April, 1884.]
NOTES ON POISON IN CHOLERAIC ALVINE DISCHARGES. much
COMMUNICATIONS.
ORIGINAL
instance the alvine
far
so
I
as
blished by
experiments. given as to the
any hint been
esta-
true
Removed the semi-solid
nature of
poisonous agent, further than it was supposed to be a "germ" of some description. Dr.
alvine
Koch,
liquefying
dis-
whole to
and within the
covered in choleraic
discharges bodies of the affected, a peculiar bacillus which he believes to be the cholera-producing agent. He has not, however, succeeded in producing any appreciable results by the inoculation of isolated and cultivated bacilli. I have no
knowledge tigations, had he
natural
only
marked
met with any
to assume success
ments case
a
made with choleraic of
dogs,
that I failed
pigs,
on
it
and
to obtain
lucky thought it ment
short account of
struck
which
are
small
pig,
three months
that
so
met with in
This
was
hospital.
in In
common
be
the animal had vomited
remembered
By a the try expericountry, at least,
I gave to a choleraic discharge
restless,
pinkdischarges'
when
I visited the
it
reported
once
and that it had
an
undoubted choleraic
evacuation.
was
after
soon
that
being
very afterwards died.
At the post-mortem examination I found the stomach contained a glairy yellowish fluid, part of the smaller intestines empty, and the rectum full' of semi-fluid- greyish feces. The lungs were'
*
:;
I
patient
results.
the most fatal form of the disease.'
morning the evening
of
the administration
I may
dejections
the alvine
the
patient,
ii.
in this
in
The
was
Removed the contents of the intestines of.a who died overnight from cholera, and
which had just been evacuated by a patient in the hospital. The evacuation was of the !sh colour
like
rice-water
slightly coloured observe, recovered The animal was never affected, but it was dn a subsequent occasion some days afterwards, killed in one hour and twenty-eight minutes by
in that
animals.
old,
of
from
apparently suffering from The discharge cholera.
in the
to
a
stage
discharges
The
experi-
positive
Peculiarly foul-feeding
Never affected.
some
will
me
first
with bile.
we
March I published
half-grown pig.
it the alvine
though
should have heard of it. In the number of the Indiciu\ Mcchcal Gazette
direction,
them with water, administered the
a
day gave patient who was
the
of the details of Dr. Koch's inves.
but it is
a
next a
of the
contents
pig which had been killed by the discharges of a cholera patient, and after
inestines of
the
the eminent German savant, has
the
I.
Still less has
actual
contained
discharge
human excrement, which must be to
aware, the fact has
am
been satisfactorily andconclusively
The
empty.
fortunate that in this
country-pigs consume them, under ordinary circumstances, perfectly innocuous. But the following experiments shew that they even suspected discharges with can consume apparent impunity.
Richards, f. r. c. s. e. It has been customary?though not universally so?to regard the choleraic alvine discharges as possessing some peculiar poisonous properBut
was
was
that
It is well known
By Vincent
never
side of the heart
in view of my past experience I been inclined to abandon the enquiry
poison, or might have
DISCHARGES.
ties.
It
fluid.
was
right
and the left
blood,
full of fluid blood
SOME NOTES ON THE POISON CONCHOLERAIC ALVINE TAINED IN
the
congested,
92
l
The oz., to a half-grown pig. gave half, about 2.r v' and was fluid had a most offensive odour, partly decomposed. Kept several days under observa'
v
tion, but ment was
was never
affected.
repeated on
unaffected.
the
animal,
same
experi-
but it remained ......
-?
:
The
)
III. the other half of the fluid rer
Administered expt. II to a half-grown pig. Kept but was never many days under observation,
ferred to in
affected. Repeated the experiment with a susit pected evacuation, and although appeared to be unwell, it was never seriously affected. This
sphear .wound" in the side, and it became rather weak;;:..Onra'subsequent occasion it died in fifteen minutes after having him given animal had
a
THE INDIAN MEDICAL GAZETTE.
