham Brown and C.S. Sherrington, and in Italy in 1886 by C.S. Sherrington.

  • Roy, Charles Smart, 1854-1897.
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: Report on the pathology and etiology of Asiatic cholera / as observed in Spain in the summer of 1885, by C.S. Roy, J. Graham Brown and C.S. Sherrington, and in Italy in 1886 by C.S. Sherrington. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Tvliicii we found these bacilli in the tissue of the mucosa, the situation was always either close to the free surface, or else in or close to the tubules of Lieberkiihn's glands ; that is, in parts to which they might readily have entered either after death or during the few hours preceding death, when the patient was lying in a moribund condition. We cannot confirm Koch's state- ment of their number present in the mucous membrane bearing any definite relation to the acuteness or severity of the attack. We need not say more on this subject. The small numbers of the comma bacilli to be found in the contents of the intestine in fatal cholera cases, and their apparently complete absence in many cases of cholera, together with the fact that we very rarely found them in the substance of the mucous membrane, make it impossible for us to accept absolutely the conclusions arrived at by Koch as to the causal relation between his comma-shaped bacilli and Asiatic cholera. Koch's theoiy of the relation of the comma bacUli and cholera was based—at first at least—entirely on the supposed constant occurrence of the parasite in the contents of the intestine •and in the mucous membrane. If his observations on these points are mistaken, as our own researches on the subject oblige us to conclude, we cannot see on what sure basis his theory rests.* Koch, by experiments on the effects of cultures of the comma bacillus when introduced into the small intestine of certain lower animals, has obtained facts which have had considerable weight in bringing about the general acceptance of his theory. We need not enter in detail into these experiments, seeing that, even accepting, as we are quite prepared to do, the accuracy of the facts observed by him, and admitting that the fatal results which he obtained in a proportion of his ■cases were not due to septicsemia, we cannot satisfy ourselves that the animals died from a disease identical with Asiatic cholera. * As very strong views bave been and are beld by many pathologists both for •and against Koch's theory of the etiology of cholera, we feel it possible that we may be suspected of ha^ving been biassed against bis views from the first. This •was not, however, the case, each of us being, we believe, in doubt as to the con- clusions that might be drawn from the observations of Koch, v. Ermengen, Watson Cheyne, Nicati, and Eietsch, &o., on the one hand ; and those of Strauss Klein, Emmerich, and others, upon the other hand. We felt and feel strongly that the observations of so brilliant an investigator as Koch, •«'hose previous discoveries have successfully withstood the test of time and virulent attacks, •deserve greater respect than has sometimes been accorded them.
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