Sawbones: A Marital Tour of Misguided Medicine - Sawbones: Fever

Episode Date: August 18, 2019

Any species could have created a bunch of bogus ways to treat fevers. But only humans could use fevers as a bogus treatment for other stuff and then end up being sort of right about it. This week on Sawbones, we're burning down the house. Music: "Medicines" by The Taxpayers

Saubones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, time is about to books. One, two, one, two, three, four. I'm your co-host. Hello everybody and welcome to Saul Bones, a metal tour of misguided medicine. I'm your co-host

Justin McAroy and I'm Sydney McAroy It's good to be back. It is good to be back. It feels like forever since we've recorded a real live episode of this podcast Well, not live. Well, I mean, it's recorded live, I guess. Real live, like SNL is live sort of. SNL is live. What do you mean? Recorded live, like those musicals on Fox. Live to tape. Live to tape.

Live to tape. Yes, this is live to tape. We are not doing this live in your phone. I guess would be the, or like streaming over the internet. I guess. I think that's called streaming. Streaming. The people do not live in the phone. I don't know how everybody like streaming over the internet. I guess. I think that's called streaming. Streaming. The people do not live in the phone.

I don't know how everybody keeps getting this out confused. Anyway, this is a Myrtle Tour of Miscite Medicine. We are here with you after some live episodes and some absences. I am sorry that we were gone. We did not want to be gone. Yeah, it's just life folks. Life finds a way.

You know, it's like if Goldham says life finds a way to kick you in the pants Everyone's in a while I don't think that's not the good that is the quote. I had the lunch box. Do not try to test me Because you know I love my geek trivia Bazinga Do not try to test me. I was always a more a bigger fan of the All you thought about was if you could, you didn't stop to think if you should.

That was always, yeah. Yeah, yeah. Sydney, I love, I love Bison's annual man as well. I celebrate Rob Williams' entire canon. No, that's from, but this is about a solbona and about medicine. Park. Jurassic Park.

Okay. Anyway, Justin, a lot of people have written to us through the years now. Anyway, Justin, a lot of people have written to us through the years now. Yeah. Gosh, just 13th, we just passed a six year anniversary. And they've asked about this topic and I, I don't know why we haven't covered it. And it just kind of struck me that we should talk about fevers because fevers are very common. And they're, I think, still seen as scarier than they typically are. Like the fever itself, not necessarily what's causing it, but I still think people tend

to get pretty anxious when they are a loved one has a fever about the fever part of it. You know what I'm, does that, is that fair to say? Right. Okay. I feel like I understand what a fever is. Okay. And I'm gonna try to give you my best understanding of it. Okay. Okay.

So imagine that your body is sort of like a, like a din of thieves and murderers and bad people, right? And then your white blood cells are like renegade cops, right? And the renegade cops are like, burn it down with them inside. And then they flick the cigarette at your body and then walk away. And they're like, I wanna burn this place down and kill the germs or criminals in our case,

is my metaphor. So, we're gonna burn this building down to just take out all the germs. And the building will be extremely uncomfortable and my gatorade, but we are going to burn this building down to try to kill all the bad stuff. Okay. That, you know, I see where you're going with this. It's not a bad analogy. It's questionable. You are, you are conflating both what a fever is and what, why a fever occurs. Yes. Together. And I, and let's break those two down because what you said is true in a sense, but there's some

parts of it that are debatable. Is that fair to us? But you, I mean, like it was pretty good. The gist. It's like a C. Maybe a B minus. You know what? I would love to be minus in science growing up so that I will take it

with pride. So first of all, what is a fever? I literally just don't wait for me to explain you. What? What? When I say fever, you think your temperature's up, right? Like that seems very bad. It makes your body hot. So there's a part of your brain called the hypothalamus. It's kind of at the base of the brain. And it's it has many jobs, but one of its jobs is to act as like your body's thermostat, right? So it's going to regulate your temperature. And there are things called pyrogens, which are these little substances that float around

in your bloodstream and they can reach your hypothalamus and tell your hypothalamus, hey, turn the heat up. Let's make a hot in here. That's their job. And they, why would pyrogens do that? Well, they are triggered by different things. The most common reason would be some sort of invader of virus of bacteria, fungus, some sort of pathogen

that will trigger the release of these pyrogens, which will then go to your brain and say, time to heat up. Crank it. We've got bad guys, right? They can be produced from the body tissues for other reasons. There's not the only thing that triggers a fever. A fever doesn't always mean infection, although it often does. But then your body generates more heat and you get all the symptoms associated with the fever, right?

