If you were to visit a doctor and leave with one more disease than you walked in with, you would probably sue, right? A Nobel Prize winner presented us with the opportunity to pose this question to patients he was treating with an infectious disease. Before antibiotics could transform the treatment of infection, physicians of the past would sometimes use one disease to combat another. This approach to medicine brought upon us malariotherapy, the deliberate infection of patients with malaria.
Syphilis, the multistage sexually transmitted infection (STI), is caused by a heat-sensitive bacteria called, Treponema pallidum. Malariotherapy came about as a treatment for neurosyphilis, a severe form of untreated syphilis that causes complications in the nervous system and produces cognitive, psychiatric, and motor impairment (CDC 2025). This manifestation of late syphilis, also called general paresis of the insane (GPI), was essentially fatal until 1917, when Austrian psychiatrist Julius Wagner-Jauregg began deliberate infection with Plasmodium (Figure 1), the parasite responsible for malaria. It was utilized to generate recurrent high fevers to terminate the treponema pallidum, then followed by quinine to cure the malaria, and further treatments to cure the syphilis (Arrow KJ et al. 2004).
It was an idea that had long been written about in historical literature, now referred to as “fever therapy,” but Wagner-Jauregg began reporting actual results to his experiments. 50 of his more than 200 patients with GPI treated with malaria recovered enough to go back to work (Tsay, C. J., 2013). His 1927 Nobel lecture presents the discovery as the outcome of a long research initiative, moving from simple observations of spontaneous remission after a fever to actual experiments with tuberculin, vaccines, and, finally, malaria (Wagner-Jauregg,J., 1927).
The intellectual importance of malariotherapy is easy to miss if judged solely by its mechanisms. It was not simply an attempt to “burn out” an infection by a mad scientist. It also challenged notions in psychiatry by demonstrating that at least some apparently psychiatric infections had identifiable biological causes and could respond to physical intervention. Historical analyses suggests that malariotherapy helped strengthen biological psychiatry and influenced the later development of psychopharmacology (Tsay, C. J., 2013). This treatment also depended on a much larger pharmacological system than just a high fever: the inclusion of quinine and other agents to cure syphilis convolutes malaria treatment and connects it to infectious disease, drug discovery, psychiatry, and medicine rather than just one specialty.
However, therapeutic novelty does not equal ethical legitimacy. Malariotherapy offered a route out of an otherwise fatal illness, but its “active ingredient” was a dangerous infection. Wagner-Jauregg mentions temperatures reaching 40-42°C and the possibility of death (Wagner-Jauregg,J., 1927). The problem was intensified by patient vulnerability, as many were institutionalised psychiatric patients whose capacity to understand or refuse treatment may have been compromised. The absence of modern research ethics committees meant that the people bearing the greatest risk to scientific development often had the least power to negotiate it.
The legacy of malariotherapy is therefore double-edged. It illustrates how observations can generate transformative hypotheses, but also how institutional authority can convert a risky experiment into accepted practice. For scientists, the lesson is not that historical clinicians were simply irrational or immoral, but that desperate innovation inadvertently coexists with exploitation. Ethical review isn’t an obstacle added after discovery; it is a part of what makes science trustworthy to the public.
References
Centers for Disease Control and Prevention. 2025. “About Syphilis.” Updated January 30, 2025. Accessed September 28, 2026. https://www.cdc.gov/syphilis/about/index.html
Arrow KJ, Panosian C, Gelband H, et al. 2007. “A Brief History of Malaria.” In Saving Lives, Buying Time: Economics of Malaria Drugs in an Age of Resistance. National Research Council. Accessed September 28, 2026. https://www.ncbi.nlm.nih.gov/books/NBK215638/
Tsay, Cynthia J. 2013. “Julius Wagner-Jauregg and the Legacy of Malarial Therapy for the Treatment of General Paresis of the Insane.” Yale Journal of Biology and Medicine 86 (2): 245-254. Accessed September 28, 2026. https://pmc.ncbi.nlm.nih.gov/articles/PMC3670443/
Wagner-Jauregg, Julius. 1927. “The Treatment of Dementia Paralytica by Malaria Inoculation.” Nobel Prize lecture, December 13, 1927. The Nobel Prize. Accessed September 28, 2026. https://www.nobelprize.org/prizes/medicine/1927/wagner-jauregg/lecture/
Kon, Kateryna. 2020. “Plasmodium malariae inside red blood cell, illustration.” Science Photo Library/Getty Images. Accessed October 5, 2026. https://www.gettyimages.ca/detail/illustration/plasmodium-malariae-inside-red-blood-cell-royalty-free-illustration/1209159872
Comments
13 Responses to “Bibitty-boppitty~ACHOO! Malariotherapy and the Ethics of Desperate Medicine”
Hi ISci!
