448 THE BACTERIOPHAGE AND ITS BEHAVIOR 



the intestine of the patient a mixed culture of the bacteriophage and 

 the refractory Hiss strain. 



In spite of every care and repeated injections of anti-dysentery serum 

 the patient became weaker and weaker; the temperature oscillated 

 between 38° in the morning and 40°C. in the evening; the number of 

 stools gradually increased and became uncountable on about the thirti- 

 eth day; and at about this time the patient fell into a marasmic con- 

 dition, the temperature stayed at about 38°C. and death occurred on 

 the thirty-fifth day. 



Bacteriologically, the stools, tested each day, showed an almost con- 

 stant bacterial flora. The pathogenic bacillus was always abundant, 

 often in almost pure culture, and presented the characteristics described. 

 The virulence of the bacteriophage increased continuously until the 

 fifteenth day when it became fixed, showing : Shiga + + + + ; Flexner 

 + + + + ; Hiss + + + + , 5. typhosus + + + ; 5. paratyphosus A -{- + + ; 

 B. paratyphosus B + + + ; B. coli + + + + ; bacillus of the patient 

 (completely refractory) when freshly isolated, + + + after fifteen trans- 

 plants. 



At autopsy* there was isolated from the contents of the colon, 

 from a fragment of mucous ulceration, from the liver, from the spleen, 

 and from the heart blood, a Hiss dysentery bacillus, presenting the same 

 characteristics as that which had been isolated at the beginning of the 

 disease. From all the organs a bacteriophage was isolated presenting 

 the same characters as that which had been isolated from the stools 

 and whose virulence has been indicated. 



This case, altogether exceptional (I believe that it is the first case 

 reported of a 5. dysenteriae Hiss septicemia) is very interesting for it 

 shows in an unquestioned manner the role that the bacteriophage plays 

 in the defense of the organism. In all of the cases examined heretofore 

 we have seen, either recovery starting from the time when the bacterio- 

 phage had acquired sufficient virulence to dominate the pathogenic 

 bacillus, or death in the case of the lack of such an adaptation. In this 

 last case, the bacteria developed a refractory condition, the bacterio- 

 phage was overcome and remained without action whatever its viru- 

 lence may have been. The barrier thus being lacking, the bacteria 

 developed freely and invaded the entire organism. The patient suc- 

 cumbed to a septicemia with the Hiss bacillus. 



This unusual case provides us with new information. A bac- 



* Performed by L. Gery, whom I thank for the specimens he was kind enough 

 to send me. 



