Medicine: Fever Therapy

With the holding of the First International Conference on Fever Therapy in Manhattan last week, a new medical art became of age. The French Government saluted the event by having its Consul General of New York, Count Charles de Ferry de Fontnouvelle confer membership in the Legion of Honor upon, four U. S. pioneers in the field—Willis Rodney Whitney, General Electric’s vice president who invented the radiotherm (high frequency electric device for creating artificial fevers in sick people); Charles Franklin Kettering, General Motors vice president, who designed the hypertherm (air-conditioned hot box in which sick people may develop artificial fever) ; Dr. Walter Malcolm Simpson of Dayton, Ohio, Mr. Kettering’s good friend who helped design the hypertherm, and who has written authoritatively on the use of artificial fevers in curing gonorrhea and early syphilis; and Dr. William Bierman of Manhattan, an early fever enthusiast who organized last week’s conference on fever therapy.

Also saluted for their applications of artificial fever to cure disease were these pioneers: Charles M. Carpenter & Stafford L. Warren of Rochester, N. Y., Clarence Adolph Neymann & Stafford Lennox Osborne of Evanston, Ill., Leland Earl Hinsie & Joseph Rogers Blalock of Manhattan.

Uses. Normal body temperature is 98.6° F. The body, however, can endure internal temperatures up to 107.5° F. without dying and at that high temperature will positively recover from an attack of gonorrhea; will usually recover from primary or secondary syphilis, especially if drugs containing arsenic are administered during the course of the fever treatment; will frequently recover from tertiary syphilis, including paresis.

Artificial fever has cured cases of St. Vitus’ dance, which developed after acute infection, in 16 days, whereas standard treatment used to require three months. Fever also benefits atrophic arthritis (but not hypertrophic, where the joints enlarge). Acute neuritic pains of rheumatism often cease after fever treatment. Asthma, when not due to allergy, improves under fever. So do many cases of rheumatic fever. Newest field for fever experiment is treatment of cerebro-spinal meningitis.

Methods. Artificial fever is created by: hot water baths (dangerous, because the patient may sweat too much); high frequency diathermy (patient lies between two electrodes connected to a 500,000 cycle-per-second high frequency current) ; Whitney’s radiotherm (patient lies in a high frequency field of 20 to 50 million cycles per second, developed by radio tubes); electric blankets (heated by resistance coils); hot boxes (heated by electric radiators or light bulbs); Kettering’s hypertherm (a fan blows hot, humid air upon the patient, who lies in an insulated box); inductotherm (developed by General Electric) produces a secondary electro-magnetic field in which the patient lies; and lastly and simply a rubber blanket in which the patient lies closely wrapped while he sips hot drinks (the rubber prevents escape of sweat, thus blocking the radiation of heat from the body).

Fever therapists are waiting for some industrial physicist to build a tiny radio tube which will emit a wave eight-tenths of a meter (31.2 in.) long at a frequency of 320 million cycles per second. Such radiation would heat only the patient’s blood and not affect flesh or bone.

An artificial fever treatment takes up to ten hours. Until Dr. Simpson learned to give patients salty water to drink to replace the salt lost in sweat, many became delirious. Dr. Neymann, a psychiatrist, last week averred that artificial fever up to 107.5° F. does not injure the brain or affect the mind.

History. Only during the last decade, after engineers helped doctors control artificial fevers by means of electricity or hot air, has the art of fever therapy matured. Impulse to this development was the success which Dr. Julius Wagner von Jauregg of Vienna had in curing paretic Austrian soldiers by means of inoculations of malaria germs. For this he received a Nobel Prize in 1927. Dr. Wagner von Jauregg is supposed to have caught the idea of malaria therapy from an Odessan named Rozenblum. Yet U. S. slave owners used to send their syphilitics to malarial swamps where, for some then unknown reason, malaria made them better.

Theory. Germs of the diseases which artificial fever benefits die in the high heat. But whether the heat kills them directly or whether the heat stimulates germicidal substances in the body is moot among doctors. In that fog they stand close to medieval predecessors who cured paresis by running threads, horse hairs or bristles (collectively called setons) under the scalp and under the skin of the chest. The setons, medieval theorists argued, caused a flow of “laudable pus” from the chest and head.

Theorists at last week’s First International Conference on Fever Therapy reasoned that seton infections caused the same sort of high fever with which they now work.