Translation

Wagner-Jauregg J (1931). Ueber die Infektionsbehandlung der progressiven Paralyse [On infection treatment of progressive paralysis]. Münchener Medizinische Wochenschrift 78:4-7.

“Malaria treatment is not the only non-specific treatment for progressive paralysis; other non-specific methods have been recommended soon after the onset of treatment with tuberculin and the quest to invent new methods has simply increased since the introduction of malaria therapy. Years ago, on the basis of [personal] experience, I tried to establish a step ladder of effectiveness of these non-specific methods. The least effective seemed to me to be the methods that use any substances not stemming from micro-organisms, for instance, …., various proteins, milk, Phlogetan, etc. More effective seemed to me to be products derived from micro-organisms, such as tuberculin, vaccines of all sorts; the most effective [seemed to me to be] the infectious diseases themselves. So far the usable infectious diseases malaria tertiana and quartana have been joined by febris recurrens Africana and related forms and rat bite disease.

“It seems to me that one has not always proceeded very critically and systematically with the introduction of other new methods. First one should demonstrate that the method is effective. This was demonstrated with tuberculin in the following way: in a sufficiently large number of unselected paralytics, one was treated alternately with tuberculin, the other was left untreated.

“This approach is no longer acceptable today, for one could not take responsibility for leaving a substantial number of paralytics untreated, in order to test the effectiveness of a new procedure, the more so as a quite effective procedure, malaria treatment, already exists. Optimally, one should therefore compare the new procedure that one wishes to test, with malaria, by treating alternately from a large number of untreated paralytics alternately one with malaria and one with the new procedure. I do not consider it appropriate that a researcher treat using one procedure at one place and another [researcher] other patients at another place with another procedure, and that the results be compared afterwards with each other. Simply consider how different the perspectives of cure are according to whether the patients are in an asylum, in a psychiatric clinic, in a general hospital ward, or in a private hospital; furthermore, an important role is played by the selection of the patients to be treated. Furthermore, the results of a treatment can only be reviewed when one has monitored over years the fate of those treated.