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THE BACTERIOLOGY OF CHOLERA IN INDIA.
THE BACTERIOLOGY OF CHOLERA IN INDIA.
replaced them. There is thus no scientific ground whatever for the assumption that all the distinct forms of comma bacilli occurring in connexion with cases of cholera are mere varieties of one species. Taking the facts as they stand, there are no more logical grounds for regarding all the forms
the eastern frontier of Belgium. There had been numerous cases of the disease last autumn in the Charleroi district, and it is thought that some of the dejecta were then thrown into the Sambre. It is just at the point where this river falls into the Meuse at Namur that cholera has reappeared. The first case occurred on Dec. 10th last, and from that date up to Jan. 25th of this year there were 41 Most of the cases were of cases and 23 deaths in the town. a very severe type and were generally fatal after an average of five or six hours’ illness. In the neighbourhood of Namur, at Flawinne, there were 7 cases and 3 deaths ; at Auvelais there were 15 or 16 cases and 8 deaths. In other districts 18 cases were notified, resulting in 13 deaths. At SaintTrond, in the district of Saint Pierre, 15 sudden deaths are recorded. As usual, the poorest, the intemperate, and those who lived in the most insanitary conditions were the principal sufferers. A special isolation hospital has been opened at Namur. Most of the clothing worn by the patients has been burnt, and the bedding has been disinfected in stoves where it was exposed to a temperature of 130° C.
Namur,
on
of choleraic comma bacilli as mere varieties than there are for regarding all schizomycete organisms as such. Any definite relation between the occurrence of cholera and the presence of a particular species of comma bacillus within the intestinal tract cannot, therefore, be shown to exist, and with this any theory ascribing the choleraic condition to the action of any distinct species of intestinal organism which has yet been discovered comes to the ground ; but, more than this, the induction of the choleraic condition cannot even be ascribed to the action of a group of organisms consisting of the various forms of comma bacilli which occur within the intestinal tract in cases of the disease, seeing that cases occur in which there is no, evidence of the presence of comma bacilli of any kind whatIf the induction of the primary choleraic condition be ever. owing to the action of any organisms growing within the intestinal tract, these have yet to be found. The introduction of large quantities of comma bacilli into the intestinal tract has never yet been satisfactorily shown to lead to the development of cholera, and comma bacilli of various kinds frequently abound in the intestinal contents of cases which are unequivocally not of choleraic origin in the ordinary sense of the term. There is thus no evidence to show that any form of comma bacillus is capable of inducing the choleraic condition if it gain access to the intestinal tract, and there are many facts suggesting that the frequency with which comma bacilli abound within the intestinal tract in cases of cholera is a consequence, not a cause, of the choleraic condition. Even, however, if this be so ; even if the prevalence of comma bacilli within the intestinal tract hold a consequential and not a causal relation to the establishment of the primary choleraic condition, it by no means necessarily follows that they are of noimportance. Some forms, at all events, may be capable of affecting the ultimate course of the disease owing to the nature of the products to which they give rise and which are liable to enter the system in bulk whenever active intestinal absorption begins to be re-established. The facts as they stand afford no reasonable grounds for supposing that any measures establishing immunity from the toxic effects of the products, which are certainly produced by certain forms of comma bacilli and other schizomycete organisms, can have any appreciable effect on the prevalence of cholera, but, at the same time, they are such as to render it not unlikely that the immunity. may be capable of affecting the mortality of the disease."
