THE HISTORY OF FEVER THERAPY IN THE TREATMENT OF DISEASE

THE HISTORY OF FEVER THERAPY IN THE TREATMENT OF DISEASE

WILLIAM BIERMAN
Attending Physician in Physical Therapy, The Mount Sinai Hospital

THE idea that fever is a method of therapy may be traced back to the early days of written history. "Give me the power to produce fever, and I will cure all disease," is a quotation attributed to Hippocrates more than twenty-three hundred years ago. Ruphos of Ephesus, four hundred and fifty years afterwards, said: "If indeed any were so good a physician as to be able to produce fever, it would not be necessary to look for any other remedy in sickness." 

The production of fever as a therapeutic procedure had to wait centuries, however, for advances in chemistry, physics, mathematic's., and medical sciences. The development of fever therapy can be divided into empirical and scientific eras. The borderline between these two eras was thermometry which was introduced in the early part of the Seventeenth Century by Galileo and Sanctorius, and developed in the second half of the Nineteenth Century by Wunderlich and Allbutt.

EMPIRICAL ERA

The origin of therapeutic fever lies buried in medical antiquity. While the rays of the sun have therapeutic value, other than their heating effects, nevertheless, early physicians used them solely for these effects. Heat was also applied to locally affected parts of the body and to its entirety by means of hot water, steam, sand, and mud baths. It is probably true that the ancient therapist might not have been aware of the fact that by these physical means he produced a rise in body temperature. However, our present knowledge of thermotherapy leads us to the reasonable conclusion, based upon the descriptions of the techniques used, that sufficient heating energy was frequently employed to accomplish such an elevation of systemic temperature. Egyptian physicians during the Fifth Century B. C. applied rules for sun and heat therapy.

In the encyclopedic compilations of Oribasius (325-403 A. D.) of Constantinople, are found quotations from Herodotus, the historian of the Fifth Century B. C., referring to this phase of Egyptian medicine. Natural hot air caverns connected with volcanic sources were utilized (Oribasius, X, 40). The epic poet Homer (Fifth Century B. C.) clearly established that hot baths for medical purposes were common among the Greeks before the Age of Pericles.

Hippocrates had ideas as to the significance of fever, and modern concepts as to its possibilities. He prescribed hot water and steam baths for "thickened" and "tense" skin, for "spasticity" and for pains of the extremities as well as of the torso. Illustrative is the case history of a man of Athens who was affected with a severe pruritus of his entire body. The skin in all regions was so thickened that he had the appearance of a leper and it was impossible to pinch up the skin anywhere. No one had been able to relieve him. Hippocrates ordered him to go to the Island of Melos where there were hot baths. 

There he became entirely cured of his itching and the thickening of the skin, but he developed a dropsy and died. 

This man may have had one of the chronic dermatoses for the treatment of which dermatologists are now finding fever therapy to be of value. It is also possible that this patient may have received burns sufficiently extensive to cause a nephritis which proved fatal. Among contraindications, Hippocrates mentioned repeated or profuse nasal hemorrhage, which, as an evidence of hypertension, would be included in modern contraindications for fever therapy.

During the reign of Tiberius Caesar, 42 B. C.-37 A. D., Aurelius Cornelius Celsus described the prevailing medical procedures and ideas regarding fever and heat. He wrote of a certain Pretonius who treated persons attacked by fever somewhat as follows: "He had the patient well covered up to excite at the same time a violent heat and thirst. When the fever began to abate somewhat, he made him drink cold water. If he broke out in a violent sweat, the patient was considered cured." "Heat," Celsus wrote, "acts well in eye diseases which are without pain and lacrimation. It is good for all sorts of ulcers but principally those due to cold." 

The techniques of heat application included wet fomentations, dry packs, steam baths, hot air baths, and sun baths. Celsus claimed that ordinarily heat would "relax the skin and draw forth corrupt humors, and change the condition of the body."