Chapter 1: Bloodletting and Malariatherapy: Treatment Methods of the Past 3
According to one researcher, “[p]atients who develop the progressive paralysis and
dementia face one of mankind’s most terrible diseases.”12
These symptoms, often termed general paresis, result from a gradual loss of cortical
function that may occur 10 to 20 years after an initial infection of syphilis in untreated
patients. Patients suffering from these symptoms are deemed “paretics.”
The Mechanisms for Fever
There is no clear answer as to why fever may benefit paretics’ treatment. Some authors
claim proteinaceous materials and vaccine-induced fevers are detrimental to the spiro-
chetes that cause syphilis.
Others suggest even low-grade fevers will improve paresis without having a clear
understanding of the cause and effect for inducing fever.13 Another theory is a malaria-
induced fever can cause alterations in the body’s immunity or biochemistry.
Authors have argued induced fevers do not “cook” the organisms, because their
thermal death point is about 41˚–42˚ C or higher for six hours. These temperatures are
too high for patients to bear.14
Why Use Malaria?
Fever therapy was employed because drugs used to treat syphilis had been ineffective.
Professor Wagner-Jauregg, in Vienna, may have been the first physician to treat syphilitic
general paralysis of the insane (GPI) with malaria-induced fever. He was awarded the
Nobel Prize in 1927 for his research.
Prior to this, GPI had been a killer. About 10% of all patients in mental hospitals in
Britain were victims of the disease, and most would die a wretched, lingering death.15
Malaria initially was induced by administering venous blood from malaria-infected
patients. Serious hazards were encountered due to a lack of awareness of certain human
malaria parasites’ lethal effects.
Colonel S. P. James, the first director of the Horton Laboratory in Britain, proposed
a criterion to be met before a parasite strain could be considered safe for use in man.
He was quite successful. His laboratory provided material for many thousands of GPI
victims and some 16,000 patients in the Horton Hospital alone.16
All three species of human malaria (excluding the later accepted Plasmodium ovale)
were available for therapeutic use in the 1920s: P. malariae, P. falciparum and P. vivax.
The latter became the most widely used in malariatherapy, primarily because the infec-
tion was treated easily with quinine, and transmission by mosquito (used later) was
relatively simple.17
There is no question about malariatherapy’s efficacy. It spared thousands of paretics
from horrible effects and premature death.18
However, with the advent of penicillin in the mid-1940s, it was obvious malaria-
therapy was being replaced slowly but inevitably. The final curtain, however, did not
come down in Britain until the 1970s, and combined therapy with penicillin, once com-
mon in the US, ceased in the mid-1960s.19,20
When combination therapy was used, the two treatments were given concurrently
or in succession. The basic course consisted of 3–10 million units of penicillin with a
short course of fever therapy.21
According to one researcher, “[p]atients who develop the progressive paralysis and
dementia face one of mankind’s most terrible diseases.”12
These symptoms, often termed general paresis, result from a gradual loss of cortical
function that may occur 10 to 20 years after an initial infection of syphilis in untreated
patients. Patients suffering from these symptoms are deemed “paretics.”
The Mechanisms for Fever
There is no clear answer as to why fever may benefit paretics’ treatment. Some authors
claim proteinaceous materials and vaccine-induced fevers are detrimental to the spiro-
chetes that cause syphilis.
Others suggest even low-grade fevers will improve paresis without having a clear
understanding of the cause and effect for inducing fever.13 Another theory is a malaria-
induced fever can cause alterations in the body’s immunity or biochemistry.
Authors have argued induced fevers do not “cook” the organisms, because their
thermal death point is about 41˚–42˚ C or higher for six hours. These temperatures are
too high for patients to bear.14
Why Use Malaria?
Fever therapy was employed because drugs used to treat syphilis had been ineffective.
Professor Wagner-Jauregg, in Vienna, may have been the first physician to treat syphilitic
general paralysis of the insane (GPI) with malaria-induced fever. He was awarded the
Nobel Prize in 1927 for his research.
Prior to this, GPI had been a killer. About 10% of all patients in mental hospitals in
Britain were victims of the disease, and most would die a wretched, lingering death.15
Malaria initially was induced by administering venous blood from malaria-infected
patients. Serious hazards were encountered due to a lack of awareness of certain human
malaria parasites’ lethal effects.
Colonel S. P. James, the first director of the Horton Laboratory in Britain, proposed
a criterion to be met before a parasite strain could be considered safe for use in man.
He was quite successful. His laboratory provided material for many thousands of GPI
victims and some 16,000 patients in the Horton Hospital alone.16
All three species of human malaria (excluding the later accepted Plasmodium ovale)
were available for therapeutic use in the 1920s: P. malariae, P. falciparum and P. vivax.
The latter became the most widely used in malariatherapy, primarily because the infec-
tion was treated easily with quinine, and transmission by mosquito (used later) was
relatively simple.17
There is no question about malariatherapy’s efficacy. It spared thousands of paretics
from horrible effects and premature death.18
However, with the advent of penicillin in the mid-1940s, it was obvious malaria-
therapy was being replaced slowly but inevitably. The final curtain, however, did not
come down in Britain until the 1970s, and combined therapy with penicillin, once com-
mon in the US, ceased in the mid-1960s.19,20
When combination therapy was used, the two treatments were given concurrently
or in succession. The basic course consisted of 3–10 million units of penicillin with a
short course of fever therapy.21