93
contents of the intestines of
the
had died two hours
previously
patient
a
who
The
from cholera.
nity of the poison contained in choleraic alvine discharges at certain stages of the disease. I may here observe that the pinkish colored evacuations appeared to be the most poisonousIV. at 10-30 A.M. I
removed
the fluid contents of the intestines of a patient who had died from cholera and to a
bled
administered them
nearly full-grown pig. The fluid reseman ordinary cholera evacuation of a pink-
ish colour. At
the animal
11-20
passed a large quantity clay-coloured faces. It became
of semi-fluid
very restless and gasping for breath. 1 r.M.?Passed another stool of a similar charStill
acter.
restless, and the respiration embarrassed; soon after this it became
is much
more
convulsed. 1-10 P.
M.?It
1-20 P.
M.?Dead?in
again passed 2
similar faeces.
hours and 50 minutes.
V. 9 A.
Gave
M.
a
choleraic evacuation to
a
half-
pig. At 9-15 A. M. it became extremely restless, and the respiration greatly embarrassed. The nose and ears, which had been of a light pink colour, became bluish. The animal's grown
restlessness increased and at was
an
ineffectual
attempt
intervals there take
to
inspiration. 9-58 A. M.?Strongly convulsed. 10 A. M.?Respiration ceased, but until 10-28
A.
M.
a
it
long
was not
that the heart's action
quite
ceased. The chest was opened some time after the cessation of respiration. The animal had
passed
a
small
of urine which
quantity
was
found to contain albumen and a trace of uroxanthine. I should have tested for the chlorides as
suggested by Crombie,
silver at hand. as
in such
of any
It is not
an acute case
purging,
but had
it is
no
nitrate of
important however,
and in
the absence
scarcely likely
would have been any marked the chlorides.
principal post-mortem
appearances
were
the
In strong contrast to these experiments are the following, which prove the extreme malig-
On the 18th March
[April, 1884.
that there
deficiency
of
following :?The lungs were normal; the heart nearly empty. The rectum contained a small quantity of solid faeces. The small intestine contained a small quantity of bloody fluid, and the large intestines were empty. The stomach contained a small quantity of greenish coloured fluid. Liver gorged with blood ; gall-bladder full. Kidneys also gorged with blood. Blood fluid throughout. face of these results it
In the be
that
questioned
can no
longer
the alvine
discharges at contain a powerful
certain stages of cholera do poison whose chief action is to enfeeble and de-
stroy the function of respiration. And in this respect it seems somewhat to resemble the action of the
proteid?venom globulin?which has been venom of snakes by Drs. Weir Mitchell and Reichert. Now, what is the nature of the poison ? Is it an organism, or is it a chemical compound ? In my opinion the rapidity with which it acts altogether excludes it from the possibility of its being an organism. While on the other hand the rapidity of its action and its comparative instability as plainly
discovered in the
indicate that it is in the nature of
compound?possibly,
but this is
chemical
a
conjecture body. Its instability is, I think, very clearly shown by experiments II. and III, The poison which had, no doubt, existed in the fluid of the intestines had been destroyed by decomposition ; at least that appears to be the most probable explanation of the in ocuousness of the material used in those two experiments. Had the poisonous character of the alvine discharges depended upon the contained bacilli, the results of the experiments would have been very different, since the decomposition of the vehicle would scarcely have affected the mere
albuminoid
an
vitality
of the bacilli.
stood to
mean
poisonous
element is
composition emphatically
I would not be under-
that I think it
given
off
impossible
during
of the evacuations.
I
the
the de-
do
most
believe that the evacuations lose
qualities by decomposition ; but whegiven off or is destroyed, it is present impossible decidedly to say, though
their toxic
ther the poison is at
the
probabilities
are
much in favour of the lat-
PRECIS OF OPERATIONS.?BY K. McLEOD.
April, 1884.] ter
It may, of course, be
supposition.
ed whether the
poison
proved
now
question-
to exist in
choleraic alvine discharges is the identical poiwhich
son
point
out
feet is
precisely the
principal physiological ef" same. Any one experienced
that the
in the observation of cholera
"
post-mortem appearances, and the order of the symptoms, tend to show that the blood is obstructed in its passage through the
lungs
The
; and that the loss of animal
heat,
em-
arrest
barrassment of the respiration, and gradual ?f circulation are produced by some aberration ?f the proper respiratory changes or impediment a
The
them."
to
prominent symptom
purging,
which is not
the
pigs experi-
in
mented on, may be mainly due to ?f the mesenteric nerves the result
paralysis
circulation of
a
nated
or
oxygeeffort of
blood, eliminat'on.
so
rapid
the
though
imperfectly
or
it may be
there
mere
a
of the
poisoning
The
that
complete
vitiated
pigs
was
not sufficient time for
was
evacuation of the intestinal canal
it will be noted
that
a
found in the intestines of
was
of the
bloody
one
.
fluid
of the anj.
