Malaria therapy in Spain: 100 years after its introduction as a treatment for the general paralysis of the insane

This article addresses the implementation of malaria fever therapy in Spain. Neuropsychiatrist Rodríguez-Lafora first used it in 1924, but Vallejo-Nágera was the main advocate for the technique. He had learned the method from Wagner von Jauregg himself, and he worked in the Military Psychiatric Clinic and the San José Mental Hospital, both in Ciempozuelos (Madrid). Vallejo-Nágera worked with the parasitologist Zozaya, who had travelled to England with a Rockefeller Foundation grant in order to learn from British malariologist, Sydney Price James. This article details the results of the uneven implementation of this treatment in Spanish psychiatric institutions. Although syphilologists and internists used fever therapy for the treatment of general paralysis of the insane, they were much less enthusiastic than psychiatrists.

Fever Therapy With Intravenously Applied Mistletoe Extracts for Cancer Patients: A Retrospective Study

Purpose. So-called spontaneous remissions in cancer often seem to occur after febrile events. Mistletoe preparations (MPs) are used off-label intravenously to induce fever within concepts of integrative oncology. We wanted to investigate the frequency of febrile reactions and safety related to intravenously applied MPs (IAMPs). Methods. This was a retrospective analysis of data from consecutive cancer patients who were treated in 2 anthroposophic hospitals with IAMPs. The main outcome parameter was the rate of core temperature increase to ≥38.5°C within 24 hours after IAMPs. Secondary outcome parameters were Common Toxicity Criteria for Adverse Events (CTCAE; version 4.0). Results. 59 patients, with in total 567 IAMPs, were analyzed; 45 patients (76%, 95% CI = 65%-87%) had an increase of core temperature to ≥38.5°C after at least 1 treatment. Mean increase in temperature was 1.5°C ± 0.8°C. Adverse events were mostly fever-related symptoms (headache, joint pain, shivering). Grade 1 allergic reactions were documented in 0.6% of treatments. CTCAEs grade 3 to 5 did not occur; 38/59 patients had advanced and/or metastatic disease. Conclusion. IAMPs resulted in febrile reactions to >38.5°C in the majority of patients and can be considered as safe. Adverse events were mostly related to fever and were not severe.

Wahnsinn und Malaria – Schnittpunkte und Grenzverwischungen zwischen Psychiatrie und Tropen medizin in Hamburg (1900–1925)

The object of this article is to point out and to discuss the significant intersections and boundary blurring between psychiatry and tropical medicine while treating malaria in the German «colonial metropolis» Hamburg. The focus of this study is the Hamburg asylum at Friedrichsberg and the Institute for Maritime and Tropical Diseases (Hamburg Tropical Institute). Under analysis are two groups of patients as well as the means with which their doctors treated them: 1. patients who have been sent back from the German colonies in Africa after mental disorders had been diagnosed, and 2. patients suffering from general paralysis and treated in Friedrichsberg after 1919 using the then newly developed malaria fever therapy (according to Wagner-Jauregg). The implementation of this latter led to an intensification of the cooperation between psychiatry and tropical medicine in Hamburg which prior to this had been only very sporadic.

A Moral/Ethical History of American Psychiatry

This article examines the moral/ethical dimensions of psychiatric practice in the United States. It begins with a historical overview of American psychiatry, from the establishment of mental hospitals and asylums to the emergence of institutionalization and the theory of moral treatment. It then turns to a discussion of nineteenth-century initiatives calling for an end to dual responsibility and for the state to assume sole responsibility for persons with severe mental disorders. It also looks at the rise of dynamic psychiatry in the early twentieth century, along with the mental hygiene movement and the introduction of novel therapies such as fever therapy, insulin, metrazol, lobotomy, psychosurgery, and electric shock therapies. Finally, the article considers the transformation of American psychiatry during and after World War II.