Streptococcus Pyogenes 325 



cocci of different stocks had nothing to do with their virulence. 

 Simon* also found that the toxic products of the streptococcus were 

 diverse and pecuUar. The bodies of the cocci contained an intra- 

 cellular toxin the activity of which was independent of virulence. 

 This poison is liberated only when the bactericidal activities of the 

 body act upon the cocci. The cocci also excrete a toxic substance 

 whose activity is greater than that of the intracellular toxin, but 

 whose production is subject to great variation and is entirely in- 

 dependent of the intracellular toxin. The toxins and hemolysins 

 are entirely different bodies. 



In general, the effects of streptococcus intoxication are vague. 

 The animals appear weak and ill, and have a slight fever; but un- 

 less the virulence of the culture be exceptional or the dose very large, 

 they usually recover in a short time. 



Coley's Mixture.- — The chnical observation that occasional ac- 

 cidental erysipelatous infection of malignant tumors is followed 

 by sloughing and the subsequent disappearance of the tumor, 

 suggested the experimental inoculation of such tumors with Strep- 

 tococcus erysipelatis as a therapeutic measure. The danger of the 

 remedy, however, caused many to refrain from its use, for when one 

 inoculates the Hving erysipelas virus into the tissues it is impossible 

 to estimate the exact amount of disturbance that wiU follow. 



To overcome this difficulty Coleyf has recommended that the 

 toxin instead of the hving 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 bouillon, and allowed to grow for 

 three weeks. The flask is then reinoculated with Bacillus prodigiosus, allowed 

 to grow for ten or twelve days at the room temperature, well shaken up, poured 

 into bottle of about f §ss capacity, and rendered perfectly sterile by an exposure 

 to a temperature of 50° to 6o°C. for an hour. It is claimed that the combined 

 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 

 had 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 attention 

 has been bestowed upon the antistreptococcus serum of MarmorekJ 

 and Gromakowsky,§ which is said to act specifically upon strepto- 

 coccus infections, both general and local. Numerous cases of 

 suppuration, septic infection, puerperal fever, and scarlatina are 

 upon record in which the serum seems to have exerted a beneficial 

 action. 



The serum is prepared by the injection of cultures of living viru- 

 lent streptococci into horses, until a high degree of immunity is 



* "Centralbl. f. Bakt.," Jan. 16, 1904, xxxv. No. 4, p. 350. 

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

 I "Ann. de ITnst. Pasteur," July 25, 1895, rx. No. 7, p. 593. 

 § Ibid. 



