Artificial Fever
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Pyrotherapy (artificial fever) is a method of treatment by raising the
body temperature Thermoregulation is the ability of an organism to keep its body temperature within certain boundaries, even when the surrounding temperature is very different. A thermoconforming organism, by contrast, simply adopts the surrounding temperature ...
or sustaining an elevated body temperature using a
fever Fever or pyrexia in humans is a symptom of an anti-infection defense mechanism that appears with Human body temperature, body temperature exceeding the normal range caused by an increase in the body's temperature Human body temperature#Fever, s ...
. In general, the body temperature was maintained at 41 °C (105 °F). Many diseases were treated by this method in the first half of the 20th century. In general, it was done by exposing the patient to hot baths, warm air, or (electric) blankets. The technique reached its peak of sophistication in the early 20th century with malariotherapy, in which ''
Plasmodium vivax ''Plasmodium vivax'' is a protozoal parasite and a human pathogen. This parasite is the most frequent and widely distributed cause of recurring malaria. Although it is less virulent than ''Plasmodium falciparum'', the deadliest of the five huma ...
'', a causative agent of
malaria Malaria is a Mosquito-borne disease, mosquito-borne infectious disease that affects vertebrates and ''Anopheles'' mosquitoes. Human malaria causes Signs and symptoms, symptoms that typically include fever, Fatigue (medical), fatigue, vomitin ...
, was allowed to infect already ill patients in order to produce intense fever for therapeutic ends. The sophistication of this approach lay in using effective anti-malarial drugs to control the ''P. vivax'' infection, while maintaining the fever it causes to the detriment of other, ongoing, and then-incurable infections present in the patient, such as late-stage
syphilis Syphilis () is a sexually transmitted infection caused by the bacterium ''Treponema pallidum'' subspecies ''pallidum''. The signs and symptoms depend on the stage it presents: primary, secondary, latent syphilis, latent or tertiary. The prim ...
. This type of pyrotherapy was most famously used by psychiatrist
Julius Wagner-Jauregg Julius Wagner-Jauregg (; 7 March 1857 – 27 September 1940) was an Austrian physician, who won the Nobel Prize in Physiology or Medicine in 1927, and is the first psychiatrist to have done so. His Nobel award was "for his discovery of the therape ...
, who won the
Nobel Prize for Medicine The Nobel Prize in Physiology or Medicine () is awarded yearly by the Nobel Assembly at the Karolinska Institute for outstanding discoveries in physiology or medicine. The Nobel Prize is not a single prize, but five separate prizes that, accor ...
in 1927 for his elaboration of the procedure in treating neurosyphilitics.


