SPECIFIC THERAPY WITH BACTERIOPHAGE SUSPENSIONS 557 



suspension, 250 million bacilli per cubic centimeter, of the strain derived 

 from the patient. Clearing was perfect in 8 hours. I gave, with a 

 48 hour interval, two injections of 2 cc. of this filtered suspension. 

 Fifteen days after the last injection there had been no improvement, 

 for the urine was as heavily loaded with B. coli as before, in fact, it was 

 simply a culture of the bacillus. 



I then gave the patient a bladder instillation, using 20 cc. of the same 

 bacteriophage diluted with physiological saline. Five days later the 

 urine was sterile. Cure was permanent, for 6 months later examination 

 showed that the urine was still sterile. 



Since this experience I have always combined subcutaneous injection 

 with bladder lavage, a procedure which offers no inconvenience. 



I have had occasion to treat one case of angiocholecystitis. The 

 patient, a woman aged 32 years, had been in the hospital for 6 months. 

 During this time the temperature had varied between 37.8 and 39°C. 

 The infection had resisted all of the usual types of treatment, including 

 vaccine therapy. The patient was extremely weakened and emaciated. 

 Two hours after the injection of 2 cc. of a suspension of the bacterio- 

 phage (a race isolated 2 years previously from the stools of a cholera 

 convalescent, and developed at the expense of a stock strain of B. coli) 

 the temperature rose and quickly reached 40.5°C. It stayed there 

 from the 7th to the 11th hour after the injection. Then there occurred a 

 rapid fall, without general disturbances but with a profuse sweating, 

 and 22 hours after the injection the temperature was 37.2°C. and the 

 patient entered upon convalescence. She left the hospital in a perfect 

 state of health 12 days later. For the 2 years following her discharge 

 from the hospital she has shown no morbid symptoms. 



What is the principle which causes the recovery in these B. coli 

 infections? Is it the dissolved bacterial substance, or is it the bacterio- 

 phage itself acting as a parasite of the bacteria? 



In order to reach an answer to this question it is only necessary to 

 recall that in all cases, whether cure resulted or whether the diseased 

 state persisted without change, the dissolved bacterial substance was 

 injected. But recovery followed only when the bacteriophage inocu- 

 lated was virulent for the pathogenic bacterium. It is, then, the 

 "virulence" which is effective. This means that recovery occurs be- 

 cause the bacteriophage protobes parasitize and destroy the pathogenic 

 bacteria. 



The treatment of infections due to B. coli by the bacteriophage is 

 specific. When someone succeeds in isolating a race of the bacterio- 