There are, of course, other explanations, either there may be some slight difference in mals.
the ?f
mode of action of the and that of man,
pigs
poison
in the
case
exterior to the
or
system it may acquire a further special property. But be this as it may, the main physiological
character
What is
same.
and
of the two now
poisons
required
searching enquiry
alvine discharges in cholera may
be,
if
so
precisely
the
thorough chemistry of the that the poison a
most
isolated and its chemical and
possible,
physiological
is
into the
is
characters
definitely determined^
As regards disinfection, I am persuaded that from the nature of the poison the best means ?f
disinfecting
mixture of of
potash
tunity
of
a
choleraic evacuations is the ad-
solution
of
I have
not
? but
deciding
summarise the
the
yet question.
results
deducible from my
the
permanganate had
an opporI would thus
which I think fairly
investigation.
if the poison finds its way into
2ndly.?That stomach, it
the
is absorbed and
rapidly
proves
fatal.
knows that
cases
the really prominent symptoms are the restlessness and distress consequent upon embarrassed respiration. In this connection Dr. Ait-
ken remarks,
istly.?That choleraic evacuations, at certain stages of the disease, contain a most virulent poison.
But I would
the disease.
produces
94
3ydly.?That
the principal action of the poison
is to enfeeble and
destroy
the function of
res-
piration.
4thly%?That
the
poison
but of the nature of a
comparatively
is not
chemical
a
organism, compound of an
unstable nature.
5thly.?That it will probably be found to be easy to destroy the power of the poison existing in the evacuations, in other words to disinfect them. it
6thlys?That although might by desiccation
some
considerable
time.
stained with choleraic source
of danger.
the poison
decomposes,
its powers for Hence clothes, &c.,
retain
discharges might
be
a
NOTES ON POISON IN CHOLERAIC ALVINE DISCHARGES. much
COMMUNICATIONS.
ORIGINAL
instance the alvine
far
so
I
as
blished by
experiments. given as to the
any hint been
esta-
true
Removed the semi-solid
nature of
poisonous agent, further than it was supposed to be a "germ" of some description. Dr.
alvine
Koch,
liquefying
dis-
whole to
and within the
covered in choleraic
discharges bodies of the affected, a peculiar bacillus which he believes to be the cholera-producing agent. He has not, however, succeeded in producing any appreciable results by the inoculation of isolated and cultivated bacilli. I have no
knowledge tigations, had he
natural
only
marked
met with any
to assume success
ments case
a
made with choleraic of
dogs,
that I failed
pigs,
on
it
and
to obtain
lucky thought it ment
short account of
struck
which
are
small
pig,
three months
that
so
met with in
This
was
hospital.
in In
common
be
the animal had vomited
remembered
By a the try expericountry, at least,
I gave to a choleraic discharge
restless,
pinkdischarges'
when
I visited the
it
reported
once
and that it had
an
undoubted choleraic
evacuation.
was
after
soon
that
being
very afterwards died.
At the post-mortem examination I found the stomach contained a glairy yellowish fluid, part of the smaller intestines empty, and the rectum full' of semi-fluid- greyish feces. The lungs were'
*
:;
I
patient
results.
the most fatal form of the disease.'
morning the evening
of
the administration
I may
dejections
the alvine
the
patient,
ii.
in this
in
The
was
Removed the contents of the intestines of.a who died overnight from cholera, and
which had just been evacuated by a patient in the hospital. The evacuation was of the !sh colour
like
rice-water
slightly coloured observe, recovered The animal was never affected, but it was dn a subsequent occasion some days afterwards, killed in one hour and twenty-eight minutes by
in that
animals.
old,
of
from
apparently suffering from The discharge cholera.
in the
to
a
stage
discharges
The
experi-
positive
Peculiarly foul-feeding
Never affected.
some
will
me
first
with bile.
we
March I published
half-grown pig.
it the alvine
though
should have heard of it. In the number of the Indiciu\ Mcchcal Gazette
direction,
them with water, administered the
a
day gave patient who was
the
of the details of Dr. Koch's inves.
but it is
a
next a
of the
contents
pig which had been killed by the discharges of a cholera patient, and after
inestines of
the
the eminent German savant, has
the
I.
