The Malarial Treatment of General Paralysis; Some Psychological and Physical Observations

Numerous articles have appeared within the last few months in both Continental and English literature describing the value of the malarial treatment in cases of general paralysis. Thus Yorke and Macfie state that out of 84 general paralytics treated with malaria, 23 (or 27.4 per cent.) had been, or were about to be, discharged, at the time of writing, from the mental hospitals. Weygandt in 50 cases obtained good remissions in 48 per cent., and Kirschbaum in 51 in 58.8 per cent. Scripture states that in Wagner-Jauregg's clinic complete remissions were obtained in 44 per cent, out of 141 cases treated. This percentage of complete remissions is still being maintained, Gerstmann reporting recently that 40 per cent, show complete remissions with ability to work, 30 per cent, improvement, and 30 per cent, no improvement. If only early cases are treated Wagner-Jauregg states that nearly 100 per cent. of cures can be obtained. These figures compare very favourably with the percentage of spontaneous remissions recorded by Kirschbaum. This writer found that spontaneous remissions occurred in only 11.4 per cent. of untreated general paralytics. At present it is too early to make any definite statement with regard to the permanence of the remissions, although the three oldest successful cases in Wagner-Jauregg's clinic have now shown complete remissions for years.