THE BACTERIOLOGY OF CHOLERA IN INDIA. . AT the
present time,
when the International
361
Sanitary Con-
ference has opened its proceedings in Paris, it will interest to learn what has been taking place in India in to the regard bacteriological question of cholera. In reply to a communication from the Editors of THE LANCET sent
- our readers
towards the end of last year Brigade-Surgeon-LieutenantColonelD. D. Cunningham, C.LE., M.B., has been good enougla to forward us the following proof copy of a paragraph which he has contributed to the forthcoming annual report of the Sanitary Commissioner with the Government of India as to the views which the results of his bacteriological experiments and observations have led him to entertain regarding the bacteriological question of cholera :" The evidence which has been gradually accumulated in the laboratory attached to the office of the Sanitary Commissioner with the Government of India during the course of the past four years appears fully to justify tha conclusion that there is no one specific choleraic Certain distinct forms of comma bacilli comma bacillus. obtained from cases of cholera have now been in continuous cultivation for nearly four years, and various others for periods ranging from over three years to one year THE REPORT OF THE ROYAL COMMISSION and a half. During the periods in which they have been APPOINTED TO CONSIDER THE DRAFT cultivated they have all been exposed to the influence of preCHARTER FOR THE PROPOSED cisely similar conditions. They have been grown in portions z, of the same media in the strictest sense, they have been GRESHAM UNIVERSITY OF transplanted simultaneously, and have been exposed to like LONDON. conditions of environment during growth, and yet they Abundant i eontinue to present well-defined differences. THE Royal Commissioners appointed to consider the draft evidence has been acquired that the majority of them are ’, extremely susceptible to both morphological and physiological charter for the proposed Gresham University of London have modifications under the influence of prolonged exposure to ’, concluded their report, in which they point out the lines particular environments, and consequently there are fair z, on which they think the charter might be amended and grounds for concluding that, under the influence of proan efficient longed cultivation under precisely common conditions, any extended so as to form a practical scheme for distinctive peculiarities which were originally present, not Teaching University of London. as the result of any inherent specific - peculiarities, but The Royal Commissioners, after full and careful inquiry, merely owing to antecedent exposure to unlike conditions, have come to the conclusion that there should be but ought to have disappeared. But no tendency to any such one university, and that the existing University of London general assimilation in the characters of the various forms should be reconstructed so as to discharge the teaching has manifested itself. Prolonged cultivation under special duties. The necessary changes, in their opinion, should conditions has certainly in many cases givemrise to important be effected not by charter, but by legislative authority, modifications of property, but these have not been of a nature and by the appointment of a Commission with statutory to produce any general unification of the various forms ; they powers. These powers and the duties consequent upon them have not led to the development of any common average should be as follows : (1) To determine in what mode, and form as the result of disappearance of distinctive features. under what conditions, any property now held by the UniverThe distinctive features which the various forms now present sity of London should continue to be held by the University - ae net invariably precisely of the- same nature- as they as reconstituted, regard being had to any trusts to which the oxiginally were, which, of course, is only natural in a same is now subject. (2) To receive the assents of the various group of modifiable organisms; but where the original differ- institutions to be admitted as schools in the University, and with reference thereto to determine, in the first instance, ences have disappeared equally conspicuous new ones have ,
.
’
replaced them. There is thus no scientific ground whatever for the assumption that all the distinct forms of comma bacilli occurring in connexion with cases of cholera are mere varieties of one species. Taking the facts as they stand, there are no more logical grounds for regarding all the forms
the eastern frontier of Belgium. There had been numerous cases of the disease last autumn in the Charleroi district, and it is thought that some of the dejecta were then thrown into the Sambre. It is just at the point where this river falls into the Meuse at Namur that cholera has reappeared. The first case occurred on Dec. 10th last, and from that date up to Jan. 25th of this year there were 41 Most of the cases were of cases and 23 deaths in the town. a very severe type and were generally fatal after an average of five or six hours’ illness. In the neighbourhood of Namur, at Flawinne, there were 7 cases and 3 deaths ; at Auvelais there were 15 or 16 cases and 8 deaths. In other districts 18 cases were notified, resulting in 13 deaths. At SaintTrond, in the district of Saint Pierre, 15 sudden deaths are recorded. As usual, the poorest, the intemperate, and those who lived in the most insanitary conditions were the principal sufferers. A special isolation hospital has been opened at Namur. Most of the clothing worn by the patients has been burnt, and the bedding has been disinfected in stoves where it was exposed to a temperature of 130° C.
