Created by Sydney Price James
25 May 1923
Description:

‘During my recent visit to Austria I had an opportunity of seeing the above treatment carried out by Professor von Weeber at the State Mental Disease Asylum in Graz.

Dr. Weeber emphasised the necessity of using a mild strain of benign tertian malaria which in the first event had been contracted in the country concerned, not from an imported case, but from a local case in an area where the disease is mildly endemic. He considered that the use of an imported strain would probably do more harm than good as being likely to produce alarming or dangerous symptoms in the particular patients treated, especially as the attack of malaria induced must be allowed to run its course through several parozysms [sic] (10 or 12 days) before being checked by quinine. This desideratum has apparently been accepted as necessary by physicians in other countries for I understand that some patients from Denmark (were local malaria is believed not to occur) have been sent to Austria for inoculation with the mild strain which is maintained from patient to patient there.

The strain is also a special one in that it has never been subjected to the action of quinine: it was inoculated from the child who first contracted the infection before the child had received any treatment; and the passage from patient to patient has since been performed during the period before the commencement of quinine treatment.

The patients who maintain the strain of the parasite are sufferers from G.P.I. with adequate proof of former syphilis for which they have been vigorously treated during some months or years prior to receiving the treatment by malaria attack.

Every precaution is taken to avoid inoculation of patients who cannot be proved to have suffered from syphilis.

The blood for inoculation (2 c.c.) is drawn from a vein while parasites are present but not necessarily during a febrile attack. One c.c. is injected under the skin in the scapular region and then Dr. Weeber makes a number of scarifications of the surface of the skin with the point of the needle and makes a surface inoculation of the rest of the blood into these scarifications. (The idea is to reproduce the kind of inoculation made by a mosquito!)

The temperature charts and clinical accounts which I saw show that the attacks of malarial fever produced are typical in character. Treatment with quinine is begun after some days (6 to 10 presently) and at the same time the patient is usually treated with neosalvarsan.

Dr. Weeber showed us five persons who had formerly been inmates of the Asylum suffering from G.P.I. but were now back in their own homes apparently cured. He also showed a number of statistics which appeared to indicate that the new treatment had effected a considerable reduction in the number of cases and deaths from the disease during recent years. On the other hand he expressed a guarded view as to final prognosis and emphasised that the treatment is still in the experimental stage. He noted that the procedure had been successful in one or two cases of epilepsy.

I should add, perhaps, that if it were desired to essay the treatment experimentally in England it could only be done in an Institution where the Ministry or other responsible Government Department could control the arrangements for the diagnosis of syphilis and for otherwise safeguarding the interests of the patients who act both as the subjects of treatment and as carriers of the particular strain of malaria parasites. Given a well worked-out scheme we could doubtless obtain a strain of parasites fulfilling the desired requirements from one or other of the centres of endemic malaria in England.

(Signed) S.P. James, 25th May 1923.’