Bacteriophage therapy
convalescents. 14 D’Hérelle also described the microbe as a true immunity microbe and an obligate bacteriophage, which means ‘bacteria eater’ in Frenc h and later became its recognized name. Although both d’Hérelle and Twort character ize d bacteriophages as viral parasites, these microbes’ true nature remained an unsettled matter of dispute until the introduction of electron microscopy in the early 1940s. 15 More than 100 years have passed since that summer morning on 2 nd August 1919, when d’Hérelle had Robert K., a desperate young boy with severe bacillary dysentery, swallow 2cc of a culture of bacteriophages having a high virulence for dysentery bacilli. The outcome of this bold and untested clinical attempt turned out to be unexpectedly successful: Robert’s symptoms disappeared within hours, and he became ‘fully convalescent’ the next day. 16 It was the birth of phage therapy. According to d’Hérelle (1931), ‘this method of treatment was applied on a large scale, principally in Sudan and in Brazil’. At the same time, phage therapy preparations were widely commercialized and once became reasonably popular in Europe and in the United States, where industrialized production lines of phage broth cultures and other phage products were set up. Phage therapy came into the public view with the 1925 fiction Arrowsmith written by Sinclair Lewis, which was subsequently made into a film in 1931. 17 In his book, Lewis told the story of a young and scientifically-minded physician, Martin Arrowsmith, who eventually discovers a phage and uses it to tackle a local outbreak of bubonic plague. 18 It did not take long for phage therapy to land in Soviet Russia, which became its only place of refuge under the Iron Curtain, soon after d’Hérelle made acquaintance with Georgian -Soviet microbiologist George Eliava at the Pasteur Institute in Paris. George Eliava founded a bacteriological research institute in Tbilisi, Georgia and succ essfully invited d’Hérelle to research and promote phage therapy together as loyal companions. Phage therapy quickly became appealing in the USSR, mainly because of the new ecological vision of bacterial infection it offered and the suitability of its promising therapeutic power with both the practical ethos and the developmental reality of Soviet microbiological research. 19 With the strong tailwind, the flourishing phage therapy reached its historic pinnacle in spite of increasing controversies over its actual efficacy. However, its triumph in the western world was short- lived and superseded by penicillin and other broad-spectrum antibiotics in the early 1940s. Antibiotics became one of the most significant accomplishments ever in the history of medicine, and the de facto definition of medical treatments was consequently reshaped under a strictly science-based regulatory framework for industrial medicinal products. The glamour of phage therapy rapidly faded away, and phage therapy eventually became a practice in the dust. Although kept in a much smaller scale, the sense of tradition and shortage of antibiotics allowed phage therapy to survive and extensively mature as a peripheral field of medical science in Soviet countries, in particular Georgia, where the research institute formerly founded by George Eliava eventually turned into the Eliava Institute of Bacteriophages, Microbiology and Virology. 20
Since the millennium, this long-forgotten practice has been witnessing its resurgence of interest in western countries, albeit there had been widespread hostility from physicians towards the therapeutic
14 D’Hérelle 1917. 15 Twort 1915; D’ Hérelle 1917; Shnayerson & Plotkin 2003. 16 D’Hérelle 1931.
17 Ford 1931. 18 Lewis 1976.
19 Myelnikov 2018. 20 Myelnikov 2021.
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