Like when you get a fever, you feel uncomfortable. You get achy, you get chills. It's like that paradoxical thing. You know, somebody has a fever when it's like a comfortable room and they're covered in eight blankets and you can get the shakes. We call them riggers. That's the, it's like really intense shakes that you can get the shakes we call them rikers. That's the like really intense shakes that you can get chills.

And and you feel really bad and sometimes you can act a little goofy, you know, you know, you know, floaty. Yeah. Get tired. It children can get higher fevers and can get faster fevers. So it can be really disturbing when a kid gets a fever, because it can seem to come out of nowhere. I fully can remember a night at like 2 a.m. taking Charlie like a two-year-old Charlie like opening the door to the porch because she was so hot that we were just trying to do anything to cool her off a little bit. And here's the thing, as we tell this story, I am going to tell you that I know, I know

in my doctor brain that that was unnecessary. And my doctor brain at the time knew it was unnecessary. My parent brain could not hear anything from my doctor brain at the moment. My parent brain was screaming, ah, your child's so hot, her brain's gonna boil. That's not a thing that happens. That's not a thing that happens, but this is why doctors don't treat their family. Exactly, exactly.

It's the case study. So you kind of alluded to the next part, which is why do you get a fever? Why? Why would this happen? Like what is the, what is the cause? What is the, what is the application? Yeah, why would this, what is the application? What is the purpose of the application? Why would this what is the application? What is the purpose of a fever?

So partially to stimulate your immune response, there are different factors in your body that respond to that change in temperature and to the pyrogens themselves and other factors that are released because of the temperature and all that. But the other part is that we think it is to make our body less hospitable for the invaders. Because we know that heat can kill some viruses and bacteria. And so maybe if we're, that was the hypothesis, right? So if our body is heating up, it's in an attempt to kill these invaders. Now, this is still debatable, though. We're not 100% sure that that's true because, well, because in a lot of cases, you can

heat somebody up and it won't kill an infection. You know, if that were the case, then a fever would kill off all the infections, right? Right. But they don't. And we know, specifically, for things like bacterial infections, we often need antibiotics to help out. Sure. You know, because in the pre-annabotic era.

We got lots of defense mechanisms that are busted, though. It doesn't mean that it's like, like, what about the bugger thing? Like, oh, I'll catch all the germs here with these little hairs. Nice try. You didn't get all of them. It didn't work. I still got sick. Nice, Silvia.

Well, and maybe that's more the answer. It's more of a, it aids in the process. And it also was a lot, it was as helpful as, as anything could get before we had better things, right? These dumb things weren't meant to last as long as we've made them last. These dumb bodies, they're doing their best, but they're, I mean, they're not meant for a modern world. That's where our brains are helping out,

you know, by making medicine. Yeah, I wish we could just tell our body like, hey, dumb dumb, you don't even get so hot, you're not doing anything. The scientists looked at it and you didn't kill anything. It didn't work bad drives. I'm not saying that I'm not saying. I thought my body was doing all cool

and killing a bunch of germs. And you're telling me it's doing nothing, just like, Dad help, help, dad's in pills, help. I'm not saying that it doesn't do anything. I'm not saying it doesn't help at all. I'm just saying that obviously a fever in and of itself is not going to cure disease. I mean, that's true.

Yes. Now, what there was one interesting point I found as I was reading about like, why do fever, then if this isn't it, because this really rocked my world, because I always thought that too. That was kind of honestly what I was told in med school. But if that's not the reason for a fever, what is? One theory that I thought was really interesting is the idea that because of fever produces really obvious symptoms, most people know when their febrile have a fever, most people feel it. And it is something that another person can feel

by simply putting their hand on you. You can feel that someone's hot. That doesn't always mean that you know they have a fever, but you can feel that they're hot. Because it is something that is so easy to recognize, it is a good way to communicate. This person is sick, stay away from them, isolate them from the community. They might have an infection that is contagious. So from an evolutionary perspective, fevers are very useful because then, you know, you stay away from the person. Is it possible that you're maybe it's partially also your body

trying to get you to like chill out so it can fight infection? Like you don't feel like doing anything so you're just gonna lay down. Just please stop doing a bunch of stuff so we can do our jobs down here. I mean, I don't have any evidence that that's the real evidence.

I'm not sitting on personifying like white blood cells to have intent. I'm saying, do you blood cells to have intent. I'm saying, that's true. Do you think it makes sense though? I think that that's like, if it's your body's way of saying like,

hey, slow down a little bit, just take a break. You're not gonna grant me this because you make fun of me for resting when I'm sick and you never rest when you're sick and you don't want to let, you don't want to blame biology. I'm like the girl from the ring I never sleep. You just, that's ever rest. Lane biology. I'm like the girl from the ring. I never sleep.