Use

Wagner-Jauregg’s 1917 treatment method, also known as malariotherapy, involved the introduction of ''
Plasmodium vivax ''Plasmodium vivax'' is a protozoal parasite and a human pathogen. This parasite is the most frequent and widely distributed cause of recurring malaria. Although it is less virulent than ''Plasmodium falciparum'', the deadliest of the five huma ...
''
malaria Malaria is a Mosquito-borne disease, mosquito-borne infectious disease that affects vertebrates and ''Anopheles'' mosquitoes. Human malaria causes Signs and symptoms, symptoms that typically include fever, Fatigue (medical), fatigue, vomitin ...
via injection into patients with advanced stages of
syphilis Syphilis () is a sexually transmitted infection caused by the bacterium ''Treponema pallidum'' subspecies ''pallidum''. The signs and symptoms depend on the stage it presents: primary, secondary, latent syphilis, latent or tertiary. The prim ...
. Advanced syphilitic infection can invade the brain causing
neurosyphilis Neurosyphilis is the infection of the central nervous system by '' Treponema pallidum'', the bacterium that causes the sexually transmitted infection syphilis. In the era of modern antibiotics, the majority of neurosyphilis cases have been report ...
, affecting neural performance and function, which can in turn lead to
general paresis of the insane General paresis, also known as general paralysis of the insane (GPI), paralytic dementia, or syphilitic paresis is a severe neuropsychiatric disorder, classified as an organic mental disorder, and is caused by late-stage syphilis and the chr ...
(GPI), a severely debilitating mental disorder. Doing so induced high-grade (103 °F, 39.4 °C or above) fever that was easily sustainable to eradicate invading spirochaetal bacterium ''
Treponema pallidum ''Treponema pallidum'', formerly known as ''Spirochaeta pallida'', is a Microaerophile, microaerophilic, Gram-negative bacteria, gram-negative, spirochaete bacterium with subspecies that cause the diseases syphilis, bejel (also known as endemic ...
,'' the pathogen responsible for syphilitic infection. Successive rounds of treatment were required to fully eradicate the infectious bacteria, while simultaneously using
quinine Quinine is a medication used to treat malaria and babesiosis. This includes the treatment of malaria due to ''Plasmodium falciparum'' that is resistant to chloroquine when artesunate is not available. While sometimes used for nocturnal leg ...
to treat the malaria infection. Management of the fevers was risky as malaria fevers can sometimes cause death, but syphilis was a proliferate and terminal disease at the time with no other viable treatment. This procedure was used to treat syphilis until
penicillin Penicillins (P, PCN or PEN) are a group of beta-lactam antibiotic, β-lactam antibiotics originally obtained from ''Penicillium'' Mold (fungus), moulds, principally ''Penicillium chrysogenum, P. chrysogenum'' and ''Penicillium rubens, P. ru ...
was found to be a safer, more effective measure in the 1940s. The
general paresis of the insane General paresis, also known as general paralysis of the insane (GPI), paralytic dementia, or syphilitic paresis is a severe neuropsychiatric disorder, classified as an organic mental disorder, and is caused by late-stage syphilis and the chr ...
caused by
neurosyphilis Neurosyphilis is the infection of the central nervous system by '' Treponema pallidum'', the bacterium that causes the sexually transmitted infection syphilis. In the era of modern antibiotics, the majority of neurosyphilis cases have been report ...
was effectively overcome by the method. Pyrotherapy was also employed in
psychiatry Psychiatry is the medical specialty devoted to the diagnosis, treatment, and prevention of deleterious mental disorder, mental conditions. These include matters related to cognition, perceptions, Mood (psychology), mood, emotion, and behavior. ...
. Of note here is the use of
sulfozinum Sulfozinum (sulfazin) is a pharmaceutical drug that causes a pyrogenic reaction (body temperature elevation) and severe pain. Sulfozinum is a 0.37 – 2% sterilized solution of purified elemental sulfur in peach oil or olive oil for intramuscul ...
and pyrogenal that was relatively widespread in
Soviet psychiatry This list of Russian physicians and psychologists includes the famous physicians and psychologists, medical scientists and medical doctors from the Russian Federation, the Soviet Union, the Russian Empire and other predecessor states of Russia. P ...
. Against
schizophrenia Schizophrenia () is a mental disorder characterized variously by hallucinations (typically, Auditory hallucination#Schizophrenia, hearing voices), delusions, thought disorder, disorganized thinking and behavior, and Reduced affect display, f ...
"Saprovitan" and "Pyrifer" were tried.Bangen, Hans: Geschichte der medikamentösen Therapie der Schizophrenie. Berlin 1992, Pages 32–37 Fiebertherapien .


Effectiveness

In 1921, Wagner-Jauregg reported impressive success and many other physicians attempting malaria induced pyrotherapy made similar claims. Later analyses have shown this might not have been true since approximately 60% would relapse within 2 years and 3–20% died from the resulting fevers. Significant consideration should be used here, as syphilis was considered deadly and without other treatment options pyrotherapy was used as a
heroic measure In the context of medicine, heroic measures refer to any courses of treatment or therapy aimed at saving or prolonging a person's life, despite the potential harm those treatments may cause. Heroic measures are almost always used in the scenario ...
.


Citations


General bibliography

* {{cite book , author=Braslow, Joel T. , title=Mental ills and bodily cures: Psychiatric treatment in the first half of the twentieth century , publisher=University of California Press , location=Berkeley , year=1997 , isbn=0-520-20547-2 History of medicine Therapy