metchntkoffs researches on the CHOLERA VIBRIO. In tlie August number of the Annates de L' institut Pasteur for 1894 there is an important contribution by Metchnikoff on cholera immunity and
as considered from an experiof view. Dealing first of all with
susceptibility
mental
point immunity, Metchnikoff
cites the observaand of Sanarelli in which tions of Blackstein
local
these observers found where
no
comma
epidemic prevailed.
bacilli in In
localities
Versailles, for
INDIAN MEDICAL GAZETTE.
422
[Nov.
1894.
comma bacilli were discovered in water previous swallowing of choleraic cultures protects examined in 1893, and yet this suburb of Paris with certainty against the pathogenic effect of was not affected with cholera during that 3rear. later and larger doses. From these facts, MetchDuring every epidemic of cholera in France there nikoff thinks that the hypothesis of a permahave been a few cases in Versailles, but they are nent vaccination against cholera in persons in-
example,
isolated and have never spread. Its re- susceptible ought to be putation for immunity was well established in On the other hand, the the and this the influence of time and between
always
definitely discarded. immunity of man and
place he is inclined to 1832?1865, has been maintained during the later attribute to the microbian flora which may inIn 1873 there were three deaths; in habit the digestive tract during an epidemic. He found that in a plate cultures certain microbes, single case; and in 1893 three
early epidemics
reputation epidemics. 1884 only
deaths. With Sanarelli's discovery of the comma more especially sarcines and torula, favoured the bacillus in the drinking water of Versailles the growth of commas, while others, notably the immunity of the inhabitants cannot be attri- bacillus pyocyaneus and a white coccus derived buted as heretofore to the impossibility of the from the air, restrained or prevented the growth in this of the commas. Investigations in this direction and cholera microbe
multiplying
living
place, by a
unless it be that the
Sanarelli is not
series of
who
cholora
experiments
given
were
a
comma
bacillus found
micro-organism. By
on men
residing
cultures of the
comma
in Paris
bacillus
to swallow, this question was set at rest, and the choleraic nature of the vibrios demonstrated.
lead him to the conclusion that cholera bacilli very sensitive to the influence of the microbes which surround them, their growth and are
even
the
their
shape being subject
organisms
Passing
on
to the action of
in contact.
with which
come
to
animals
they immunity of
against
suffered intestinal cholera, Metchnikoff mentions as an subjects experimented from diarrhoea not of a very characteristic nature, exception the interesting discovery of Sabolotny, others were unaffected, while two had rice-water who was able to produce this disease in the Some of the
on
stools, and one of these had a typical attack of Spermophilus guttatus of Russia. With other cholera, suffering the day after swallowing the animals the various attempts to produce intestimicrobes from a profuse diarrhoea which quickly nal cholera has proved a failure, notwithstanding became rice-water in appearance, and accom- the fact that the comma bacilli have been detect-
panied
with
of
and cramps, suppression of temperature. The explanation
vomiting
urine and fall of
immunity must, accordingly,
be
sought
for in
other direction, and with this object in view certain researches were undertaken. First
some
of all, the blood of and
Lyons
power tested
was
people residing
examined,
in Versailles
and its
guinea-pigs subjected peritoneal injections of comma bacilli. on
protective to intra-
The facts
established in 14 cases indicated that the blood of the inhabitants of such localities was not dis-
tinguished by possessing tive power
against
assumption
that
a
any peculiar prevencholera. Secondly, on the
mild attack of cholera
diarrhoea produced by the tures of
attempts
commas were
vaccination.
swallowing
or
a
of cul-
relatively weak waj protective, produce an intestinal
made to
Metchnikoffs former experiments
led him to favour this
view, especially as facts collected by Klemperer, Hasterlich, Sawtchencho and Sabolotny seemed also to be corroborative ?, but the further
experiments now related were directly opposed to the supposition that the
ed in
large quantities
animals very sensitive
in the intestines. to
Even
the subcutaneous
or
intra-peritoneal injections enjoy an immunity against the action of commas introduced by the mouth. this the
Impressed with the view that possibly immunity depended on the influence of microbian flora of the digestive tract, and
the fact that for several weeks, the intestinal tract of the newly-born rabbit is particularly poor, both in the quantity
guided by
and variety of the micro-organisms it contains, Metchnikoff decided to feed young rabbits nourished with their mother's milk on small quantities of cultures of comma bacilli. The result
was
ed with ing the
torula, a research
an
that the rabbits
so
iutestinal cholera.
commas
with three
treated
were
affect-
Further, by mixother microbes, a
bacillus, which in a former found to favour the growth of
sarcine and
a
had been the commas, a very rapid cholera was produced. Of 22 rabbits which received this combination two survived, death, as a rule, occurring in
only
36 to 48 hours.
