Wagner-Jauregg and fever therapy.

Among the recipients of the Nobel prize for medicine and physiology are two psychiatrists. The first to be awarded the prize, in 1927, was the Austrian psychiatrist Julius Wagner von Jauregg for his malaria therapy for general paralysis of the insane (GPI). The second, in 1949, was the Portuguese neuro-surgeon Egas Moniz, who developed the operation of leucotomy for the treatment of severe, intractable, and progressive psychiatric disorders. The operation was often dangerous and brought with it undesirable side effects. Despite modification in the procedure, it has now been made largely obsolescent by the introduction of psychotropic drugs. Similarly, malaria therapy is no longer used for the treatment of paralytics, as this late stage of syphilis is now rarely seen because the disease is treated at an earlier stage with antibiotics. This paper examines the work that led to the award of the first psychiatric Nobel Prize to Wagner-Jauregg.