266 THE BACTERIOPHAGE 



After being assured of the innocuity of the ingestion of cultures 

 of the anti-Shiga bacteriophage, this treatment was applied for 

 therapeutic purposes to patients affected with bacillary dysentery. 8 

 As in the experimental work, so also here in the clinical tests, 

 the therapy has been limited to those cases in which the etiology 

 of the infection was proved by the isolation of the pathogenic 

 organism, and where, in addition, the virulence of the intestinal 

 bacteriophage was negative toward the different dysentery bacilli 

 at the time of the administration of the culture of bacteriophage. 

 It is evident that in routine practice it would not be necessary to 

 investigate all these points, especially since the administration 

 of the bacteriophage cultures is always inoffensive. 



In each of the following cases the only treatment instituted 

 has been the ingestion of the culture of the bacteriophage. 



Robert K. . . . (eleven years). This is a case of bacillary dysentery 

 of moderate severity with from 5 to 7 bloody stools a day. 



August 1. The stool examination showed: B. dysenteriae Shiga present. 



The intestinal bacteriophage with virulences as follows: B. coli ++, 

 Shiga 0, Flexner 0, Hiss 0. 



August 2. At 10 o'clock in the morning the patient ingested 2 cc. of a 

 anti-Shiga bacteriophage culture. This culture had been lysed for thirty- 

 five days. During the afternoon of this day there were 3 bloody stools, in 

 the evening there was one stool and that was free of blood. 



August 3. During this day there was only the one formed stool. Exami- 

 nation showed: B. dysenteriae Shiga absent. 



The intestinal bacteriophage with virulences as follows: B. coli + +++, 

 Shiga + + + + , Flexner +++, Hiss +++. 



8 These experiments have been made with the assistance of M. Nadal, 

 on the service of Pr. Hutinel, at the Hopital des Enfants Malades. 



Tests have also been made in cases of toxic diarrhea of infants, but they 

 will not be discussed here since a conclusion regarding them has not yet 

 been reached. In those cases there is an especial difficulty, for the path- 

 ogenic organism is still unknown. It was at first thought that this might 

 be determined through the ability to isolate and cultivate an active strain 

 of bacteriophage which might be used for curative purposes. It is indeed 

 probable that there is, not one, but several diarrheas of infants caused by 

 different bacterial types, as the experiments of Nob6court made during 

 the past few years would also indicate. The solution of the problem is not 

 impossible but it would be necessary to administer to the affected infants 

 a mixture of cultures of diverse strains of the bacteriophage, active against 

 the diverse bacterial types capable of inciting the diarrhea. It can readily 

 be conceived that under such circumstances the investigation must be 

 protracted. 