You just, that's the only way in which you're like the girl from the ring. And they're crawling backwards. But that's nothing like the girl from the ring. One point I'd like to make briefly is that a fever is a temperature of 100.4 Fahrenheit or greater, 100.4 Fahrenheit or greater. That's 38 degrees Celsius. If that's your, if that's your jam, I I'm gonna imagine that the 38 came first, right? Yeah.

Because it's like, I know such a nice round number, right? 38, as opposed to 100.4. How do I point four is like, it's tough. You don't have a, this took me so long. This is way after we got married before, I finally learned that like, I just kind of, I guess I've always associated like, if it's above 98.6, then you got a fever.

Basically, that that's a fever. Your body temperature varies throughout the day. It is, depending on the activities you've done, depending on the temperature of the room, the ambient temperature. I mean, if you're outside, and it's really hot, if you've just had a meal, it can vary throughout like an ovulatory cycle

and a person who an ovulatory cycle and a person who has ovulatory cycles. I mean, there are a lot of different reasons that your temperature varies. So if you have a temperature of 99, you do not have a quote unquote low grade fever. Just a little point there, 100.4 or greater. Now, we have obviously been having fever since ancient times

because as far as I know, humans have been having fevers as long as they've been humans. But if you look back to ancient Greek and Roman writings, you don't see a lot of distinction between fever, the symptom, and the fever as in some sort of disease process. Because a lot of times, a disease that was causing a fever within the community, something that would be like communicable, so the flu going around or it will, in a lot of times, a disease that was causing a fever within the community, something that would be like communicable, so like the flu going around or it, or in a lot of these cases, it was malaria. They would just say, oh, it's the fever.

Okay. Because people got a fever and it's contagious and we don't really know what it is. And sometimes they'd say like the fever with a rash or the fever with, you know, the red spots, the fever with the sore throat, the fever with the headache, like they'd kind of, the fever with a cough. And all of these were probably correlated with different infectious diseases that we would now test for or diagnose clinically or whatever. But the fever and fever were used kind of interchangeably. So sometimes it's hard to tell what they're trying to like diagnose your treat, a fever or the fever. They knew it was an elevated temperature though, whether talking about a fever or the fever, either way,

we're talking about something where you got hotter. The Greek word, pyrrexia, which is a word, there were pyrrexia. And the verb of it translates to I am on fire. That's really interesting. Pyrex is a material used in a lot of baking stuff that is a heat proof glass. Pyrex. It'd be good for being on fire. Yeah, it wouldn't. It's a wooden. It's a wooden.

There's a wooden. Galen talks about fever saying that basically you have an excess of heat. And that was a lot of the early Greek writers, and then the Roman writers talked about. The idea that fever was this excess heat that had accumulated in the body that comes from the heart and then is pumped out of the heart through the arteries and spreads throughout the body. And it was really seen as like a substance of sorts, like a whole other thing. There was this, there was

this stuff that was heat and it was flowing through your body and then we could tell because you're hot, right? There were certain connections that were drawn, like Hippocrates talked about. If you have a lot of headaches or a lot of fevers that keep coming with headaches, then you're probably gonna die. So I don't know exactly, maybe meningitis is what that was talking about, but like you could see riders connecting like this fever not so big a deal. This fever if you have this with it,

I mean we don't know what it is, but you're gonna die. I think you're probably gonna die is one that people should have leaned on a lot more in ancient times, because if you think about it, like if you sell someone like, oh, that's about fever, you're gonna die. There's two outcomes, like one, they die, and then you're like, got another one. I was right. I knew it.

I knew it. I called it, or they come back and they're like, hey, I didn't die. You're like, ah, thank our multiple gods. That is excellent. It's what a gift. What a gift, what a gift, what a gift, man. Awesome, awesome. So glad to be wrong on this one. Anyway, that'll be 60, 60 Drockmen.

That sounds like a good idea, but I could tell you in practice, I, that would, that is not something I would endorse. I can't imagine the fallout of me telling all my patients, like, well, this is probably fatal. No, I mean, bye. Bye. Bye. Just stop at the desk for your bill. So Galen went on all the work of his predecessors to like take all that and break down fevers into

three main types. And this kind of got into like what they caused a fever, because a fever was not necessarily seen as just a symptom that can be connected to a multitude of diseases or processes, right? Because that's what a fever is. A fever isn't caused by one thing. A fever is caused by lots of different things. It's a symptom.

