646 THE BACTERIOPHAGE AND ITS BEHAVIOR 



distributed throughout all of the different States, who have requested prepara- 

 tions of the bacteriophage. 



The Director of Public Health of the State of Bahia has kept us informed of the 

 results obtained in a series of patients, and at Sao Paolo a very large number 

 of cases have been observed by various physicians who have applied the treat- 

 ment in their individual clinics. All have reported good results. Here in Rio de 

 Janiero, the method has been thoroughly tried out, and is today the routine 

 method of treatment. 



Nevertheless, we still advise the use of serum in cases infected with the Shiga 

 bacillus, since the toxin is not neutralized by the bacteriophage. 



It is possible to find only a few rare cases in which the administration of the 

 bacteriophage has not been followed by benefit to the patient. Of these cases', 

 the first was a patient infected with the Hiss strain of the bacillus, perfectly 

 susceptible in vitro to the bacteriophage, but in whom the bacteriophage failed, 

 for reasons not yet discovered, to exert its action in the intestinal tract. The 

 second was an infant who died of a very severe infection caused by the Shiga 

 bacillus, in spite of the fact that both serum and bacteriophage treatment were 

 used. These are the only two completely unsuccessful cases which have up to 

 the present come to our attention, but to judge from the very wide use which has 

 been made of the method it would seem that there must be other cases of failure 

 of which we have not yet heard. 



The therapeutic effect, — the sudden change in the condition of the patient, — 

 consequent to the administration of the bacteriophage has astonished all of the 

 physicians who have ,worked with it. A few hours after the administration of the 

 first dose improvement has been noted, and the rapidity of the recovery has been 

 a cause of amazement. In examining the collected data pertaining to the patients 

 treated it appears that the majority of them had first received all known treat- 

 ments, and had been given the bacteriophage as a last resort. We are, therefore, 

 absolutely convinced that it has saved the lives of a great many patients. 



The dysentery bacteriophage is by far the best therapeutic agent in the bacil- 

 lary dysenteries known up to the present time. 



Its action incomparably surpasses that of all other agents, including serum, 

 for in the majority of cases the symptoms materially diminish in intensity within 

 4 to 8 hours after treatment, and the patient enters upon convalescence within 

 24 to 48 hours. 



The only criticism that I would make of the conclusions of this 

 scientist at the Institute Oswaldo Cruz bears on the use of anti-dysentery 

 serum. The results observed in the 7 cases of severe dysentery which 

 have been cited above, as well as many comparable observations which 

 I have made since those results were first reported, all deahng with 

 cases of dysentery caused by the Shiga bacillus, have shown that the 

 administration of the bacteriophage alone results in a prompt and com- 

 plete cure, without requiring the administration of serum. I might 

 say further that I have gained the impression from two cases where I 

 have been obliged (because of the demands of the parents) to give an 