Still less has
actual
contained
discharge
human excrement, which must be to
aware, the fact has
am
been satisfactorily andconclusively
The
empty.
fortunate that in this
country-pigs consume them, under ordinary circumstances, perfectly innocuous. But the following experiments shew that they even suspected discharges with can consume apparent impunity.
Richards, f. r. c. s. e. It has been customary?though not universally so?to regard the choleraic alvine discharges as possessing some peculiar poisonous properBut
was
was
that
It is well known
By Vincent
never
side of the heart
in view of my past experience I been inclined to abandon the enquiry
poison, or might have
DISCHARGES.
ties.
It
fluid.
was
right
and the left
blood,
full of fluid blood
SOME NOTES ON THE POISON CONCHOLERAIC ALVINE TAINED IN
the
congested,
92
l
The oz., to a half-grown pig. gave half, about 2.r v' and was fluid had a most offensive odour, partly decomposed. Kept several days under observa'
v
tion, but ment was
was never
affected.
repeated on
unaffected.
the
animal,
same
experi-
but it remained ......
-?
:
The
)
III. the other half of the fluid rer
Administered expt. II to a half-grown pig. Kept but was never many days under observation,
ferred to in
affected. Repeated the experiment with a susit pected evacuation, and although appeared to be unwell, it was never seriously affected. This
sphear .wound" in the side, and it became rather weak;;:..Onra'subsequent occasion it died in fifteen minutes after having him given animal had
a
THE INDIAN MEDICAL GAZETTE.
93
contents of the intestines of
the
had died two hours
previously
patient
a
who
The
from cholera.
nity of the poison contained in choleraic alvine discharges at certain stages of the disease. I may here observe that the pinkish colored evacuations appeared to be the most poisonousIV. at 10-30 A.M. I
removed
the fluid contents of the intestines of a patient who had died from cholera and to a
bled
administered them
nearly full-grown pig. The fluid reseman ordinary cholera evacuation of a pink-
ish colour. At
the animal
11-20
passed a large quantity clay-coloured faces. It became
of semi-fluid
very restless and gasping for breath. 1 r.M.?Passed another stool of a similar charStill
acter.
restless, and the respiration embarrassed; soon after this it became
is much
more
convulsed. 1-10 P.
M.?It
1-20 P.
M.?Dead?in
again passed 2
similar faeces.
hours and 50 minutes.
V. 9 A.
Gave
M.
a
choleraic evacuation to
a
half-
pig. At 9-15 A. M. it became extremely restless, and the respiration greatly embarrassed. The nose and ears, which had been of a light pink colour, became bluish. The animal's grown
restlessness increased and at was
an
ineffectual
attempt
intervals there take
to
inspiration. 9-58 A. M.?Strongly convulsed. 10 A. M.?Respiration ceased, but until 10-28
A.
M.
a
it
long
was not
that the heart's action
quite
ceased. The chest was opened some time after the cessation of respiration. The animal had
passed
a
small
of urine which
quantity
was
found to contain albumen and a trace of uroxanthine. I should have tested for the chlorides as
suggested by Crombie,
silver at hand. as
in such
of any
It is not
an acute case
purging,
but had
it is
no
nitrate of
important however,
and in
the absence
scarcely likely
would have been any marked the chlorides.
principal post-mortem
appearances
were
the
In strong contrast to these experiments are the following, which prove the extreme malig-
On the 18th March
[April, 1884.
