A Case of Cellulitis Treated with Marmorek's Antistreptococcic Serum
Authors: F. Heatherley
Journal: BMJ (1895)

counting all cases of sarcomata in which the mixed toxins have been used, we find 38 cases with 9 cures.The toxins prepared in the way last stated represent the present method of dealing with these cases.I am aware that Coley9 has treated several cases with blood serum obtained from animals inoculated with the two organisms under dis- cussion, but I am informed by my friend Dr. Parker (Clifton) that Dr. Coley has told him that the results are unsatisfactory.The following is a brief record of a case which I treated unsuccessfully in this way, the toxins being obtained from America, where they had been prepared according to Coley's directions.G. K.. aged 48, had the right upper jaw removed on April 10th, 1894, for malignant disease.Microscopical examination of the growth showed it to be round-celled sarcoma.On December 3rd, 1894 he again came under my care with a recurrence, and the remainder of the malar bone and part of the zygoma were removed.On June 2nd, 1895, he was admitted to the Bristol Royal Infirmary for the third time.There was then a large re- current sarcomatous growth occupying the whole of the right cheek, and extending into the orbit and towards the bake of the skull.There were enlarged lymphatic glands in front of the right ear, in the right submaxillary region, and at the angle of the jaw.There was also a secondiry subperiosteal deposit in the frontal region immediately above the root of the nose.On June 3rd, injections with the toxins were commenced and continued until July 9th.In all the patient had twenty- eight injections, which at first were given daily.The quan- tity of injection used was gradually increased from nl j up to mnxviij, according to the effect produced.The first eleven in- jectioDs were given either under the healthy skin, or into the affected cheek or glands.utij into the cheek was the smallest dose which produced a rise in temperature.but as no temperature reaction followed the injection of invij under the healthy skin, all the later injections were given either into the affected cheek or lymphatic glands.The maximum temperature recorded was 163.80 F. Rigors frequently fol- lowed the injections.The details are as follows: June 4th.mi injected into affected cheek.One hour afterwards com- plained of feeling cold but there was no rise of temperature.June 8th.miiij injected into gland in front of ear, followed by rigor, and temperature rose to 100°.Complained of severe burning pain in throat, and was very restless.June 10th.miiiv iujected into gland in front of ear, followed by rigor and temperatuv e of 101.80.Centre of affected cheek had become softer and more prominent, and on the following day the skin ' broke," and pus was discharged.June 12th.mytv injected into cheek.There was a slight rigor but no rise of temperature occurred.Complained that it "made him feel ill."The gland in front of the ear was found to be fluctuating.June 15th.mvj injected into cheek.Two hours afterwards had head- ache (which was an usual result), tollowed by muscular pains in limbs.Vomited twice.June 20th.msj injected into cheek.No rigor had occurred since June i2th.The discharge from the cheek still continuing.Several other parts of the growth where inje tions had been given were softening, and some appeated less in size.Patient had lout 2 lbs. in weight since admission.June 27th.lltxiv inje ted into gland at angle of jaw.Temperature rose to 101.80.June 28th.mitxv injer'ted into gland in front of ear, followed by rigor and temperature of 1030 Patient lhad lost another I lb. in weight.Feels weak and ill.Gland at angle of jaw rather larger, but softer.(Tland in front of ear and secondary deposit on forehead both smaller and softer.