since 1991 in Italy, the substitution of neutral glass bottles, perfectly ozoneresistant, with plastic bags because they are cheaper and easier to stow away. These bags are made of about 55% polyvinyl chloride (PVC) mixed with a number of additives, among which about 43% of phthalates (Valeri et al., 1973; Lewis et al., 1977; Lawrence, 1978; Thomas et al., 1978; Callahan et al., 1982; Labow et al., 1986; Whysner et al., 1996). These compounds make the PVC elastic but a minimal amount of phthalates is released into blood. This little contamination is permissible and bags are commonly used for storage of blood but the problem arises after the addition of ozone into the bags because ozone causes a huge release of plastic microparticles and phthalates into the blood with worrisome consequences for the patient after reinfusion. After my notification to Health Authorities, the Italian Ministry of Health established very clearly that plastic bags should never be used for ozonetherapy. In spite of this precise regulation, some Italian ozonetherapists, shamefully unconcerned about the patient’s safety, continue to use them! Fortunately, this does not seem to happen in other European countries but, once again, this reprehensible behaviour discredits this approach. Phthalates may not be toxic but plastic microparticles, taken up by the reticulo-endothelial system in the spleen liver and bone marrow, may represent a cancerogenic stimulus. After several years of laboratory experimentation and clinical work, we have now optimised an autohemotherapeutic method that is fairly simple, ozone-resistant, absolutely atoxic and flexible in the sense that one can use a blood volume from 100 to 270 ml (depending on the patient), a suitable volume of sodium citrate (3.8 %) solution and the necessary gas volume without increasing the atmospheric pressure in the glass bottle. Our device consists of 1) a neutral 500 ml glass bottle (sterile and under vacuum) where we inject, as a first thing, the chosen anticoagulant, 2) a new atoxic tubing with an Y form where one tubing (Segment A, when connected with the Butterfly G19) collects blood and the other (Segment B) is used for insufflating sterile-filtered O -O via an antibacterial (0.2 micron), 2 3 hydrophobic ozone-resistant filter. As one can see in the Figure 5, both Segment A and B are connected to Segment C, which carries firstly blood and then gas inside the glass bottle, 3) a standard tubing (Blood filter) that is used, firstly for infusing saline and, secondly, for returning the ozonated blood to the donor. In this way, we perform only one venous puncture because, while we carry out the ozonation of blood, the patient receives a slow infusion of saline. It is important that the exposure of blood to the gas mixture lasts at least 5 min because mixing of blood MUST be gentle to avoid foaming. Because blood is very viscous, it takes 5-10 min to achieve a complete and homogenous equilibrium. It can be noted that the pO slowly 2 reaches supraphysiological values (up to 400 mmHg) and then it remains constant: on the other hand, ozone progressively dissolves in the water of the plasma but then reacts instantaneously with biomolecules so that the entire 38 The Actual Six Therapeutic Modalities ozone dose is practically exhausted within 10 min. The visible clamps in Segments A, B and C are open or shut throughout the procedure for allowing the passage of blood and gas without losing the vacuum. The ozonetherapist must follow this procedure for avoiding either negative effects on the patients, or being found guilty of medical malpractice. I can assure the ozonetherapist that, after a preliminary experience, this procedure apparently complicate is indeed easy, rapid and clean. Figure 5. A schematic drawing of the components necessary to perform the ozonated