La inoculación preventiva contra el cólera morbo asiático.

Ferrán y Clúa, Jaime, 1852-1929.

Valencia : Imprenta y Librería de Ramón Ortega, 1886.

Description : [1]-337 p., 1 pl. ; ill.: 2 photo., text fig.s, tables ; 23.9 cm.

Photographs : 2 clichés (title vign. & frontis.).

Photographers : authors.

Subject : Cholera — Vaccination.

Notes :


WE have received a volume of upward of 350 pages, entitled " La Inoculación Preventiva contra el Cólera Morbo Asiático," written by Dr. James Ferrán, with the assistance of Drs. Gimeno and Pauli, in which is contained the complete history, from the author's point of view, of the so called preventive cholera inoculations. The work is divided into six parts, in which are discussed the doctrine of parasitism, the nature of microbial infection, the effects upon the organism of attenuated virus, the nature of the symptoms caused by cholera inoculation, the mode of procedure employed in "cholerization," and the value of the same in preventing the disease. The last part contains the reports of the various commissions sent to study Ferrán's method, and of the individual investigators who visited Spain at the time of the cholera epidemic, to satisfy themselves concerning the value of inoculation. The volume ends with an appendix containing the statistics of cholerization as practised in the different towns visited by the scourge.

These statistics were presented to our readers at the time when they were first published in separate form, and we expressed our conviction then that they were not sufficiently strong to warrant us in accepting without further proof the author's assertions. We need not refer to these again, but will review briefly Ferrari's conclusions concerning the present state of the question, leaving the reader to judge as to the soundness of the author's argument.

It is time, he thinks, now that the period of heated discussion has passed, to review the subject calmly and judicially, and to pass upon its merits without bias and without passion. He recognizes the fact that his theories have not met with the universal acceptance which he would wish that they might, and he is fully aware that he is looked upon by many as a " vulgar charlatan ;" yet he believes that an impartial study of his methods, and of the results obtained, will convince anyone not blinded by prejudice or jealousy that he is right. The statistics are before the world, and they can be denied only by impugning the credibility of the physicians, municipal authorities, and parish priests who have certified under oath to their correctness. The whole question, he maintains, rests upon the acceptance of two propositions, viz. : 1. Does preventive inoculation by cultures of the comma-bacillus rest upon a rational scientific basis ? 2. Do the results thus far obtained warrant the belief that Ferrán's prophylactic method is the true one ? Naturally the author himself would answer these two questions in the affirmative, and he believes that no impartial critic can do otherwise.

Whatever may be the final judgment of the scientific world upon this method, we believe that Ferrán is sincere in his convictions, and we only wish he were as scientific in his methods as we believe him to be honest in his intentions.

The medical record, a weekly journal of medicine and surgery, New York: William Wood & Co., October 30, 1886 ; pp. 493-494.

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5060. Murga on Ferran's Anticholera Inoculations,— Dr. L. Murga was commissioned by the provincial deputation of Seville to study on the spot Ferran's inoculations. For this purpose he joined Ferran in the early days of the epidemic, and accompanied him throughout the campaign. His opinion is, therefore, worth hearing. He gives the results of his experience in a paper of 119 pages. He accepts the morphology of the comma-bacillus described by Ferran, and recognises the comma-spirilla, the presence of spores, oögonia, and mulberry-shaped bodies, but has never seen the sudden ejection of the filament of protoplasm, nor the pollinide, nor the oosphères. The pathogenic power of the commas in animals he regards as clearly demonstrated. Inoculation of a sufficient dose into the subcutaneous cellular tissue of animals produces a marked immunity to succeeding inoculations of even larger doses. Inoculation of a cubic centimetre of a pure cultivation of the comma-bacillus in the posterior region of each arm in a healthy man, produces characteristic local and general symptoms, which, in some cases, have a great analogy with the symptoms of cholera. The liquid employed for the inoculations is a pure cultivation of the comma-bacillus in broth, and the method of its preparation is most simple. Inoculation never gives rise to alarming or dangerous symptoms. He is convinced of the absolute truth of the published statistics, and holds that the problem of anticholera inoculation is solved, and that preventive inoculation must in future hold a pre-eminent place in the prophylaxis of cholera.

The London Medical Record, London: Smith, Elder, and Co., vol. xiv., January 15, 1886 ; p. 35.

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Koch isolated the cholera vibrio bacterium in 1884 but his report was publicly disfavored by Klein and Gibbes of London and leading British medical scientists who believed that there were other forms of the germ, of variable morbidity. To prove his point, Klein swallowed a culture of the pathogen without suffering any ill effects. Likewise, Ferrán claimed to have found the oögonia of cholera in the dejecta of infected patients and further claimed that these spores were the true agents of the disease. By 1885, cholera was epidemic in Spain. Ferrán felt compelled to rush the development of a Pasteurian vaccine while shortcutting animal studies, and he tested the experimental serum on himself and two colleagues, Drs. Sarenana and Bertram. Even though the vaccine was partly derived from bile that was infected with the purported spores of cholera — attenuated by Pasteur's process but still virulent — all three men survived and demonstrated themselves resistant to more pathogenic strains of the bacillus. Ferrán published his results in the journal La Independencia Medica (March 1 and 11, 1885). The Ferrán reports immediately brought worldwide attention and elicited pressure on Spanish authorites to use the vaccine on behalf of the populace of Valencia which was hardest hit by the disease. During the ensuing months of 1885, over 250,000 cases of cholera were reported of which 92,000 proved fatal. According to Spanish accounts, Ferrán's imperfect vaccine was effective against this scourge, but British medical journals slandered his work, the source of the libel coming from a 70 year-old Englishman by the name of Dr. Jelly, living in Valencia at the time of the epidemic. Jelly was later exposed by the American epidemiologist, E. O. Shakespeare — however, the damage was done, and Ferrán never recovered the recognition he deserved for developing the first cholera vaccine.

Ferrán and his colleague, Inocente Paulí Galcerá, were both accomplished photographers and co-wrote a manual on bromide gelatin titled, La instantaneidad de la fotografía, Tortosa: Establecimiento Tipográfico de Pedro Llanes, 1879.

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