Treating one Disease by Causing Another

Bruce Charlton

May 4, 2013

Treating one disease by causing another is actually a pretty mainstream therapeutic strategy in medicine – and especially psychiatry. The idea is to use a milder or temporary disease to treat a more severe or permanent one.

Examples:

1. Malarial Therapy of GPI (“General Paralysis of the iInsane” – cerebral syphilis)

Patients with incurable and fatal GPI were deliberately infected with malaria. The very high pyrexia (temperature) killed the syphilis germ, but (hopefully) not the patient. The patient was then (hopefully) cured of their malaria using quinine.

2. Leucotomy/Lobotomy

Patients with chronic and incurable anxiety or tension were deliberately given brain damage, cutting off the frontal lobes of the cerebral cortex from the rest of the brain. This made the patients docile and indifferent – which was presumed to be an improvement. The procedure became so popular that brain damage was inflicted on patients with less severe and probably temporary anxiety and other conditions, too.

3. Neuroleptics/Antipsychotics create Parkinson’s disease (or, rather, Parkinsonism, which may be reversible) for the treatment of fear, agitation, delusions, hallucinations, and hyperactivity

Patients with a range of very distressing psychological and psychotic symptoms were deliberately made to suffer from Parkinson’s disease by giving them dopamine blocking drugs. As well as producing the physical symptoms of Parkinsonism (tremor, stiffness, movement disorders), the drugs produced the psychological symptoms of Parkinsonism – emotional blunting and demotivation. Patients could no longer be bothered to respond to delusions and hallucinations.

Unfortunately patients could no longer be bothered to do anything else, either and became asocial, withdrawn, idle, and without the ability to experience pleasure. Also, when treatment was sustained, the drugs were found to have a permanent effect (tardive dyskinesia) and to create dependence – such that withdrawal often caused a psychotic breakdown.

In a recent development neuroleptic/antipsychotic drugs are being given to tens/ hundreds of thousands of over-active children (aka ‘bipolar’). Parkinson’s disease certainly puts a stop to these children’s hyperactivity! – and this is regarded as progress.

Some drugs ‘normalize’ the situation as their primary therapy – for example a narrow spectrum antibiotic (more or less) does this by killing an invading germ.

‘Side effects’ are often an instance of the phenomenon. Epilepsy may be prevented, at the cost of causing chronic sleepiness. Pain may be alleviated, at the cost of causing reduced alertness and constipation, or stomach pains and potentially ulcers.

Ideally the side effects are less severe than the original pathology, and temporary – but unfortunately this doesn’t always happen.

Examples also occur in surgery: treating colon cancer by removing the colon – creating a disease state (colostomy etc.), but often saving the patients life. The same applies to many ‘resections’.

Or, in plastic surgery, face wrinkles are treated by causing muscle paralysis (using ‘Botox’).

Indeed, ‘curing’ is relatively rare. Medicine is mostly about trying to relieve symptoms, or choosing the least worse of several pathological alternatives.

But it is important to know that that is what you are doing.

Things get nasty when people pretend they are ‘normalizing’ a patient when they are actually, deliberately, causing them to suffer from a different disease.

Bruce Charlton

Hypotheses for Self-Help Psychiatry: Bruce G. Charlton is Visiting Professor of Theoretical Medicine at the University of Buckingham, and Reader in Evolutionary Psychiatry at Newcastle University. Bruce is medically qualified, and has a doctorate in the neuroendocrinology of depression. From 2003-10 he edited Medical Hypotheses.

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9 thoughts on “Treating one Disease by Causing Another

  1. Bruce,

    Great blog. An interesting subject.

    It seems we see the same thing with cancer treatment.
    An intentional taking down of the immune system (which is deemed to be “over-active”) in order to hold cancer cells at bay.

    None of it makes any sense to me.

    Duane

  2. @David

    And let us not forget that Egas Moniz won a Pulitzer for that whole leucotomy procedure.

    Worse than that…

    The Nobel Prize in Physiology or Medicine 1949 was divided equally between Walter Rudolf Hess “for his discovery of the functional organization of the interbrain as a coordinator of the activities of the internal organs” and Antonio Caetano de Abreu Freire Egas Moniz “for his discovery of the therapeutic value of leucotomy in certain psychoses”.

    ….and such a nice friendly charming man…arn’t they all?

  3. great article. Is there not terminology in English to distinguish a treatment that treats underlying pathology from a treatment that causes a new disease? It would seem to be a susbet of iatrogenesis, but not the exact same as iatrogenesis since, for example, so-called “side-effects” are iatrogenic as well as things that are considered “therapeutic effects.”

    This is terminology we need if it doesn’t exist. Half the battle is just getting people to conceptually grasp WHAT psychiatric drugs are and WHAT they do. A lack of proper terminology (as well as the deliberate introduction of false theories, misleading metaphors, and outright lies by Big Pharma) is definitely part of the problem.

  4. @m – A treatment that treats underlying pathology is sometimes called a ‘magic bullet’ – but rather than be honest about the other kind, and develop a different term, the tendency is to pretend that a treatment that actually causes a new disease is a magic bullet.

    In psychiatry things went backwards in this respect – e.g. where neuroleptics (meaning drugs that seize the nervous system) were renamed antipsychotics; or antipsychotics/ sedatives/ tranquillizers were renamed mood stabilizers.

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