BACTERIAL INOCULATION 303 



Coley's fluid, so-called, is a mixed bacterin of the 

 streptococcus of erysipelas and the Bacillus prodigi- 

 osus. It is indicated (1) in all cases of inoperable 

 sarcoma, excepting the melanotic type; (2) for two 

 or three weeks even in operable cases, if there be a 

 chance of saving a limb, that is when the giant-celled 

 type of tumor exists; (3) as a prophylactic against 

 recurrence after operation, and (4) post-operatively, 

 even against carcinomatous recurrence. Apparently, 

 a large number of properly selected cases have been 

 cured by administering daily inoculations, starting 

 with one-quarter minim in the gluteal or pectoral 

 region, and increasing the size of the dose one-quarter 

 minim daily until a reaction is evoked, that is a tem- 

 perature of 102° to 104° F. The dosage must not be 

 increased and may have to be diminished on the super 

 vention of reaction. It is recommended that the inocu- 

 lations be made subsequently in the tumor if the pa- 

 tient be not too susceptible. The initial tumor in- 

 jection should be only one-quarter of the previous 

 inoculation into the gluteal or pectoral region. Coley 

 states that carcinoma is not influenced by the treat- 

 ment. In the treatment of 430 cases of inoperable 

 sarcoma he reports 47 cases of complete cure, in 28 

 of which there was no recurrence for three to fifteen 

 years. He asserts that as a prophylactic after opera- 



