The therapeutic value of the mixed toxins of the streptococcus of erysipelas and bacillus prodigiosus in the treatment of inoperable malignant tumors : with a report of one hundred and sixty cases / by William B. Coley.

  • Coley, William Bradley, 1862-1926.
Date:
1896
Catalogue details

Licence: Public Domain Mark

Credit: The therapeutic value of the mixed toxins of the streptococcus of erysipelas and bacillus prodigiosus in the treatment of inoperable malignant tumors : with a report of one hundred and sixty cases / by William B. Coley. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    the growth, and in some cases to diminish the size. The‘solution was so weak that it required very large doses, 2 to 4 c.c., to produce much reaction. In order to increase the virulence of the cultures and the strength of the toxins I made use of the principle demonstrated by Roger, of Paris, that the bacillus prodigiosus, a non-pathogenic organism, has the power to intensify certain pathogenic germs, notably erysipelas. As far as I am aware, no one had tried a combination of erysipelas streptococcus with any other germ, or their mixed toxins in the human being, nor had the idea ever been suggested in connection with the treatment of malignant tumors. With the valuable aid of Dr. Alexander Lambert, at that time Fellow in Bacteriology at the College of Physicians and Surgeons, a filtrate containing the soluble toxic products of the strepto- coccus of erysipelas (obtained from a fatal case) and another containing the soluble products of the bacillus prodigiosus were prepared. These solutions were sterilized by filtration without the use of heat, and pre- served in glass-stoppered bottles by the addition of thymol crystals. The two solutions were mixed at the time of using in about the pro- portion of one part of the bacillus prodigiosus toxin to four or five parts of the erysipelas-toxin. The reaction that followed was much more severe — a chill coming on in one-half hour to an hour after the in- jection, and lasting fifteen to forty-five minutes. Nausea, vomiting, severe headache, with temperature 103° to 104°, usually followed an injection of up ij to iv of the bacillus prodigiosus toxins, with np viij to xvj of the erysipelas-toxins. The reaction and disagreeable symp- toms usually subsided within twelve hours, but not infrequently a marked herpes labialis followed. The effect upon the tumors was much more marked than when the erysipelas-toxins alone were used. A little later, at the suggestion of Mr. B. H. Buxton, Director of the Loomis Laboratory (without whose untiring zeal and unremitting assist- ance during the past three years much of this work would have been impossible), the two germs were grown together in the same broth, the erysipelas streptococcus being first grown alone for ten days, the prodigi- osus-toxin then added, and the two allowed to grow together for ten days. The results showed this to be a further improvement in technique. Two years ago I made another change, with a vieAV to utilize whatever of value might exist in the toxins contained in the dead germs themselves. The cultures were heated to a temperature sufficient to render them sterile (which was found to be 58° to 60° C.) for one hour, and then used without filtration. This preparation proved to be by far the strongest, and experience has shown it to be superior to the filtered solution in its action upon malignant tumors. The v^-lue of all the preparations of the toxins has been found to depend largely upon the virulence of the original cultures employed, and in the successful cases the. toxins were all made from cultures obtained from