In 75 per cent, of the
cases
the
Nov.
MEDICAL NEWS.
1894.]
comma
bacilli
were
of cholera, can be easily reconciled with the facts of epidemiology, notably with the influence of place and time on the invasion of cholera epidemics.
found to be localised in the
specific agent
in 25 per cent, small iutestines and its the commas had become generalised and were It is not a question cultivated from the blood. here of a mixed infection but of something anaannexes ;
established by Vaillard in the case vibrio of Koch is as much the The of tetanus. cholera as the bacillus of of specific microbe of tetanus. The Nicolaier is the causative agent of the phagocytes an latter finds on the part and the association of to its to that
logous
obstacle germination, certain microbes appears necessary for the manifestation of its the tetanus
properties, but once begun to develop, the
pathogenic
bacillus
has
useless, and the tetanic
are
favouring bacteria
work of the
specific bacillus. process is the unique The intestinal cholera produced in the young rabbits was found to be contagious, being transthe the teats of the mother soiled with mitted by
Similar
microbes.
experiments
on
guinea-pigs
old led to the result that guinea-pigs a few days same kind of treatthe to are also sensitive howment. The intestinal cholera produced is, that in j^oung rabthan ever, less characteristic take intestinal cholera bits. Young but the comma rabbits, less easily than young
guinea-pigs
bacillus has
a
ralised in the
to become genegreater tendency the guinea-pig. system of
intestinal set himself the Metchnikoff cholera in rabbits, the disease. The to
Having succeeded
task of
attempting
in
producing
an
prevent
hitherto employed have methods which he has Vaccination with sterilized or however failed.
living
had cultures of commas with the
influence; vaccination
no
protective
serum
of the
the intestinal chohorse was useless to prevent the comma bacillus of lera of rabbits caused by vaccination with the serum of
Massowah; while animals
against peritoneal
previously vaccinated apparently
cholera, though sometimes
effective,
of cholera
the
by uncertain. The prevention was tried, but the exaction of other microbes the lesults too intoo few and was
periments
were
conclusion. A further definite to lead to any is piomised. Metcontribution on this point inteiesting paper by a chnikoff concludes his that in the immunity reiteration of the view and of animals in man and susceptibility of cholera, the microbian flora relation to intestinal an important partj of the digestive tract plays of view he thinks that the and from this point that the vibrio of Koch is the fundamental truth
m
1
as considered from an experiof view. Dealing first of all with
susceptibility
mental
point immunity, Metchnikoff
cites the observaand of Sanarelli in which tions of Blackstein
local
these observers found where
no
comma
epidemic prevailed.
bacilli in In
localities
Versailles, for
INDIAN MEDICAL GAZETTE.
422
[Nov.
1894.
comma bacilli were discovered in water previous swallowing of choleraic cultures protects examined in 1893, and yet this suburb of Paris with certainty against the pathogenic effect of was not affected with cholera during that 3rear. later and larger doses. From these facts, MetchDuring every epidemic of cholera in France there nikoff thinks that the hypothesis of a permahave been a few cases in Versailles, but they are nent vaccination against cholera in persons in-
example,
isolated and have never spread. Its re- susceptible ought to be putation for immunity was well established in On the other hand, the the and this the influence of time and between
always
definitely discarded. immunity of man and
place he is inclined to 1832?1865, has been maintained during the later attribute to the microbian flora which may inIn 1873 there were three deaths; in habit the digestive tract during an epidemic. He found that in a plate cultures certain microbes, single case; and in 1893 three
early epidemics
reputation epidemics. 1884 only
deaths. With Sanarelli's discovery of the comma more especially sarcines and torula, favoured the bacillus in the drinking water of Versailles the growth of commas, while others, notably the immunity of the inhabitants cannot be attri- bacillus pyocyaneus and a white coccus derived buted as heretofore to the impossibility of the from the air, restrained or prevented the growth in this of the commas. Investigations in this direction and cholera microbe
multiplying
living
place, by a
unless it be that the
Sanarelli is not
series of
who
cholora
experiments
given
were
a
comma
bacillus found
micro-organism. By
on men
residing
cultures of the
comma
in Paris
bacillus
to swallow, this question was set at rest, and the choleraic nature of the vibrios demonstrated.
lead him to the conclusion that cholera bacilli very sensitive to the influence of the microbes which surround them, their growth and are
even
the
their
shape being subject
organisms
Passing
on
to the action of
in contact.
