For what was malaria fever therapy used

With the benefit of modern hindsight, we might point out that compared to other mental illnesses GPI was highly unusual, since it was caused by an external pathogen infecting the brain. In asylums around the country, patients with schizophrenia, depression, mania, and hysteria were soon infected with a wide variety of fever-producing diseases. Some alienists even went so far as to inject malaria-infected blood through the skulls of schizophrenic patients directly into their brains.

Alas, pyrotherapy did not turn out to be the panacea that so many had hoped for. Though the fever cure mitigated the psychotic symptoms of GPI, it proved impotent against all other forms of mental illness. Since other disorders were not caused by pathogens, there was nothing for the fever to kill, except, occasionally, the patient.

Even so, the unprecedented effectiveness of pyrotherapy in treating GPI shined the first glimmer of light into the darkness that had dominated asylum psychiatry for over a century. Sakel had been treating drug addicts with low doses of insulin as a way of combatting opiate addiction. Often, heavy users of morphine and opium would exhibit extreme behaviors similar to mental illness, such as relentless pacing, frenetic movement, and disorganized thought.

Sakel noticed that when addicts were accidentally given higher doses of insulin, their blood sugar would drop precipitously, inducing a hypoglycemic coma that could last for hours at a time—but after they awoke, they were much calmer, and their extreme behavior had abated.

Sakel wondered: Might comas also relieve the symptoms of mental illness? Sakel began to experiment with artificially induced comas. He overdosed schizophrenic patients with insulin, which had recently been developed as a treatment for diabetes. The insulin overdose put them into a coma, which Sakel ended by administering intravenous glucose. After the patients regained consciousness, Sakel would wait a short while, then repeat the procedure. He would sometimes induce a coma in a patient six days in a row.

One side effect was that patients invariably became grossly obese, since insulin pushes glucose into cells. A far more permanent side effect was that a small number of patients never woke from the coma and died outright. The most salient risk was permanent brain damage. Malarial Therapy in Non-Syphilitic Psychoses. Br J Psychiatry [Archives of Neurobiology] ; Tarelow GQ. Cad Hist Cienc Inst Butantan ; Hospitals continuously maintained the malaria cycle in hospitalized patients, termed source patients.

Studies were made to preserve plasmodium in frozen or cooled blood samples, and hospitals established Anopheles gambiae farms to avoid source patients. The most suitable plasmodium was Plasmodium vivax due to its benign characteristic and high and regular cycles of fever that were necessary, as believed, for the treatment.

The real efficacy of malariotherapy for GPI or other mental diseases has never been analyzed under modern clinical epidemiology studies 3 3. However, the dissemination of the therapy among physicians and institutions was considered a guarantee that GPI patients, who used to be sentenced to death, would present a significant improvement or at least live longer. Nevertheless, it is important to highlight that at the time of Wagner-Jauregg, GPI was terrible and incurable and the notion that desperate maladies justify desperate remedies was an acceptable idea up to the end of the 2 nd World War 4 4.

With the development of bioethics and the establishment of ethical parameters for research involving human beings, the principle of non-maleficence started to be considered and required. After the introduction of penicillin, malariotherapy fell into disuse for GPI. In the early s however, another desperate malady affected the human population: acquired immunodeficiency syndrome AIDS started its devastating course.

Similar to what occurred with GPI, there was no available treatment and patients usually died within 2 years of the diagnosis. In spite of this and other antiviral drug advances in the following years, experiments using malariotherapy in HIV infected patients were carried out in the s and s in China with the participation of North American scientists and institutions. The first study was published in 10 Malariotherapy for HIV patients.

Mech Ageing Dev ; Using data from scientific papers about malariotherapy in patients with neurosyphilis, the authors justified the method by arguing that the therapy was widely used, safe, and did not cause resistance to HIV. The authors reported an increase in the number of cluster of differentiation 4 CD4 cells in two of eight patients after 2 years of follow-up. Two other papers reported similar results, also with Chinese patients 11 Chin Med J ; Impact of acute vivax malaria on the immune system and viral load of HIV-positive subjects.

The authors described the methodology in detail, such as the fact that the plasmodium inoculation used 10ml of heparinized whole blood from a malaria patient and that HIV patients were subjected to 10 cycles of fever.

Viral load measurements, CD4 counts and plasma cytokine concentrations were presented. Because the preclinical or clinical evidence justifying the research was not shown, these studies are comparable to the malariotherapy studies from the beginning of the 20 th century. Furthermore, it is known that HIV patients infected with plasmodium have worse outcomes compared to individuals without the co-infection.

Henry Judah Heimlich, the North American researcher who authored the first study mentioned above, had already been the object of another polemic in when he published a letter in the New England Journal of Medicine defending the use of malariotherapy in the treatment of patients with Lyme disease. In fact, in and , the Morbidity and Mortality Weekly Report published two articles about cases of induced malaria in New Jersey and Texas USA after a group of patients with late Lyme disease went to Mexico to undergo malariotherapy.

In 19th century, the eminent French psychiatrist Philippe Pinel, in his treatise on insanity referred to the beneficial effect of fever.

However, in , the Austrian neuro-psychiatrist Julius Wagner Jauregg pointed out the therapeutic value of malaria inoculation in the treatment of dementia paralytica. In , Wagner Jauregg received for this work the Nobel Prize in Medicine, being actually the first psychiatrist to win the Nobel Prize. He studied medicine at the University of Vienna and received his doctorate in In , he was appointed Professor of Psychiatry and Director of the Graz's Psychiatric Clinic, a position that he held until Working in the asylum, Wagner Jauregg noted that insane patients with general paralysis occasionally became sane after some febrile episode.

After experimenting with several artificial methods streptococci, tuberculin to induce fever, he concluded that malaria was the most satisfactory. Actually, malaria infection was an acceptable risk for the patients, as quinine would be administered as soon as syphilis was cured.