486 BACTERIOLOGY. 



remained well sufficiently long to justify their being 

 regarded as cured. It should be distinctly stated that 

 all of the tumors under consideration were inoper- 

 able, as I have never advised treatment except in such 

 cases. 



" It is a curious fact, from the stand-point of path- 

 ology, that the largest percentage of successful cases 

 has occurred in the spindle-celled variety, the very one 

 in which errors of diagnosis are practically impossible. 

 In addition to microscopical examinations by the best of 

 pathologists, the malignancy of the tumors was further 

 confirmed by the characteristic clinical appearances, 

 and in many cases by a history of repeated recurrences. 



' I have now three cases of spindle-celled sarcoma 

 which have remained well beyond three years; one case 

 of mixed (round and spindle) celled, which, after re- 

 maining well three and one-fourth years, had a return 

 in the abdomen, and died about eight months later. 

 This case certainly would establish the correctness of 

 the early diagnosis. J> 



Dr. Coley would be the first to acknowledge that 

 even the very moderate claims put forward in this 

 communication are disputed by many surgeons, they 

 claiming that the disappearance of the tumors is due 

 to other causes than the treatment. In spite, however, 

 of the treatment being frequently deleterious to the 

 general health, and the occurrence from time to time 

 of the spontaneous disappearance of apparently malig- 

 nant tumors, I think we must allow that the proof is 

 very strong that some sarcomatous tumors have been 

 arrested and caused to disappear by the toxin injec- 

 tions, and that where they are clearly inoperative and 

 progressing the treatment should be tried. 



