TREATMENT OF GENERAL PARALYSIS, TABES, ETC. 225 



a series of acute psychoses with results that encouraged him to ex- 

 tend his experiments to other forms of mental disease. His associate, 

 Boeck, has published the results of the treatment of cases of general 

 paralysis in v. Jauregg's clinic. 



Pilcz continued the method. He gave old tuberculin in 10% 

 solution, starting the treatment with 0.01 gm., and continuing up to 

 0.5 gm. Injections were made every two days. The patients re- 

 acted with a temperature up to about 101 F. and there was an as- 

 sociated headache and lassitude. Pilcz noted that at times there was 

 an increase in the psychic disturbance at the time of the reaction, 

 but this usually rapidly disappeared. 



In contrasting a series of 66 treated cases with 66 not treated 

 the mortality was 20 and 39 respectively during the first year under 

 observation. At the end of a four-year period of observation 8 of the 

 treated group were still living, 5 of the untreated. 



In 1911 Pilcz published a further series of 86 cases, which were 

 given a combined treatment of potassium iodid and tuberculin. 



Of these 40% did not respond to treatment; 



23% were arrested, but not otherwise improved; 

 10% became fit to be returned to normal life; and 

 26% were restored to almost normal condition. 



In 1912 a further report was made. At this time 26 were still 

 living, 12 of them occupationally fit, the periods of remission in 3 

 cases having lasted for from 4 to 5 years, in 15 cases over 1 year. 



These observers used tuberculin because it was convenient to ob- 

 tain and sure in its effect. They observed that patients who seemed 

 hypersensitive to tuberculin and reacted violently were those who 

 derived the greatest therapeutic benefit from the method. 



Hudovernig, Battistessa, Dollken, Jukow and Joachim confirmed 

 these findings. 



The basic theory of v. Jauregg was that the therapeutic effect 

 in paresis was due to the increased temperature. The work of Jahnel 

 and Weichbrodt who found that in luetic rabbits subjected several 

 times to temperatures of from 42 to 43 C. living spirocheta pallida 

 could no longer be found (other spirochetes were not so susceptible 

 to high temperatures) is of particular interest in this connection. 

 Donath had previously used salt injections, and now, with other 

 neurologists, began the treatment of general paralysis with leuko- 

 cytic stimulants, considering the leukocytosis thereby obtained as 

 the important factor of benefit to the patient. Horbaczewski having 

 called attention in the early nineties that nucleic acid (as well as 

 pilocarpin and cinnamic acid) acted as powerful leukocytic stimu- 

 lants, nucleins were applied by Fisher and by Donath in the treat- 

 ment of general paralysis. 



Fisher's first series contained 22 cases so treated and 22 untreated 