But there was a thought that a fever was a distinct thing in and of itself, and that there could be certain types of them that occur independent of whatever might be going on in the body. So there were ephemeral fevers, which were like the no big deal fevers, and this is probably like a fever that was caught in connection with something like a cold,

like a viral illness, and they would say, well, you have an ephemeral fever. I don't know what's going on with you, but it's gonna go away pretty quickly, and you should be fine. And that was probably right. There were also fevers that could be caused by a corruption of humors.

Mm. So your humors, different ones can become like putrid, and then they would cause fevers. And so you'd get different fevers linked to different humors, you know, becoming put future. Going bad. Always the same thing you could click on for podcasts. I wish you could click on podcast audio

so people could click when we started talking about humor and take them to five minute diversion about how humans are a fake thing that are not real. Like we're probably gonna address these as if they're a thing, but the humors are nothing. That's the greatest, and many, many systems of medicine throughout history believe that there were four humors in the human body

that you had to keep balanced in order to maintain health. You know this is a long time slow. Blood, blood, black, bile, yellow bile. Listener, but if you're new to the show, you should know that humors are nothing. This is not a thing. I mean, we do have blood, we do have flim. We do have bile, but this is not what.

Oh, okay, so three out of four, A-Bat. Well, with the moral system, make it a comeback. The name stayed, all of everything else was wrong. And then there were also hectic fevers, which were the worst, the most unpredictable, the most dangerous fevers. And all of these things, we could probably go back and look at descriptions and link each case to what was the likely, you know, was this smallpox, was this malaria, was this typhoid, what was going on. We can probably do that now in retrospect. Later

Avacena would build on a lot of this work and correctly say, listen, all this humor stuff is wrong. He identified infection is probably the main thing that's happening behind these fevers. All of these fever curves and everything, this is nice, like, oh, you have fever every third day, fourth day, whatever, that's all cool, but it's probably from an infection. As far as what people did about fevers, well, a lot of what was done is a lot of what we talk about when we get into humoral medicine, the humor system of medicine, which again is fake. Well, you just balance your humor with, you know, letting some of one out or trying to

put more of one in. So blood letting, like leaching and cutting open a vein and bleeding people, very common, emetics, things to make you puke, laxatives to make you poop, diuretics to make you pee. Just something to get a humor out, depending on what type of fever it was considered, would be the most common target, especially bleeding a person. Bleeding a person because blood was thought to be hot and so...

Hot blood, get the blood out. Get the blood out, so bleeding was the most common. Now, I always like to see what Pliny the Elder has to say about things. Got a check-up with Pliny. Our old buddy Pliny always writes extensively about everything ever anywhere. And there was a Roman goddess of fever, February, and you could make offerings and create amulets in February.

And February's name to protect you from fever. And so as a result, Plenty documents a whole lot of things that you could do because he says basically doctors can't do anything. So amulets are your best bet. You're going to want to go amulets. Yes. I love to help you, but you are, you go the amulet.

So, so for, so here's an example. The dust in which a hawk has bathed itself can be tied up in a linen cloth with a red string and attached to the body. So you can do that. Just find the dust in which a hawk has bathed. Perfect. Yeah, I know lots of hawks around. You could take the longest tooth of a black dog where it is an amulet. Best of luck. It's a one unhappy dog. You can also the first wasp that you see in the current year.

I'll never find that for again. If you can catch it, I remember it was May 13th. You need to catch it though with your left hand. And you can tie it below your chin. He had an ass. I assume you want it dead first because that, I mean, it's a wasp, man. Yeah, that plenty. You knew that almost was beat. He had an excellent. I assume you want it dead first, because that, I mean, it's a lost man. Yeah, that plenty of you knew that almost was beat.

Cut off a viper's head, wrap it in a linen cloth. You could also take the viper's heart. I mean, you've already got the viper, right? You've already cut its head off. You might as well take its heart too. It's not doing anything with it. You could wrap that in a linen cloth, I guess.

You can also take the tips of a mouse's ears and wrap those. It's all a red cloth. The red cloth seems to be big. Maybe just the red cloth. Just wrap anything in a red cloth. These are all amulets you could create. Do you think I have a question for you, Sydney? He does say to swallow a few things like the heart of a sea diver.

So there are some things. The white. It's a kind of bird, right? Okay, I guess. But that's, yeah, it's kind of bird. I shopped his doughs hard. I messed up. My fever's gone, but I'm in jail. You can add some pepper.

Do you think they had am... I'm so hard not to say amulet. Do you think that's what our child says? She's ruined pronunciation for us on many words, like amulet or... you think that's what our child says? She's ruined pronunciation for us on many words like amulet or regular. Regular. Okay. Do you think an emulet? Do you think they have emulets, rentals? Like, do you think they did an emulet rental? I guarantee there are people who sold amulets. Not sold. A rent rental. Now that I don't know, but I guarantee they sold.

