MICROSCOPICAL RESEARCHES INTO THE AGENTS PRODUCING CHOLERA. It is with
great pleasure
that
we
again
draw
our
readers'
attention to another instalment of Drs. T. R. Lewis and I). D. into the nature of cholera ; it our authors year by year become more inti-
Cunningham's investigations seems
[January 1,
THE INDIAN MEDICAL GAZETTE.
20
to
us
that,
as
mately acquainted with the disease, they realize more fully the complicated circumstances of the work before them, and that each succeeding report is consequently elaborated with greater We care, and is therefore more valuable than its predecessor. cannot as yet compliment Drs. Lewis and Cunningham on having demonstrated the nature of the ajency producing cholera, but, from a scientific point of view, they are probably working out problems second only to discovering the actual cause of cholera, in that they are rapidly demolishing much of the unreliable work done by previous observers with reference to the disease, and thus, it is to be hoped, clearing the ground upon which soon to construct sound doctrines concerning cholera. We certainly wish that investigations such as those now under consideration could be published in a more accessible form than that in which they appear; the mass of statistics with which these pathological and physiological reports are bound up simply act as a scare-crow to most men. There is not probably one in a thousand medical officers who could digest all these statistics if he tried, and even that solitary individual must be far from certain that the figures presented to him are absolutely accurate. On the other hand, it seems to us that Drs. Lewis and Cunningham's reports should be presented to every member of the profession in India, and to all those in Europe who desire to study their work ; as public servants entertained by Government to perform a special work, it seems to us that the results of their investigations are the property of the public, who not only pay them, but actually provide the materials upon which their work is printed. "
Drs. Lewis and
Cunningham remark : The two last cases (experiments dogs, in which the nerves supplying the loops of the intestines were divided) are peculiarly instructive and noteworthy, inasmuch as they appear to demonstrate a fact which had never previously been experimentally determined, on
namely,
that the relation which the secretion of the small intes-
supply is strictly analogous to that long been known to hold in regard to the secretion It was of the sub-maxillary gland and its nervous supply. induced an ascertained fact that that gland partial paralysis of hypersecretion, whilst total paralysis diminished the secretion ; but, in as far as we can ascertain, it was a matter of mere conjectural probability that the same held in regard to the email intestines also. The importance of the determination of this point in reference to the pathology of cholera is very great, as it appears to indicate partial paralysis of the intestines With as one of the most important lesions of the disease." tines bears to their nervous
which has
reference to these remarks
we
would observe that Samuel in
trophische nerven," records several experiments upon and other animuls, in which he cats, dogs, invariably found hypenemia of the intestinal mucous membrane produced by extirpation of the coeliac plexus ; the secretion of the mucous his "Die
membrane
was
iucreused much
by
the
operution,
"
but not to
1873.
degree as in violent diarrhoeaand, further, that Pfliiger's observations go to show that the nerves of the salivary glands are directly connected with the gland cells themthe same
"
selves, and Bernard proves that
in the
sub-maxillary gland
of the vaso-motor nerves conditionates secretion
(not continuously for five weeks if the nerves are completely destroyed." Moreau performed numerous experiments before the Societe de Biologie, illustrating the fact that intestinal secretion is increased in paralysis
diminished
secretion),
which may go
on
consequence of diminished rather than of increased nervous action, and he applied these principles to the circumstances of
cholera;
but "it must not be
Medical Times and
Gazette
in vivisection there are
So far
as
ar.d unavoidable sources of
numerous
error, which render induction process. law by
forgotten (as the Editor of the observes) that in all experiments a
difficult and hardly
M. Moreau's
inquiries
go,
satisfactory
they
indicate
a
antagonistic to the inferences derived front clinical experience, and they certainly throw light on one of the most serious, and assuredly not the least obscure, points in the pathology of the alimentary canal." We would further add with reference to all such inferences, that even supposing it should be shown that partial paralysis of the nerves supplying the intestinal canal is followed by excessive secretion from its mucous membrane, it by no means follows that the flow of no
means
serous
fluid from the intestines in cholera is due
cause,
any
the
collapse
same
cause.
next issue.
more
than it
follows,
of cholera and fever
as
Mr. Simon
depend
to
a
similar
remarks,
that
upon one and the
We shall however return to this
subject
in our
great pleasure
that
we
again
draw
our
readers'
attention to another instalment of Drs. T. R. Lewis and I). D. into the nature of cholera ; it our authors year by year become more inti-
Cunningham's investigations seems
[January 1,
THE INDIAN MEDICAL GAZETTE.
