Abstract
Since the days of Hippocrates fever has been a
major concern of physicians. Originally and for a
long time it was regarded as a defensive mechanism
against disease. Then, following the work of Claude
Bernard , Virchow and others , who demonstrated suppos -
edly harmful physiological and pathological reactions
to fever, came the era of antipyresis by medical and
physical means.
That fever, however, must serve some useful
purpose, or nature would not have clung to it so
tenaciously as a reactive process to the invasion of
harmful noxa was later still the view of Welsh and
others, and during the last four decades opinion has
veered in favour of the view that fever has a beneficent
purpose. Consequently the idea of the necessity
for the combating of fever as a harmful condition
by means of hydrotherapeutic applications or by antipyretic
drugs has gradually been replaced by the
realisation that the body increases its defence
activities with the raising of systemic temperatures.
The current development of fever therapy is an
indication of the wide acceptance of this view. Under
certain conditions and within certain limits, hyperthermia
is a state not to be prevented, but to be fostered.
Many old and new methods are being advocated for
fever therapy. Since the sixteenth century curative
effects in syphilis and in various forms of rheumatism
have been ascribed to frequent bathing in hot volcanic
water. The temperature of the water being from 113
to 128°F., it has been estimated that fevers of from
103 to 105°F. were produced thereby. (Heymann &
Osborne, 1934).
It is customary to regard febrile reactions produced
by the injection of foreign protein as the
modern forerunner of fever therapy. The use of dead
organisms (Bacillus coli or typhosus) was the next
logical step, and this was eventually surpassed by
Wagner-Jauregg's success with malarial therapy in
neuro- syphilis.
While certain definite results have been obtained,
these various methods have the disadvantage that their
reactions, once initiated, are not always entirely
controllable. Hence the modern view favours a return
to the physical, in place of the bacterial, methods
of producing fever.
Steps in the development of pyretotherapy by
physical means include the use of hot baths by
Philips, (1884),, Mehrtens and Poupoirt (1929) , of hot
air by hosan_off (1927) , of high frequency diathermy
currents by Neyman and Osborne (1929), of radiothermy
by Carpenter and Page (1930) , of humidified,
electrically heated cabinets by Simpson, Kislig and
Sittler (1933).
Physically produced fever in the treatment of
gonorrhoeal arthritis is not to be regarded as just
another method of treatment to be added to the countless
ones in which all physicians have been disappointed,
for the results described, can be, and are being
duplicated by others.
This method of treatment has been the subject of
an increasing number of reports in medical literature
during the past few years. Most of the reports have
come from the United States of America and the large
majority have described results which are satisfactory
and often remarkable.
The reports indicate that good results are
'obtained by a number of different types of apparatus,
and it appears to be generally accepted that the
method of raising the temperature is not of primary
importance provided that due regard is paid to the
safety and comfort of the patient. The newer types
of fever cabinets allow a degree of accuracy of
control, for both height and duration of pyrexia,
which was previously difficult to obtain and which
contributes largely to the successful results.
The particular type of apparatus used by the
writer is the Inductotherm Fever Cabinet and the
treatment is known as "Inductopyrexia".