Because you don't need them after you got better. eh? So it would feed, it would ward it off too. These would also ward off fever. There's a lot of kids. I mean, I'm not gonna wear all these amulets. An ounce of prevention's worth a pound of care. Yeah, but 30 amulets is a pound. So that's hanging around my neck. Now I've got some lower back issues

because I'm wearing all these ding-dang amulets. I'm just saying that once you've taken the time to cut the head off a viper and all that, you're not going to want to get rid of that. Yeah, but you're going to loan it to your friend Jared for cash. I mean, maybe. I just think they had a brisk, emulant rental business. He does advise some things you can take prophylactically, like swallows dung with some goat's milk and raisin wine.

And do what with it? No drink it. Okay. And that's like a fever prevention. Also the skin of an ass prevention. That's so wild that I'm going to drink swallows dung because I don't want to get a fever. Hey listen, I don't care how little they understood that medicine they have to know that makes no sense. You have to understand though, fevers are still scary to people today and they were a heck of a lot scarier back when a fever meant well you might just die now. We have no idea what's happening. We have no idea how to fix it.

Good luck. So it makes more sense in that context. Now Justin, I've been talking about how to fix a fever, but I wanna talk about what a fever can fix. Okay, let's do it. But first, let's go to the billing department. Let's go. The medicines, the medicines that ask you let my God before the mouth.

Sydney, you had teased a little bit. You're going to tell me about what fevers can do. Right? Yes. OK. So because we have had this concept that fevers are intentional, our bodies attempt to kill an invading organism because we've had this idea for a long time, a lot of doctors

and people who weren't really doctors but practice medicine throughout history, even for ancient times, have theorized that you could use a fever to fix disease. If you could make fevers happen, then you could cure diseases as well. And this is called pyrotherapy. It's using a fever to treat things. Okay. I have found the quote, well, it's been paraphrased. I don't know what the exact quote is supposed to be, but basically it's if I could produce as well as treat intermittent fevers, I would be the greatest physician of all time.

And it has been attributed to, I found it in several different articles and in everyone it said, as hypocritees once said, as discorities once said, as more hovel once said, I don't know who said it. Maybe all of them, but the idea that the fever was so important that we just need to learn how to harness its power, the power of the fever, to treat disease is pretty pervasive. Hypocrites was one of the first to propose that if we could, he observed a patient who had epilepsy greatly improve after about of malaria, and he was one of the first ones to say,

man, if there was a way we could just do that. Does that say anything? With epilepsy, not that I'm aware of. No. Galen wrote about a case of melancholia, which was probably depression, is what we probably would have said now. Melancholia is what they would say.

That was greatly improved after they had some sort of illness that included a fever. There were a lot of ideas about this, but nobody actually tried it until the 18th century. And that's when you first start to read some like case reports of people with usually some sort of psychiatric illness. It was really focused on that. And so epilepsy cases were included as well because it used to be thought of as a psychiatric

illness. But epilepsy and then different forms of like depression or anxiety or schizophrenia, bipolar disorder, those sorts of things were attempted to be treated by wrapping people in really warm blankets and elevating their temperatures or putting them in a really hot bath. There were some scattered reports of actually infecting people with things. Like E. coli was used in one case. Like give someone E. coli so that they get a fever

in response to that to try to cure whatever illness they had. But nobody was really doing it routinely or in any sort of like controlled scientific experiment. Just doing it in the world. Yeah, just like, I don't know, I read about this. Apocrates or Borhov, maybe somebody said it. Before we invented science.

So in the 20th century is when we really start to see people trying out pyro therapy for real. And this can mainly be credited to an Austrian psychiatrist, Julius Wagner von Jorreg, who in 1917, yes, announced the discovery of malaria fever therapy, as a cure specifically for what was called the general paralysis of the insane GPI is what they called it, but what this really was was late stage syphilis, tertiary syphilis, because late stages of syphilis, the little spyrachetes, the little bugs get in the brain, and you can begin to manifest psychiatric symptoms and neurological symptoms and things like that. But of course, at this point in history, nobody really knew that it was late-stage syphilis.

