SUPPURA T/OJV. 261 



infection of malignant tumors with erysipelas cocci was 

 followed by sloughing and subsequent disappearance of 

 the tumor, suggested inoculation with the Streptococcus 

 erysipelatis as a therapeutic measure. The dangerous 

 character of the remedy, however, caused many to re- 

 frain from its use, for when one inoculated the living 

 erysipelas germs into the tissues he never could estimate 

 the exact amount of disturbance that would follow. The 

 difficulty seems to have been overcome by Coley, who 

 recommends the toxin instead of the living coccus for 

 injection. A virulent culture is obtained, inoculated 

 into small flasks of slightly acid bouillon, allowed to 

 grow for three weeks, then reinoculated with Bacillus 

 prodigiosus, allowed to grow for ten or twelve days at 

 the room-temperature, well shaken up, poured into bottles 

 of about f 3ss capacity, and rendered perfectly sterile by an 

 exposure to from 50-60 C. for an hour. It is claimed 

 that the combined toxins of erysipelas and prodigiosus 

 are much stronger than the simple erysipelas toxin. The 

 best effects are found in cases of sarcoma, where the 

 toxin causes a rapid necrosis of the tumor tissue, which 

 can be scraped out with an appropriate instrument. 

 Numerous cases are on record in which this treatment 

 has been most efficacious ; but, although Coley recom- 

 mends it and Czerny still upholds it, the majority of sur- 

 geons have failed to secure the desired results. 



Recently (1895) considerable attention has been be- 

 stowed upon the anti-streptococcus serum of Marmorek, 

 which is said to act specifically upon cases of strepto- 

 coccus-infection, both general and local. Numerous 

 cases are upon record in which the serum seemed to exert 

 a beneficial action. 



It would seem as if an antiphlogistic serum should 

 occupy an important place in the future of medicine. 



The serum is prepared upon the same plan as that of 

 Behring, except that living virulent streptococci instead 

 of the sterile toxin are injected into the horse. 



