A most important statement was that the comma bacillus seems to be killed by the bacteria of putrefaction, and consequently agents that destroy the latter organisms without the former may really do injury, by removing from the cholera bacillus an impediment to its growth.
As for destructive agents to the bacillus, he found it killed by solutions in the following proportions: oil of peppermint, 1 in 2,000; sulphate of copper, 1 in 2,500 (a remedy much employed, but how much would really be needed merely to hinder the growth of the bacilli in the intestine!); quinine, 1 in 5,000; and sublimate, 1 in 100,000.
In contrast with the foregoing measure for preventing the growth of these bacilli is the striking fact that they are readily killed by drying. This fact is proved by merely drying a small drop of material containing the bacilli on a cover glass, and then placing this over some of the fluid on a glass slide. With anthrax bacilli vitality is retained for nearly a week; whereas, the comma bacillus appears to be killed in a very short time.
Dr. Koch having found and cultivated the comma bacillus and ascertained its distinctive character, next proceeded to investigate its relation to cholera. In all there were now about one hundred cases of cholera in which the bacillus had been found, while it was never found in connection with other diseases. Three different views, said the speaker, as to its relation to the cholera process are tenable:
1. That the disease favors the growth of these bacilli by affording them a suitable soil. If so, it would mean that the bacillus in question is most widely diffused, since it has been found in such different regions as Egypt, India, and France; whereas the contrary is the case, for the bacilli do not occur in other diseases, nor in the healthy, nor apart from human beings in localities most favorable to bacterial life. They only appear with the cholera.
2. It might be said that cholera produces conditions leading to a change in form and properties of the numerous intestinal bacteria, a pure hypothesis; the only instance of such a conversion refers to a change of physiological and pathogenic action, and not of form. Anthrax bacilli under certain conditions lose their pathogenic power, but undergo no change in shape; and that is an instance of a loss of pathogenic properties, while there is no analogy to support the view of the harmless intestinal bacteria becoming the deadly cholera bacilli. The more bacterial morphology is studied, the more certain it is that bacteria are constant in their form; moreover, the comma bacillus retains its special characters unchanged through many generations of culture.
3. Lastly, there is the view that the cholera process and the comma bacilli are intimately related, and there is no other conceivable relation but that the bacilli precede the disease and excite it. "For my own part," said Dr. Koch, "the matter is proved that the comma bacilli are the cause of cholera."
Dr. Koch then described his attempts to inoculate lower animals with the bacillus, and explained the cause of his failure in the natural immunity of the animals against the disease.
In advocating the local Indian origin of the disease he said: That the virus can be reproduced and multiplied outside the body is apparent, since the bacillus can be cultivated artificially, and its growth is not affected by comparatively low temperatures. Probably it does not grow in streams and rivers, where, owing to the current, a sufficient concentration of nutrient substance does not occur; but in stagnant water and at the mouths of drains, etc., vegetable and animal refuse may accumulate and afford the necessary nutriment. Thus is explained the propagation of cholera by the subsoil water, and the increase of epidemics with the sinking of its level, which lessens the flow and diminishes the amount of surface water. Admitting the dependence of cholera upon this micro-organism it is impossible to conceive the disease having an autochthonous origin in any particular place; for a bacillus must obey the laws of vegetable life, and have an antecedent; and since the comma bacillus does not belong to the widely diffused micro-organisms, it must have a limited habitat. Therefore, the occurrence of cholera on the delta of the Nile does not depend on its resemblance to the delta of the Ganges; but the disease must have been imported there as it is into Europe. It was once thought that an outbreak in Poland had a local origin until it was discovered to have been introduced from Russia. Again, about ten years ago, there was a sudden outbreak at Hamar (Syria), thought to be an instance of local origin, but erroneously, as shown by a statement of Lortet, who told Koch, when at Lyons, that the epidemic had been introduced into Hamar, where he was at the time, by Turkish soldiers from Djeddah. All great epidemics of cholera began in South Bengal, where the conditions for the development and growth of the bacillus are most perfect.—Med. Record.