with which
come
to
animals
they immunity of
against
suffered intestinal cholera, Metchnikoff mentions as an subjects experimented from diarrhoea not of a very characteristic nature, exception the interesting discovery of Sabolotny, others were unaffected, while two had rice-water who was able to produce this disease in the Some of the
on
stools, and one of these had a typical attack of Spermophilus guttatus of Russia. With other cholera, suffering the day after swallowing the animals the various attempts to produce intestimicrobes from a profuse diarrhoea which quickly nal cholera has proved a failure, notwithstanding became rice-water in appearance, and accom- the fact that the comma bacilli have been detect-
panied
with
of
and cramps, suppression of temperature. The explanation
vomiting
urine and fall of
immunity must, accordingly,
be
sought
for in
other direction, and with this object in view certain researches were undertaken. First
some
of all, the blood of and
Lyons
power tested
was
people residing
examined,
in Versailles
and its
guinea-pigs subjected peritoneal injections of comma bacilli. on
protective to intra-
The facts
established in 14 cases indicated that the blood of the inhabitants of such localities was not dis-
tinguished by possessing tive power
against
assumption
that
a
any peculiar prevencholera. Secondly, on the
mild attack of cholera
diarrhoea produced by the tures of
attempts
commas were
vaccination.
swallowing
or
a
of cul-
relatively weak waj protective, produce an intestinal
made to
Metchnikoffs former experiments
led him to favour this
view, especially as facts collected by Klemperer, Hasterlich, Sawtchencho and Sabolotny seemed also to be corroborative ?, but the further
experiments now related were directly opposed to the supposition that the
ed in
large quantities
animals very sensitive
in the intestines. to
Even
the subcutaneous
or
intra-peritoneal injections enjoy an immunity against the action of commas introduced by the mouth. this the
Impressed with the view that possibly immunity depended on the influence of microbian flora of the digestive tract, and
the fact that for several weeks, the intestinal tract of the newly-born rabbit is particularly poor, both in the quantity
guided by
and variety of the micro-organisms it contains, Metchnikoff decided to feed young rabbits nourished with their mother's milk on small quantities of cultures of comma bacilli. The result
was
ed with ing the
torula, a research
an
that the rabbits
so
iutestinal cholera.
commas
with three
treated
were
affect-
Further, by mixother microbes, a
bacillus, which in a former found to favour the growth of
sarcine and
a
had been the commas, a very rapid cholera was produced. Of 22 rabbits which received this combination two survived, death, as a rule, occurring in
only
36 to 48 hours.
In 75 per cent, of the
cases
the
Nov.
MEDICAL NEWS.
1894.]
comma
bacilli
were
of cholera, can be easily reconciled with the facts of epidemiology, notably with the influence of place and time on the invasion of cholera epidemics.
found to be localised in the
specific agent
in 25 per cent, small iutestines and its the commas had become generalised and were It is not a question cultivated from the blood. here of a mixed infection but of something anaannexes ;
established by Vaillard in the case vibrio of Koch is as much the The of tetanus. cholera as the bacillus of of specific microbe of tetanus. The Nicolaier is the causative agent of the phagocytes an latter finds on the part and the association of to its to that
logous
obstacle germination, certain microbes appears necessary for the manifestation of its the tetanus
properties, but once begun to develop, the
pathogenic
bacillus
has
useless, and the tetanic
are
favouring bacteria
work of the
specific bacillus. process is the unique The intestinal cholera produced in the young rabbits was found to be contagious, being transthe the teats of the mother soiled with mitted by
Similar
microbes.
experiments
on
guinea-pigs
old led to the result that guinea-pigs a few days same kind of treatthe to are also sensitive howment. The intestinal cholera produced is, that in j^oung rabthan ever, less characteristic take intestinal cholera bits. Young but the comma rabbits, less easily than young
guinea-pigs
bacillus has
a
ralised in the
to become genegreater tendency the guinea-pig. system of
intestinal set himself the Metchnikoff cholera in rabbits, the disease. The to
Having succeeded
task of
attempting
in
producing
an
prevent
hitherto employed have methods which he has Vaccination with sterilized or however failed.
living
had cultures of commas with the
influence; vaccination
no
protective
serum
of the
the intestinal chohorse was useless to prevent the comma bacillus of lera of rabbits caused by vaccination with the serum of
Massowah; while animals
against peritoneal
previously vaccinated apparently
cholera, though sometimes
effective,
of cholera
the
by uncertain. The prevention was tried, but the exaction of other microbes the lesults too intoo few and was
periments
were
conclusion. A further definite to lead to any is piomised. Metcontribution on this point inteiesting paper by a chnikoff concludes his that in the immunity reiteration of the view and of animals in man and susceptibility of cholera, the microbian flora relation to intestinal an important partj of the digestive tract plays of view he thinks that the and from this point that the vibrio of Koch is the fundamental truth
m
1