I chose to write about Malariotherapy so I could talk about the integrated nature of this method of treatment and the ethics behind it. As I mentioned in my blog, this method was one of many pioneers in the integration of psychological disorders with biology and other physical sciences. With the Life Science component being a literal mix of psychology and biology, I felt this was a nice fit. I also decided to delve into the ethics of science as this topic came up in a Sci Lit lecture last week, specifically surrounding “public distrust in science” and “our role as scientists.”
Hi Frida,
This was such an interesting read! This is such a cool topic and you made it very easy and fun to read. Here are a few suggestions:
-P2S3: This sentence is a big long. I would suggest splitting it into two for better flow!
-Figure 1: Make sure that “P. malariae” is italicized in your figure caption. Also, make sure the source you used for your figure is also included in your references! Lastly, if you can find one, try to find a different figure that is from a more credible source instead of Getty Images!
-In general, I would recommend trying to use more credible sources! Try to use articles/papers that have DOIs or are peer reviewed.
Overall, great work on your blog post! I can’t wait to read your final copy 🙂
Happy editing,
Via
Hi Via,
Thank you so much for your response to my blog, I’m glad you found it interesting! I appreciate your input about the run-on sentence. I’ll also definitely try to use more credible sources next time!
Frida
Hi Frida
Great job on your blog post, I found it to be a very interesting read!
– P1S1: I would change “you’d” to “you would” to be more formal
– In your figure caption remove the brackets from “figure 1”
– Instead of “resources” for your citations label this section references. Also make sure your references are peer reviewed journals!
Overall, well done ! Happy editing!
Maya Kumar
Hi Maya,
I’m glad you enjoyed my blog and I really appreciate your input! Thanks so much for reading and commenting.
Frida
Hi Frida,
I really enjoyed reading your post, your title was very eye-catching! I think including a photo helped make the post more engaging as well. I think you should provide more clarity on the medicinal practices explored in this blog. For example, explain briefly about why fevers were thought to work. Moreover, saying “further treatments to cure syphilis” is a bit vague so if you have space it could be helpful to specify the treatments available at that time. I would also change your phrasing that “Plasmodium is the bacteria responsible for malaria.” Plasmodium is not a bacterium but a single-celled protozoan parasite. It is important to note that bacteria and parasites are not synonymous to one another. Overall, I really liked your topic and I think you executed it well with clear paragraphs and proper punctuation. I hope this helps!
Kind regards,
Vanessa Salazar
Hi Vanessa,
Thank you so much for your input on my blog. I really appreciate the time you took to read and review! I’ll make sure to take in all that you’ve given me to think about.
Frida
Hi Frida,
Great work on your blog post! I love the title of your blog, and the topic was such an interesting read.
Here are a few suggestions:
– I would recommend that you use DOI sources in the future to improve the reliability and quality of the information you’re writing about.
– P2 S3 is pretty long; I would suggest either shortening the sentence or splitting it into two sentences, as word count permits.
– You can also consider briefly explaining what quinine is in brackets, as I’m not sure this is common knowledge for readers.
Overall, great work on your blog post, and happy editing!
Saanvi
Hi Saanvi,
Thank you so much for reading and reviewing my blog. I really appreciate your input!
Frida
Hi Frida,
This was an really interesting blog post to read. I really enjoyed how you connected the use of malariotherapy and the ethics behind the use of this pharmaceutical product.
Some suggestions:
– The second sentence of the second paragraph is a little long. I would suggest breaking it up into two separate sentences
– In your third paragraph you put the word “programme”, this should be correct and spelt “program”
– Try to use sources that have DOIs, or credible peer reviewed journals
Overall great job!
– Ava
Hi Ava,
Thank you so much for reading and commenting on my blog. The connection between this practice and the ethics of treatment was my favourite part of working on this blog! I’ll definitely try to use more credible peer reviewed journals next time!
Frida
Hi Frida,
This was a super fun blog post to read. It was super interesting to learn about malariotherapy and I thought your title was super eye catching.
I have one suggestion.
– P2S1 I would recommend to state the full name for STI. Not everyone may know what STI means and typically the full name is written first with the abbreviation and then afterwards you can use the abbreviation in the rest of your writing. I would change it to “sexually transmitted infection (STI). . .”
Overall great job! Can’t wait to read the final draft.
-Stephanie
Hi Stephanie,
Thank you for reading and complimenting my blog! I will take your input into consideration while editing.
Frida