1891

NY Surgeon William Coley intentionally infects a patient with a sarcoma of the neck with erysipelas, the first instance of “nonspecific immunotherapy” that initiated “the American era of cancer immunotherapy” (Hall, 51ff.). Between 1891 and 1893, he attempted to infect 12 patients, two of whom died from the infections. In 1893, abandoning the use of live bacteria, he treated hopeless sarcomas with a “mixed toxin” of Streptococcus pyogenes (erysipelas) and Bacillus prodigiosus (believed to increase the virulence of the erysipelas germ) filtered through microscopic pores of porcelain that strained out the microbes; he believed the resulting fluid contained the active principle, “Coley’s toxins,” that shrunk and lysed sarcomas (61-67). His first case – a 16-year-old boy with inoperable abdominal tumor – resulted in permanent cure (66-67). Coley’s approach to treating bone sarcomas was abandoned following discovery of x-ray and advent of radiation therapy, endorsed by his colleague and subsequent chief, pathologist James Ewing, who turned against Coley by 1912 (83) and became president of Memorial’s Medical Board in 1913 when it became affiliated with Cornell Medical College (85). Ewing undermined Coley’s reputation at Memorial and “never passed up a public opportunity to express reservations about the bacterial vaccines and . . . came to articulate the major criticism of Coley’s toxins: that all of Coley’s cures were in fact misdiagnosed cases of diseases other than sarcoma. It took considerable gumption for Ewing to press this brief, for a number of those original diagnoses had been microscopically confirmed by Ewing himself when he served as chief pathologist at the Loomis Laboratory” (86).