266 Wound Infection; Suppuration 



of the nutrient media hinders its formation, and that it is 

 intimately associated with the bodies of the streptococci 

 by which it is produced, so that in the sediment obtained by 

 nitration or by centrifugation there is nearly one thousand 

 times as much as in the filtered fluid culture. The strepto- 

 kolysin is not destroyed by the death of the bacteria. An- 

 tistreptokolysin is present in antistreptococcus serum. 



Toxic Products. The toxic products of the strepto- 

 coccus are not well known. Cultures from different sources 

 vary greatly in the effects produced by hypodermic or intra- 

 venous injection after filtration through porcelain. Killed 

 cultures produce a much more marked effect than filtered 

 ones. 



In general the effects of streptococcus intoxication are 

 vague. The animals appear weak and ill, and have a 

 slight fever; but unless the virulence of the culture be 

 exceptional or the dose very large, they usually recover in 

 a short time. 



The clinical observation that occasional accidental ery- 

 sipelatous infection of malignant tumors is followed by 

 sloughing and the subsequent disappearance of the tumor, 

 suggested the experimental inoculation of such tumors with 

 Streptococcus erysipelatis as a therapeutic measure. The 

 danger of the remedy, however, caused many to refrain from 

 its use, for when one inoculates the living erysipelas germs 

 into the tissues it is impossible to estimate the exact amount 

 of disturbance that will follow. 



Coley's Mixture. To overcome this difficulty Coley* has 

 recommended that the toxin instead of the living coccus be 

 used for injection. A virulent culture of the streptococcus 

 is obtained, by preference from a fatal case of erysipelas, 

 inoculated into small flasks of slightly acid bouillon, and 

 allowed to grow for three weeks. The flask is then rein- 

 oculated with Bacillus prodigiosus, allowed to grow for 

 ten or twelve days at the room temperature, well shaken 

 up, poured into bottles of about f Sss capacity, and rendered 

 perfectly sterile by an exposure to a temperature of 

 5o-6o C. for an hour. It is claimed that the com- 

 bined products of the streptococcus of erysipelas and 

 Bacillus prodigiosus are much more active than a simple 

 streptococcus culture. The best effects follow the treatment 

 of cases of inoperable spindle-cell sarcoma, where the toxin 



*"Amer. Jour. Med. Sci.," July, 1894. 



