566 THE BACTERIOPHAGE AND ITS BEHAVIOR 



May 18: The blood clot was cleaned out, and bacteriophage was placed on the 

 dressing and laid over the wound. The patient had a marked reaction, beginning 

 about 8 o'clock that night, simulating the one described above, only more marked. 

 He was nauseated and had chills and fever for a week, together with marked 

 swelling of the right leg and foot. 



June 2: The wound was healed. Roentgen-ray examination showed union 

 of the fractured bones. 



From my first publications^-^ on the application of the bacteriophage 

 to therapeutic purposes I emphasized the fact that it is not wise to 

 multiply injections. All of the observations which have been made 

 since justify me in repeating this recommendation. It is never neces- 

 sary to give more than 3 injections, and it is particularly important 

 that they should he given within an interval of time not greater than It.8 hours 

 between the first and the last injection. In the great majority of cases a 

 single injection is adequate to lead to recovery, and nothing is gained by 

 repeating the treatment. 



This warning applies only to treatments given by a parenteral route. 

 Administration by mouth, by rectum, by bladder instillation, or by 

 ntroduction into the vagina, can be repeated without danger as many 

 times as seems best, and the intervals at which they are given are of no 

 moment, from the point of view of inciting harmful effects. 



It may be added that the bacteriophage treatment of infected wounds 

 is actually being used in a number of hospitals, but in view of the publica- 

 tions already made on the subject, those who are applying this form of 

 therapy have not yet thought it necessary to publish their observations. 

 They feel, however, that the method has become an established pro- 

 cedure. It so happens that in the surgical service of one of the Paris 

 hospitals they have recently shown me a number of patients who had 

 been treated by the bacteriophage. Among them was one who was 

 admitted, three weeks previously, with a large suppurating wound of 

 the thigh, with diffuse phlegmon. The general condition of the patient 

 was very poor; temperature above 40°C., adynamic, and the condition 

 of the leg was such that the surgeon believed amputation necessary. 

 But the general condition of the patient was so poor that he deferred 

 the operation until the next day. As a sort of last chance, he injected 

 2 cc. of a Staphylo-bacteriophage suspension into the muscular tissues 

 surrounding the wound. By the next morning the temperature had 

 fallen, the general condition was improved, and suppuration was mark- 

 edly diminished. Conditions as regards the infection were so far im- 

 proved that it was determined to postpone the operation. During 



