Malaria Fever Therapy for General Paralysis of the Insane: A Historical Cohort Study

Abstract

Background/Aims: This year marks the 100th anniversary of the first malaria fever treatment (MFT) given to patients with general paralysis of the insane (GPI) by the Austrian psychiatrist and later Nobel laureate, Julius Wagner-Jauregg. In 1921 Wagner-Jauregg reported an impressive therapeutic success of MFT and it became the standard treatment for GPI worldwide. In this study, MFT practice in the Dutch Vincent van Gogh psychiatric hospital in GPI patients who had been admitted in the period 1924-1954 is explored. Methods: To identify patients with GPI, cause-of-death statistics was used. Data on MFT were retrieved from annual hospital reports and individual patient records. Results: Data on MFT were mentioned in the records of 43 out of 105 GPI patients. MFT was practiced in a wide range of patients with GPI, including those with disease duration of more than 1 year, up to 70 years of age, and those with a broad array of symptoms and comorbidities, such as (syphilitic) cardiac disease. Inoculation with malaria was done by patient-to-patient transmission of infected blood. Conclusions: MFT practice and mortality rates in MFT-treated patients correspond to similar findings worldwide. MFT was well tolerated and MFT-treated patients had a significantly longer survival.

The mechanisms of action of Plasmodium infection against cancer

“…Such a location selection has profoundly reduced the possibility of malaria transmission. This can be corroborated by the fact that hundreds of thousand patients with neurosyphilis received the treatment of malaria therapy [33][34][35] without any documented malaria transmissions throughout the period of 1917-1960s. The second line of defense is the process of professional environmental evaluation for our collaborative hospitals, a surveillance of the environment within hospital and around for Anopheles genus during the peak season of mosquito activity was carried out, and only those hospitals without any Anopheles mosquitos were qualified for the clinical trials.…”

Malaria in Europe: A Historical Perspective

“…Epidemiological studies assessing the relationship between ABO blood grouping and malaria susceptibility indicate that individuals with group O are significantly protected against severe P. falciparum malaria (118)(119)(120).This is explained by the significant reduction in the cytoadherence of red blood cells, which is responsible for severe malaria syndromes, in individuals with group O compared to individuals with other groups (121,122). Another grouping system most frequently used in the case of malaria is the Duffy system, and represents the presence or absence of Fy antigens (Fy a and Fy b) on the surface of red blood cells; these antigens are considered receptors for the parasites Chronic syphilitic meningoencephalitis causes a fatal progressive degeneration of the central nervous system known as general paralysis (111,112). In the absence of any known effective treatment, Julius Wagner-Jauregg first used so-called malariotherapy in Vienna on June 14, 1917 (113).…”

“…Chronic syphilitic meningoencephalitis causes a fatal progressive degeneration of the central nervous system known as general paralysis ( 111 , 112 ). In the absence of any known effective treatment, Julius Wagner-Jauregg first used so-called malariotherapy in Vienna on June 14, 1917 ( 113 ).…”

A social history of serious mental illness

“…44 Even although this procedure killed 3% to 20% of patients (records were poorly kept), the desperation and inevitable death of end-stage syphilis justified the treatment at the time. 45 Notwithstanding, the lack of controlled trials of the procedure and uncertain prognosis of GPI clouds the certainty of success. 42 It was not necessarily the harm caused by pyrotherapy in GPI itself that is the lesson.…”