Streptococcus Pyogenes 303 



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. 



Coley's Mixture. The clinical observation that occa- 

 sional accidental erysipelatous 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. 



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 f5ss 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 

 sometimes 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 still recommends 

 it and Czerny upholds it, the majority of surgeons have failed 

 to secure the desired results. 



Antistreptococcus Serum. Since 1895 considerable at- 

 tention has been bestowed upon the antistreptococcus serum 

 of Marmorekf and Gromakowsky,t which is said to act 

 specifically upon streptococcus infections, both general and 

 local. Numerous cases of suppuration, septic infection, 



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



t "Ann. de 1'Inst. Pasteur," t. ix, No. 7, July 25, 1895, p. 593. 



J Ibid. 