20
to
us
that,
as
mately acquainted with the disease, they realize more fully the complicated circumstances of the work before them, and that each succeeding report is consequently elaborated with greater We care, and is therefore more valuable than its predecessor. cannot as yet compliment Drs. Lewis and Cunningham on having demonstrated the nature of the ajency producing cholera, but, from a scientific point of view, they are probably working out problems second only to discovering the actual cause of cholera, in that they are rapidly demolishing much of the unreliable work done by previous observers with reference to the disease, and thus, it is to be hoped, clearing the ground upon which soon to construct sound doctrines concerning cholera. We certainly wish that investigations such as those now under consideration could be published in a more accessible form than that in which they appear; the mass of statistics with which these pathological and physiological reports are bound up simply act as a scare-crow to most men. There is not probably one in a thousand medical officers who could digest all these statistics if he tried, and even that solitary individual must be far from certain that the figures presented to him are absolutely accurate. On the other hand, it seems to us that Drs. Lewis and Cunningham's reports should be presented to every member of the profession in India, and to all those in Europe who desire to study their work ; as public servants entertained by Government to perform a special work, it seems to us that the results of their investigations are the property of the public, who not only pay them, but actually provide the materials upon which their work is printed. "
Drs. Lewis and
Cunningham remark : The two last cases (experiments dogs, in which the nerves supplying the loops of the intestines were divided) are peculiarly instructive and noteworthy, inasmuch as they appear to demonstrate a fact which had never previously been experimentally determined, on
namely,
that the relation which the secretion of the small intes-
supply is strictly analogous to that long been known to hold in regard to the secretion It was of the sub-maxillary gland and its nervous supply. induced an ascertained fact that that gland partial paralysis of hypersecretion, whilst total paralysis diminished the secretion ; but, in as far as we can ascertain, it was a matter of mere conjectural probability that the same held in regard to the email intestines also. The importance of the determination of this point in reference to the pathology of cholera is very great, as it appears to indicate partial paralysis of the intestines With as one of the most important lesions of the disease." tines bears to their nervous
which has
reference to these remarks
we
would observe that Samuel in
trophische nerven," records several experiments upon and other animuls, in which he cats, dogs, invariably found hypenemia of the intestinal mucous membrane produced by extirpation of the coeliac plexus ; the secretion of the mucous his "Die
membrane
was
iucreused much
by
the
operution,
"
but not to
1873.
degree as in violent diarrhoeaand, further, that Pfliiger's observations go to show that the nerves of the salivary glands are directly connected with the gland cells themthe same
"
selves, and Bernard proves that
in the
sub-maxillary gland
of the vaso-motor nerves conditionates secretion
(not continuously for five weeks if the nerves are completely destroyed." Moreau performed numerous experiments before the Societe de Biologie, illustrating the fact that intestinal secretion is increased in paralysis
diminished
secretion),
which may go
on
consequence of diminished rather than of increased nervous action, and he applied these principles to the circumstances of
cholera;
but "it must not be
Medical Times and
Gazette
in vivisection there are
So far
as
ar.d unavoidable sources of
numerous
error, which render induction process. law by
forgotten (as the Editor of the observes) that in all experiments a
difficult and hardly
M. Moreau's
inquiries
go,
satisfactory
they
indicate
a
antagonistic to the inferences derived front clinical experience, and they certainly throw light on one of the most serious, and assuredly not the least obscure, points in the pathology of the alimentary canal." We would further add with reference to all such inferences, that even supposing it should be shown that partial paralysis of the nerves supplying the intestinal canal is followed by excessive secretion from its mucous membrane, it by no means follows that the flow of no
means
serous
fluid from the intestines in cholera is due
cause,
any
the
collapse
same
cause.
next issue.
more
than it
follows,
of cholera and fever
as
Mr. Simon
depend
to
a
similar
remarks,
that
upon one and the
We shall however return to this
subject
in our
