Just discovered, swiftly applied: Bacteriophage therapy during the early years of the 20th century in the United States

Susie Fisher
Natural Science, The Open University of Israel

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     Last modified: February 10, 2005
     Presentation date: 07/14/2005 11:00 AM in MACK 236
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Abstract
"Do bacteria suffer from infectious disease?" This rather surprising question was the title of an editorial appearing in the July 1921 issue of JAMA referring to the then newly described phenomenon, observed by two medical researchers Edward Twort and Felix d'Herelle in 1915 and 1917 respectively. Twort and d'Herelle noticed that filtrates of bacterial cultures were capable of dissolving freshly prepared bacterial cultures of the same type or produce clear areas on bacterial lawns. D'Herelle claimed that the filtrates contained a live virus, an "invisible microbe", which he named bacteriophage and called the phenomenon "bacteriophagy". In the above mentioned editorial the editor informed the medical community of this remarkable phenomenon and described Twort and d'Herelle's findings. Regarding its therapeutic potential he wrote: "These observations suggest at once the existence of ultravisible viruses pathogenic for bacteria, a possibility of enormous significance for the problems of infection and immunity." Driven perhaps by the editor's enthusiasm, many physicians and medical researchers, in the USA, began exploring the phage's therapeutic potential. They were followed by major pharmaceutical firms (e.g., Parke-Davis and Lilly) seeking to make a profit from this new and promising biologic . By the early 1930's numerous and conflicting results regarding phage therapy were reported, an evidence of its extensive use. Concerned by the inconclusiveness of the results, the American Medical Association commissioned its "Council on Pharmacy and Chemistry" to try and evaluate the therapy.
Today, we are so accustomed to strict medical regulation and to FDA supervision of every new drug and medical procedure that we find the medical practitioner's attempts to apply forthwith bacteriophage therapy at the bedside rather surprising ; particularly as its nature and mode of action were still widely disputed.
In my talk I will focus on the early years of this medical practice, dating from 1921 when the editorial mentioned above appeared to 1934 when the first extensive and commissioned review of the therapy was published in JAMA. I will present and discuss a number of factors that allowed for this expeditious application of a new therapy making use of reports published in research journals of the period. Some of the questions that I will address are: Can we discern a particular group of physicians or bacteriologists that advocated the therapy and mobilized the practitioners? How did Public Health officers react towards this new biological weapon in their fight against the dreaded infectious diseases? What part, if any, did medical tradition play in this episode? And how did medical regulation affect these trials?
I would also like to comment on the relation between newly acquired scientific knowledge and its application, namely bacteriophagy and bacteriophage therapy. Traditionally the relation between a basic science and its application is presented as proceeding from basic to applied. Bacteriophage therapy seems, however, to follow a different path.