Namur,
on
of choleraic comma bacilli as mere varieties than there are for regarding all schizomycete organisms as such. Any definite relation between the occurrence of cholera and the presence of a particular species of comma bacillus within the intestinal tract cannot, therefore, be shown to exist, and with this any theory ascribing the choleraic condition to the action of any distinct species of intestinal organism which has yet been discovered comes to the ground ; but, more than this, the induction of the choleraic condition cannot even be ascribed to the action of a group of organisms consisting of the various forms of comma bacilli which occur within the intestinal tract in cases of the disease, seeing that cases occur in which there is no, evidence of the presence of comma bacilli of any kind whatIf the induction of the primary choleraic condition be ever. owing to the action of any organisms growing within the intestinal tract, these have yet to be found. The introduction of large quantities of comma bacilli into the intestinal tract has never yet been satisfactorily shown to lead to the development of cholera, and comma bacilli of various kinds frequently abound in the intestinal contents of cases which are unequivocally not of choleraic origin in the ordinary sense of the term. There is thus no evidence to show that any form of comma bacillus is capable of inducing the choleraic condition if it gain access to the intestinal tract, and there are many facts suggesting that the frequency with which comma bacilli abound within the intestinal tract in cases of cholera is a consequence, not a cause, of the choleraic condition. Even, however, if this be so ; even if the prevalence of comma bacilli within the intestinal tract hold a consequential and not a causal relation to the establishment of the primary choleraic condition, it by no means necessarily follows that they are of noimportance. Some forms, at all events, may be capable of affecting the ultimate course of the disease owing to the nature of the products to which they give rise and which are liable to enter the system in bulk whenever active intestinal absorption begins to be re-established. The facts as they stand afford no reasonable grounds for supposing that any measures establishing immunity from the toxic effects of the products, which are certainly produced by certain forms of comma bacilli and other schizomycete organisms, can have any appreciable effect on the prevalence of cholera, but, at the same time, they are such as to render it not unlikely that the immunity. may be capable of affecting the mortality of the disease."
THE BACTERIOLOGY OF CHOLERA IN INDIA. . AT the
present time,
when the International
361
Sanitary Con-
ference has opened its proceedings in Paris, it will interest to learn what has been taking place in India in to the regard bacteriological question of cholera. In reply to a communication from the Editors of THE LANCET sent
- our readers
towards the end of last year Brigade-Surgeon-LieutenantColonelD. D. Cunningham, C.LE., M.B., has been good enougla to forward us the following proof copy of a paragraph which he has contributed to the forthcoming annual report of the Sanitary Commissioner with the Government of India as to the views which the results of his bacteriological experiments and observations have led him to entertain regarding the bacteriological question of cholera :" The evidence which has been gradually accumulated in the laboratory attached to the office of the Sanitary Commissioner with the Government of India during the course of the past four years appears fully to justify tha conclusion that there is no one specific choleraic Certain distinct forms of comma bacilli comma bacillus. obtained from cases of cholera have now been in continuous cultivation for nearly four years, and various others for periods ranging from over three years to one year THE REPORT OF THE ROYAL COMMISSION and a half. During the periods in which they have been APPOINTED TO CONSIDER THE DRAFT cultivated they have all been exposed to the influence of preCHARTER FOR THE PROPOSED cisely similar conditions. They have been grown in portions z, of the same media in the strictest sense, they have been GRESHAM UNIVERSITY OF transplanted simultaneously, and have been exposed to like LONDON. conditions of environment during growth, and yet they Abundant i eontinue to present well-defined differences. THE Royal Commissioners appointed to consider the draft evidence has been acquired that the majority of them are ’, extremely susceptible to both morphological and physiological charter for the proposed Gresham University of London have modifications under the influence of prolonged exposure to ’, concluded their report, in which they point out the lines particular environments, and consequently there are fair z, on which they think the charter might be amended and grounds for concluding that, under the influence of proan efficient longed cultivation under precisely common conditions, any extended so as to form a practical scheme for distinctive peculiarities which were originally present, not Teaching University of London. as the result of any inherent specific - peculiarities, but The Royal Commissioners, after full and careful inquiry, merely owing to antecedent exposure to unlike conditions, have come to the conclusion that there should be but ought to have disappeared. But no tendency to any such one university, and that the existing University of London general assimilation in the characters of the various forms should be reconstructed so as to discharge the teaching has manifested itself. Prolonged cultivation under special duties. The necessary changes, in their opinion, should conditions has certainly in many cases givemrise to important be effected not by charter, but by legislative authority, modifications of property, but these have not been of a nature and by the appointment of a Commission with statutory to produce any general unification of the various forms ; they powers. These powers and the duties consequent upon them have not led to the development of any common average should be as follows : (1) To determine in what mode, and form as the result of disappearance of distinctive features. under what conditions, any property now held by the UniverThe distinctive features which the various forms now present sity of London should continue to be held by the University - ae net invariably precisely of the- same nature- as they as reconstituted, regard being had to any trusts to which the oxiginally were, which, of course, is only natural in a same is now subject. (2) To receive the assents of the various group of modifiable organisms; but where the original differ- institutions to be admitted as schools in the University, and with reference thereto to determine, in the first instance, ences have disappeared equally conspicuous new ones have ,
.
’