There's a lot of debate about how to treat it because no one knew what caused it, and so it really fell to psychiatrists to manage it. Even though, as we would eventually discover, I think it was around 1913 that syphilis was the cause, and this was actually an infectious disease, it needed to be treated as opposed to a psychiatric illness that was managed differently. So, your egg was one of the, was a psychiatrist, and so he was interested in ways to treat GPI in new methods

since nothing so far had been very effective. And he observed that one of his patients, Hilda, who was inpatient at the hospital in the psychiatric unit, recovered after an attack of aerocipleus some so a strep infection. The patient had a strep infection, had high fevers, got better, and he also noticed that a lot of the psychiatric symptoms that she was manifesting also improved after she recovered from her fever. And so his theory was, well, the heat of the fever must have killed whatever was causing this.

So, he decided the best way to mimic this is to give patients the same thing that the patient had, that the Hilda had, in order to treat their GPI. So that was the first thing he tried. He actually gave patients water that had strep bacteria, strep to coccle bacteria in it. Similar to what would cause strep throat, he basically gave patients strep throat. And I'm going to go ahead and assume that was terrifically effective and that is why we still give ourselves strep throat all the time to this day. Whenever we catch a straight

syphilis. No, it was not, it was not particularly effective, except I guess it giving people strep throughout. It was probably effective if that was your... You went a couple days off school, you went to Mr. Field Trip, you went a good excuse to eat some dream sickles, he's got you. So he tried that that didn't work very well, so then he tried to burculine. And to burculine is it's derived from tuberculosis from the toxin. And it actually is like used to make the vaccine against tuberculosis,

which we don't use in the U.S. but they use other places. And there was a lot of research being done on tuberculine at the time and a lot of thought that it could be used in good other good medical applications. Tiberculin sounds like the worst artificial sweetener of all time. Now made with tuberculin. Remember, other different. If you see that, don't buy that. Don't buy anything with tuberculin, folks.

Yes, it's delicious. Yes, we know. So he started treating patients with tuberculine and actually published a series of papers based on this indicating some success that he did notice some improvement in his patients with GPI, which as we're doing these different studies, they's occur over the course of many years by the way. Like his first idea, the fever therapy could be used for GPI, he doesn't do anything with it for like five or six years.

And then he starts doing some of these studies and he stops for a while when they don't work very well and then he tries them again. So this whole course takes place over many years. And during the course of all these different studies is when they actually figure out that syphilis is the cause of GPI. They still don't know how to treat it.

But they have, they have by now figured out that syphilis is the cause of GPI. They still don't know how to treat it, but they have, they have by now figured out that syphilis is the cause. But so he's using the tuberculin, he's doing the fevers, and some of his patients seem to be recovering from the syphilis, the tertiary syphilis of GPI. He even wrote that one of the patients that he treated with tuberculin the next day, her family came to visit her, and her sister came up to him and said,

what have you done with my sister? She has suddenly become intelligent. This is sister burn if I've ever heard one. That's that, that's very sister. Probably like just within your shot of it, just like just barely within hearing range. She was like, hey, hey, did you say that about me? Come on. That was mean. No, you must have heard. I didn't say anything. It was just the syphilis. It's the syphilis. So, but the problem was, even though he was having some some success with this tuberculin

or so his research indicated, there was a lot of argument in the medical community at this time as to the toxicity of tuberculin. And there were a lot of people saying that it could do things it couldn't do. And a lot of people who were so concerned that we should just stay away from it all together. So it was kind of a controversial thing to be using. And he really didn't wanna be associated with all of that argument at that moment.

He just wants to live in peace and give people fevers. Malaria. He just wants, hey, we're not there yet. He's not giving them Malaria. Oh, right, okay. He just wants to give them fevers. And he also wasn't completely satisfied with the results because a lot of his patients

would relapse later. So they would seem to get better for a while, but then they would revert to the symptoms of tertiary cyphalus again. And so he started looking for other sources of infection to cause the fever, other ways that he could trigger a fever and a patient. It was around this time that a soldier who had been at the mastoneum front came and was admitted to the hospital for some injuries.

And he also happened to have malaria. And you're agnotis this. And before he could be treated, he kind of told the other doctors, like, wait, don't treat his malaria just yet. Let me get out and real quick. Let me, let me get at that malaria blood. I need, I need some of that malaria blood.

So he went and he took a sample of the soldier's blood. And he injected it into several of his patients who had the GPI, who had the tertiary syphilis. And then after he did that, he got worried. What? Why for the obvious reasons, Dean? What do I do? Not for the obvious reasons.

Although, I mean, he may have, history does not say whether or not he was worried about that. But we do know that he was worried that perhaps he could cause an outbreak of malaria if there wasn't an awful least mosquito hanging around because that's the way malaria is spread. You have its mosquito spreads it person to person, not directly from person to person. And then people he didn't want to definitely give malaria to might get malaria.

