Cholera : inquiry by Doctors Klein and Gibbes and Transactions of a committee convened by the Secretary of State for India in Council.
- Heneage Gibbes
- Date:
- 1885
Licence: Public Domain Mark
Credit: Cholera : inquiry by Doctors Klein and Gibbes and Transactions of a committee convened by the Secretary of State for India in Council. Source: Wellcome Collection.
Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.
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![exempt; if the commabacilli were in reality the contagium, then it is impossible to understand why direct contagion should not be a very common thing. [It would be quite unjustifiable to maintain that the extraordinary panic which seized a section of the French and Italian nations on the visitation by the cholera in the summer of 1884 was caused by this theory of the commabacilli, but considering the authoritative position that Koch occupies, and considering the very decided way in which Koch, his Govern- ment, and the daily and most of the medical press gave expression to this view, it is not unreasonable to say, that that panic, although not caused, derived material support from it, for has it not been preached from day to day that the cholera evacuations are full of commabacilli, and that the commabacilli are the contagium of cholera ? What, after this, is more natural than that the general public, reading such statements as coming from the highest authorities, should take up and spread the cry?] Again, it is well established by the researches of Pettenkofer and others, that between the introduction of the cholera virus into a new locality and the outbreak of the disease in the form of an epidemic there is always a considerable lapse of time; according to Pettenkofer the cholera matter introduced into a locality must, before becoming active virus, pass a certain stage of development in the soil, this soil must at the same time be of a definite character, and only after having undergone these changes and having had access to the system of persons can produce the disease. If the commabacilli of the evacuations were the actual materies morbi, such notorious immunity from cholera as is enjoyed by Versailles, by Lyons, Birmingham, by ships on the high seas, &c., could not easily be understood. In the several epidemics of cholera that visited Paris, thousands of persons fled from Paris into Versailles, some of them had contracted the disease in Paris, were ill in Versailles, but the disease did not spread in Versailles to other persons; if the commabacilli were the contagium, surely, when introduced into Versailles, there is no possible reason why, having taken a footing in Versailles, they should not have exerted the same power there as in Paris; the conditions under which in Paris the commabacilli can find entrance into healthy persons (linen and cloth contaminated with cholera evacuations, water, food, and other articles) are precisely the same as in Paris ; the people in Versailles do not differ in respect of personal cleanliness, habits, &c., from those of Paris, and notwith- standing all this the disease did not spread in Versailles. The same can be said of Lyons and other places. A fact as well established as to have led to the adoption of radical and thoroughly efficient measures is this, that if into any ship lying off an infected country cholera cases are introduced, or cholera breaks out amongst the personnel, after removing the ship to the high seas cholera cases cease and the epidemic dies out; if the commabacilli present in the evacuations were the disease germs such a thing would be impossible, the whole personnel of such a ship, at any rate all susceptible persons, would become liable to attack. Another noteworthy observation, constantly acted on in India with conspicuous success, is this,—when in any military cantonment cholera cases occur, the troops are at once moved into camp and cholera ceases; surely no amount of shifting of the troops could in the least affect the commabacilli, for as long as there is one case of cholera amongst the troops, there would be available sufficient numbers of commabacilli to infect any number of persons. Another great difficulty in accepting this theory of Koch is this: the commabacilli cannot, according to Koch, exist in acid media, and, therefore, when introduced into the stomach, this mode of infection being, according to Koch, the general one, they could not pass unscathed into the small intestine (the ileum being their true breeding ground). In an epidemic of cholera it is notorious that not only those become attacked by cholera that suffer from some gastric disturbance, for many persons previously in perfect health become subject to the disease, and a dyspeptic condition of the stomach ought to be the very best protection against cholera, seeing that in such a state it is hyperacidity which is present in the stomach, and therefore the commabacilli ought to have less chance. An empty stomach, that is, in the morning before any food lias yet entered the stomach, would be the only condition in which the commabacilli could pass unscathed into the small intestine ; but it can hardly be seriously assumed that this is the time when infection is carried out in all cases of cholera. If the commabacilli entered the stomach with the first morsel of food they would be attacked by the gastric juice, the secretion of which is immediately set o-oino-, and since they would have to sojourn in the stomach for some time like all the rest they would, no doubt, be killed. Thus we see that here are many weighty facts against accepting Koch’s view as to the specific nature of the commabacilli. ”ln order to make good the proposition that the commabacilli are specific, it is necessarv for Koch to show (1) that these commabacilli occur only and exclusively](https://iiif.wellcomecollection.org/image/b24976714_0008.jp2/full/800%2C/0/default.jpg)
