Observations on the Treatment of General Paralysis and Tabes Dorsalis by Vaccines and Anti-sera

Abstract

The investigations that have led us to employ specific vaccines and antisera in the treatment of general paralysis and tabes dorsalis have been the subject of several previous papers, the last of which formed the basis of a discussion at a meeting of this Association on May 16th. It is necessary, however, to state here in a few words the more immediate reasons which seemed to us some eighteen months ago to justify the undertaking of these experimental observations of therapeutic aim. Prior to their initiation we had definitely ascertained that a threading diphtheroid bacillus, isolated from the brain and the bronchus of a rapidly progressing case of general paralysis, was capable of producing a subacute disease in rats, in which the symptoms were distinctly comparable to those of general paralysis, that on postmortem examination of the animals the brain showed the characteristic changes of general paralysis, and that there was also the characteristic invasion by the thread form of the bacillus. It was thus evident that among the various species of diphtheroid organisms that can be isolated from a general paralytic there is at least one capable of producing the disease general paralysis. We had also ascertained numerous facts which harmonised with this view. We had obtained cultures of a diphtheroid bacillus from the brain of the general paralytic in ten out of twenty-four cases; and whilst attempts to cultivate the organism from the blood and cerebrospinal fluid of the living patient had, as in the experience of most other observers, been in most instances entirely negative, we had succeeded in obtaining pure growths from the blood in four cases and from the cerebro-spinal fluid in two. We had also ascertained that diphtheroid bacilli, in a more or less advanced state of disintegration, are frequently recognisable in these fluids, even when a culture cannot be obtained, and that such altered bacilli are almost constantly present in the walls of the inflamed vessels of the brain in cases dying in a congestive attack. We had also evidence of the occurrence of a diphtheroid cystitis in all of several cases of tabes dorsalis examined, and of the existence of a high intracorpuscular bacteriolytic index to certain diphtheroid bacilli on the part of such patients and of general paralytics, which we interpret as denoting that they were defending themselves against the attack of an organism of this kind.

Malaria fever therapy for general paralysis of the insane in Denmark

“…Yet in 1913 Hallager invented a treatment that bore a resemblance to Wagner-Jauregg's malaria fever therapy. Hallager had been inspired by some studies of GPI by the Scottish doctor William Ford Robertson (1867Robertson ( -1923, who claimed to have discovered a special bacillus, the so-called Bacillus paralyticans (Ford Robertson and McRae, 1907;Hallager, 1909;Sturrock, 1975). Robertson further stated that an anti-substance prepared from this bacterium had a curative effect on GPI.…”

‘The Cruel Madness of Love’

“…92 While physiognomy was being seen as an aid to the study of medicine in general, Lavater had in fact recommended any student of physiognomy to commence with the insane, since they afforded 'extreme and crucial instances' of this art. 93 By the mid-nineteenth century, GPI was claimed to be one such disorder where the face of the patient clearly divulged their illness, for, as one commentator noted: 'The facial expression of the paralytic is peculiar.' 94 George Robertson, Physician-Superintendent of the REA, later defined this expression as 'somewhat expressionless and heavy'.…”

“…Two years later, the same authors discussed the treatment of GPI and tabes by vaccines and anti-serum. 93 Such therapy could be administered by mouth, nose or hypodermic. Although initial experimentation with vaccines was undertaken, they were to place their reliance on the anti-serum.…”

“…92 The case notes of James N., a 33-year-old married marine engineer, admitted in February 1908, record that he was 'a very heavy cigarette smoker, consuming as many as 100 cigarettes a day: in fact the steward had to be induced not to supply him with tobacco'. 93 It was noted that Elizabeth S., a 39-year-old married housewife, admitted in September 1930, was 'teetotal but smoked about fifteen cigarettes a day until two years ago when she gave it up'. 94 Such behaviour was often linked to a more generally degenerate lifestyle.…”