And then everybody would be like, you're egg, you gave everybody malaria. Hey, all are syphilis is great though. But now we have malaria. Dang. So he started to get worried about that. So he went and he got one of his other patients is what is this is what's documented. He got another one of his patients and said, Hey, I want you to go outside and catch as many bugs as you can.

Just whatever bugs. Just catch some bugs and bring them back to me. It's okay if they're dead. I just need to see them. That patient was being treated for terminal gullibility. That's very sad. It'll be misused in this way. So the patient went outside and caught a bunch of bugs, brought them back to Dr. Yeregg and gave them to him and he examined them all and decided none of these are the

Anopheles mosquito, which is the mosquito that has, you have to have that mosquito to get them, carry them malaria. So he said none of these are the Anopheles mosquito, which is the mosquito that has, you have to have that mosquito to get them, carry the malaria. So he said, none of these are the Anopheles mosquito, so we're good. The small sample, my patient has captured of bugs. I picture this in the middle of the night, like, this poor guy run around catching bugs. Anyway, so he was happy they weren't, and so he wasn't going to cause an outbreak of malaria. So he, he, he, he followed the patients so he wasn't gonna cause an outbreak of malaria. So he followed the patients, and he treated, and he found that several of them

seemed to get better. The syphilis symptoms seemed to resolve, or at least improve greatly. And so based on these results, he continued these experiments, and he published a whole series of cases. Every time he'd get more patients in, he had to have somebody nearby of a malaria.

Right. It had access to a malaria patient, which wasn't terribly hard at the time, but he would go get blood from someone who had malaria and he would then inject it into the new patients he had. And what he found at the end of it all with all the different cases, could you treat him any patients this way,

is that it offered about a 30% chance of complete remission. Pretty good. Pretty good. A lot of patients still did relapse. Some of them never improved completely. And unfortunately, also about 30% died of malaria. Malaria. Right.

Because it's so bad. Yes. Because malaria, especially, there wasn't always control for which type of malaria, and sometimes they'd get it wrong. They thought a patient had one type, and they really had a different type of malaria, and some of them are more aggressive than others,

are more fatal. He's wanting him to chill malaria, and they had that really bad stuff. They just wanted the fun malaria, and it was serious malaria. Like, when you need to get out of a field trip, or you want to see dream cycles, fun malaria. It's serious malaria. Like, when you need to get out of a field trip or you want to see dream cycles, that malaria. So he continued to do these treatments. And as he published results, it became so interesting to the rest of the medical community

that a lot of other people started following suit. And they tried other types of fevers. They tried something a rat bite fever. There was an African relapsing fever, all kinds of things that we probably would identify by different names today. But basically let's give our patients something to make them sick and then get a fever and then maybe it'll cure their tertiary syphilis. In some places instead of giving them inoculations of blood from other patients,

they would actually get mosquitoes that carried malaria and capture them and just put them on the patient, put a little cup or something over it so it had to sit on your arm until it. How unpleasant. How unpleasant. It's also kind of exploitative for the mosquito, right? Well, you want me to just perform on command?

I'm not a robot. I eat what I'm hungry. Maybe you get a little while, I'll bite this dude, but give me a sec. You know, they've done this. I may have mentioned this in our malaria episode, but they've done this in places to look at like the density of like mosquitoes in an area. Like they'll have people just sit out and get bitten and count how many mosquito bites they get. So I mean, it's a nice work if you can get it, but...

I love science. But anyway, for all of this work and then all the people who followed in his footsteps, he won the Nobel Prize for Medicine for the discovery of malaria therapy for tertiary cell list in 1927. Nice, congratulations. And this was used for quite a while eventually they started creating something called fever machines That's a good. It's got to be a bad name, right? I don't know. I don't know. It's a good name Definitely definitely a more Spotify. It's a good name But they started getting these fever machines or fever cabinets And they use this technology based on ultra sounds to like up these big, they look kind of like iron lungs.

It's like a big thing you lay in, like your head sticks out and then they make you really hot. They induce a temperature of 104 or 105. They want to get you really hot, like a really serious fever to treat at the time. It could be any kind of infection. Like it was tertiary syphilis, but they tried it for other infections that were resistant to any other treatment. They tried it for cancer when we could diagnose but had no idea what to do with cancer.

They started using this kind of treatment for cancer. You can find a lot of cool pictures of this online. If you're interested, I would recommend Google. Cool. It is. Whatever I think the cool said, or do you think they're cool? I've ever been to think they're cool.

They also do this in that show the the Nick that used to be a... Oh, yeah, yeah. They cure a case of tertiary syphilis. John Hodgmann's the Nick. Yes, John Hodgmann's the Nick. That's how I could think of it. They cure a case of syphilis with a fever cap. And I remember thinking like, no way.

