STREPTOCOCCUS PYOGENES. 485 
cases has been largely carried out by or under the 
direction of Dr. Coley. He has kindly sent me the 
following notes on his results : 
‘¢ The improvement and inhibitory action which the 
toxins have upon carcinoma have proved to be, in 
nearly all cases, but temporary, and in no case has 
the disease remained in abeyance sufficiently long to be 
regarded as cured. 
‘On the other hand, in sarcoma, which is the only 
form of malignant tumor in which I have advocated 
the treatment, sufficient time has elapsed to enable us 
to draw the following conclusions : 
‘¢ The toxins injected subcutaneously into the tissues, 
either into the tumor substance or into parts remote 
from the tumor, exercise a distinctly inhibitory action 
upon the growth of all varieties of sarcoma. This 
action is the least marked in melanotic sarcoma, and 
thus far no cases of this form of tumor have disap- 
peared under the treatment. The influence of the 
toxins upon round-celled sarcoma is much more pow- 
erful than it is upon melanotic, although distinctly less 
than upon the spindle-celled variety. A number of 
cases of round-celled sarcoma in which the diagnosis 
was unquestioned disappeared, and the patients have 
remained well beyond three years. Nearly half of the 
cases treated showed no appreciable decrease in size; the 
majority of the others which did show marked improve- 
ment at first, after decreasing in size for a few weeks, 
again began to increase and were no longer influenced 
by the treatment. 
“In half of the cases of spindle-celled sarcoma 
treated by the toxins the disease has disappeared 
entirely, and the majority of the successful cases have 