that there
deficiency
of
following :?The lungs were normal; the heart nearly empty. The rectum contained a small quantity of solid faeces. The small intestine contained a small quantity of bloody fluid, and the large intestines were empty. The stomach contained a small quantity of greenish coloured fluid. Liver gorged with blood ; gall-bladder full. Kidneys also gorged with blood. Blood fluid throughout. face of these results it
In the be
that
questioned
can no
longer
the alvine
discharges at contain a powerful
certain stages of cholera do poison whose chief action is to enfeeble and de-
stroy the function of respiration. And in this respect it seems somewhat to resemble the action of the
proteid?venom globulin?which has been venom of snakes by Drs. Weir Mitchell and Reichert. Now, what is the nature of the poison ? Is it an organism, or is it a chemical compound ? In my opinion the rapidity with which it acts altogether excludes it from the possibility of its being an organism. While on the other hand the rapidity of its action and its comparative instability as plainly
discovered in the
indicate that it is in the nature of
compound?possibly,
but this is
chemical
a
conjecture body. Its instability is, I think, very clearly shown by experiments II. and III, The poison which had, no doubt, existed in the fluid of the intestines had been destroyed by decomposition ; at least that appears to be the most probable explanation of the in ocuousness of the material used in those two experiments. Had the poisonous character of the alvine discharges depended upon the contained bacilli, the results of the experiments would have been very different, since the decomposition of the vehicle would scarcely have affected the mere
albuminoid
an
vitality
of the bacilli.
stood to
mean
poisonous
element is
composition emphatically
I would not be under-
that I think it
given
off
impossible
during
of the evacuations.
I
the
the de-
do
most
believe that the evacuations lose
qualities by decomposition ; but whegiven off or is destroyed, it is present impossible decidedly to say, though
their toxic
ther the poison is at
the
probabilities
are
much in favour of the lat-
PRECIS OF OPERATIONS.?BY K. McLEOD.
April, 1884.] ter
It may, of course, be
supposition.
ed whether the
poison
proved
now
question-
to exist in
choleraic alvine discharges is the identical poiwhich
son
point
out
feet is
precisely the
principal physiological ef" same. Any one experienced
that the
in the observation of cholera
"
post-mortem appearances, and the order of the symptoms, tend to show that the blood is obstructed in its passage through the
lungs
The
; and that the loss of animal
heat,
em-
arrest
barrassment of the respiration, and gradual ?f circulation are produced by some aberration ?f the proper respiratory changes or impediment a
The
them."
to
prominent symptom
purging,
which is not
the
pigs experi-
in
mented on, may be mainly due to ?f the mesenteric nerves the result
paralysis
circulation of
a
nated
or
oxygeeffort of
blood, eliminat'on.
so
rapid
the
though
imperfectly
or
it may be
there
mere
a
of the
poisoning
The
that
complete
vitiated
pigs
was
not sufficient time for
was
evacuation of the intestinal canal
it will be noted
that
a
found in the intestines of
was
of the
bloody
one
.
fluid
of the anj.
There are, of course, other explanations, either there may be some slight difference in mals.
the ?f
mode of action of the and that of man,
pigs
poison
in the
case
exterior to the
or
system it may acquire a further special property. But be this as it may, the main physiological
character
What is
same.
and
of the two now
poisons
required
searching enquiry
alvine discharges in cholera may
be,
if
so
precisely
the
thorough chemistry of the that the poison a
most
isolated and its chemical and
possible,
physiological
is
into the
is
characters
definitely determined^
As regards disinfection, I am persuaded that from the nature of the poison the best means ?f
disinfecting
mixture of of
potash
tunity
of
a
choleraic evacuations is the ad-
solution
of
I have
not
? but
deciding
summarise the
the
yet question.
results
deducible from my
the
permanganate had
an opporI would thus
which I think fairly
investigation.
if the poison finds its way into
2ndly.?That stomach, it
the
is absorbed and
rapidly
proves
fatal.
knows that
cases
the really prominent symptoms are the restlessness and distress consequent upon embarrassed respiration. In this connection Dr. Ait-
ken remarks,
istly.?That choleraic evacuations, at certain stages of the disease, contain a most virulent poison.
But I would
the disease.
produces
94
3ydly.?That
the principal action of the poison
is to enfeeble and
destroy
the function of
res-
piration.
4thly%?That
the
poison
but of the nature of a
comparatively
is not
chemical
a
organism, compound of an
unstable nature.
5thly.?That it will probably be found to be easy to destroy the power of the poison existing in the evacuations, in other words to disinfect them. it
6thlys?That although might by desiccation
some
considerable
time.
stained with choleraic source
of danger.
the poison
decomposes,
its powers for Hence clothes, &c.,
retain
discharges might
be
a