But you know, the thing is, there's enough data to say there may have been some people who went into remission from this therapy from heating people up. It is possible that this did work somewhat sometimes. Obviously it wasn't an ideal treatment and fell out of favor for multiple reasons. And this was used, I should say, this was used standardly until like the 50s, but of course antibiotics came around in the 40s and that would that would be the death knell for a lot of interesting but ineffective treatments

for infections. Yeah, sadly. So with the rise of antibiotics, we had a much safer, more than old antibiotics. Much safer, much more effective infectious diseases intentionally unethical. So we would not give a patient malaria today. And it's an interesting conversation because he did, I mean, his justification is what a lot of bad science is based on. Well, we don't have anything else and you're going to die of this.

So I might as well try this. And that's not, I mean, that's unethical. There's a reason we don't, we don't have anything else and you're going to die of this. So I might as well try this. And that's not, I mean, that's unethical. There's a reason we don't, we don't do that. That's not good enough for IRB approval. You know, you got, you got to do better. You can't just say, well, we don't have anything else to try it. But this came out of the heroic era of medicine. When everything was a little haggle-dee-pigle-dee.

When it was just like, I have no idea what I'm doing, but I'm a doctor. So let's go. Look at this cool mirror on my head. Come on. I'm going to give you malaria now. So obviously we don't do this anymore. There is some interest in like the concept of elevating the body temperature to help alongside other treatments for infections or for cancer. I saw that there's some of that

research that's been done, but none of this is like standard right now. So if anybody's offering you fever therapy for your cancer or fever therapy for an infection, I would raise an eyebrow at that. That's not real. Because I mean, this is all just an interesting area of research. And it would all be used in conjunction with real medicine, antibiotics or chemotherapy or whatever. These are the ways in which this research is being done, but nobody is advocating to give people malaria or any other infection. Please don't do that. But generally speaking fever, I think this is one important point to make about fever. It has been scary throughout history because a lot of times people got fevers and died and

we had no idea why. And there was nothing we could do, right? We have many, many treatments now. I still think fevers are kind of scary. Especially for your parents. Yes, especially in kids, they can be, they can make you feel really helpless and they can be really scary. But it is important to know that the fever in

and of itself is generally harmless to your body. Obviously, very high temperatures or sustained fevers, you know, if you're getting temperatures up over 103, I would be concerned about that. There are things like febrile seizures, like a seizure associated with a fever that usually happen in children and they can be quite upsetting, although generally they are harmless. They can be very scary. And things like that, I would get evaluated for, of course, and you're going to anyway. But fevers that you don't know where they're coming from or whatever. But a lot of the time, this idea, I see a lot of people like, we've got to get you on

the cycle of Tylenol and then ibuprofen and, Tylenol and then I'd be profan, and then ice you down and do a cold bath and all this stuff to like fight a fever. And we've been those parents. You really don't have to do that. The vast majority of the time. Treating a fever can make you feel better. And that's worthwhile. I'm not saying it's not, but you don't have to. You don't have to. Most of the time it's not necessary. You need to address the underlying cause. And once the underlying cause is either being treated or in a lot of things like the common cold, allowed to run its course, you don't necessarily have to do anything about the fever.

So I think that that's useful to remember. You don't necessarily have to do anything about the fever. So I think that that's useful to remember. Folks, thank you so much for listening to our program to play us out this week from their 2011 album Living in Oblivion. This is the fever machine So sadly the band name is taken heartbreak We want to thank the maximum fun network for having us as this is pretty intense for our show actually turn it open Like the next one that works for our biggest is a part of their extended podcasting family. Thank you to the taxpayers for these their song medicines is the intro and outro of our program and Thank you to oh oh oh I wanted to mention before I thank anybody else. I want to thank you in advance for heading over to McRoy

Merch.com and checking out our new Sommens Caduceus pin. It's kind of based on our logo. And it's neat. If you wanted to pick one of those up, that's new this month. So go check that totally out. There's a couple of other pins and some other trouble and stuff there too.

And I don't think we got to plug anything else this week, Sid. We got a book, the商 month book. It's on Amazon or a bookstore, as you can go buy it. If you would be so kind, but that is going to do it for us, I believe. So, until next week, my name is Justin McRoy.

I'm Sydney McRoy. As always, don't drill a hole in your head. Alright! Maximumfun.org Comedy and Culture Artists don't? Audience supported. I'm Riley Smirl. I'm Sydney McAvoy and I'm Taylor Smirl.

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