straight bacilli, other organisms also characterized by this—that they are curved or comma-shaped. Whatever else has been said by Koch, his followers, and critics, scientific and daily papers, as to these "comma-shaped" bacilli being the cause of cholera, is simply and purely a supposition, which, as we shall presently show, is wanting in the most essential elements.
First and foremost, Koch has been unable to find anything of this "comma-shaped" bacillus in the blood or tissues in any stage of cholera. Now, all experience on cholera teaches that, whatever its cause may be, the alimentary canal is not the only passage through which the cholera-poison enters the system, but that its entrance through the respiratory organs is also an established fact. For this reason it is necessary to assume that, as in other infectious diseases, it passes through the blood and system in the stage of incubation of the disease. The symptoms of cholera, the whole nature of the disease, shows that it is not a local distemper of the alimentary canal, but that the latter is merely a symptom of the malady, as much as in typhoid fever the distemper of the ileum and spleen, or in scarlatina that of the skin, throat, and kidney. Had Koch found the "comma-shaped" bacillus in the blood or the tissues, e. g., the bloodvessels of the alimentary canal, mesenteric glands and spleen, the nature of this "comma-shaped" bacillus would have been as obscure as ever, but still there would have been some sure element in the chain of surmises. Of course it might be argued, and as a matter of fact it is argued by Koch in the reports to his Government, that the bacillus, having found entrance into the cavity of the intestines, there multiplies, and produces some ferment, which, absorbed into the system, sets up the whole chain of appearances constituting the symptoms of cholera. This is quite possible, and, to a certain limited extent, is borne out by experience, notably in the case of putrid or pyæmic poisoning, where, owing to the presence of putrefaction in a wound, the products of putrefaction—the sepsin—absorbed in sufficient quantities into the system, create the above disease, often terminating fatally. In this case no specific organisms are detected in the blood or tissues; their presence is limited to the wound only, and their effect is merely this, that some ferment—ptomaine or some other substance—produced by them is absorbed into the system.
That this should also be the case in cholera is, as we just said, possible, but it is not probable, for the simple reason that the cholera-virus in a large percentage of cases enters the system by the respiratory organs, and therefore it must be assumed in these instances to pass into the general circulation, and consequently, if it is to be identified, must be identified in the blood or tissues.
The practical consequences of an assumption that the cholera-virus passes into the system exclusively by the alimentary canal, and that it has its breeding-ground in the latter only, are so great, that before
