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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![in cholera; (2) that the commabacilli being absent from the blood and other tissues, must be present in the tissues of the small intestine in acute typical cases in enormous numbers, so as to cause the production of a correspondingly large amount of the chemical ferment—the direct poison ; (3) that not only differ the commabacilli from other similar putrefactive bacilli as regards shape, but also as regards other characters, such as growth, behaviour towards reagents, &c. ; and (4) that the commabacilli of pure cultivations are capable of producing the disease when introduced into the animal system. As regards No. 1, Koch maintains that the commabacilli occur only and exclusively in the intestine of patients suffering from cholera, and hence regards their presence as characteristic of cholera. The examination by Koch of a number of cases of diarrhoea (infantile diarrhoea, diarrhoea due to other causes, dysentery, cholera nostras, and a variety of other con- ditions) invariably proved that commabacilli were absent.* [In a subsequent publication, Deutsche Woch, No. 45, 1884, Koch has modified this view, since he admits that comma-shaped bacilli occur also in other conditions.] And for these reasons Koch is of opinion that in doubtful cases the presence of commabacilli in the stools is of an infallible diagnostic value. From these statements of Koch we must differ most decidedly. In typical rice-water stools of cholera cases, however fresh, there occur, as is well known, a variety of micro-organisms :—(n) various species of micrococci, differing from one another in size of the elements in the mode of aggregation, some forming dumb-bells, and curved chains, and zoogloea, others forming only dumb-bells and sarcina-like groups, but not chains; (b) various species of bacillus subtilis, differing from one another in the length and thickness of the elements; (c) bacterium termo and lineoia, this bacterium seems to possess in Bombay a wide distribution, since many artificial cultivations appear contaminated with it, but it is never missed in cholera stools ; (d) vibrio rugula of Cohn (Beitr. z. Biol. d. Pfl. II.); but there are sometimes more than one species of them, differing from one another in the length and thickness of the elements ; (e) spirillum, in all respects identical with the spirillum tenue of Cohn (spirillum denticola, spirillum Obermyeri), is often found in great numbers in cholera stools, particularly those that have been kept standing for several days ; but we have seen also tolerably fresh stools containing a great number of them, although there were stools in which they were absent or only scarce; these spirilla, when abundant, present themselves in all shapes and lengths, from that of a single turn to that of three or four turns, either conspicuous by being twisted spirally or only more or less wavy; (/) Koch’s commabacilli; these are caraway seed shaped curved organisms, with very slightly pointed or blunt ends; their length, measured like the tendon of the arch, varies between 00017mm. and (>0026 mm. ; they differ slightly in length and thickness in the same sample, but show greater differences in the amount of curvature. In the best examples the curve amounts to as much as half a circle, in most others it is only comparatively slight. Now and then one comes across two commabacilli joined end to end, but so that their curves point in opposite directions, and nearly an S-shaped figure is produced. Note I.—Since the name of commabacillus has been now universally adopted, we will retain it under protest. Its claim of being compared to a comma is in no way admissible, especially not to English readers, since an English comma is distinctly hook shaped ; its resemblance to a comma as used by the Germans in writing is, however, more real. Nor is its claim to the name of “ bacillus ” more justifiable, since by “ bacillus ” a cylindrical or rod-shaped bacterium is understood. A great deal of misunderstanding has been caused by this unhappy comparison of Koch’s cholera organism to a commabacillus; most English microscopists when first reading of it expected to find an organism of a distinctly hook-shaped appearance, and some went so far as actually to identify it with a hook-shaped something with thickened end. Thus, Dr. Bristowe states in the “ Lancet ” that some years ago, when engaged in a microscopic inquiry into cholera, he had actually seen (and drawn in his notes, un- published till urged by Dr. Wilks) the “ comma-shaped bacillus,” and he figures a huge hook-shaped or rather club-shaped corpuscle with a thickened curved head, which he thinks corresponds to the cholera organism of Koch. * Whatever Koch and his adherents may now state, there can be no doubt in the mind of any one who reads his pamphlet on cholera, that at the time he wrote it, i.e., at a lime when he had concluded his researches in Egypt, India, and France, lie was not aware of there occurring comma-shaped bacilli in other conditions besides cholera. “ Everywhere where I was able lo come across a liquid containing bacteria I examined it in search “ of commabacilli, but never found them in it” (see his pamphlet, p. 25) ; and “ I therefore think I may say “ positively that the commabacilli are constant concomitants of the cholera process, and that they are never “ found elsewhere ” (see his pamphlet, p. 25).](https://iiif.wellcomecollection.org/image/b24976714_0009.jp2/full/800%2C/0/default.jpg)
