The Heat's On

It has been clearly demonstrated that temperature increases of only a few degrees greater than normal induce profound cellular changes and even cell death. The first beneficial effects of these phenomena were recorded more than a century ago by Busch,¹ who observed the disappearance of a sarcoma after high fever in a patient with erysipelas. In 1893, Coley² noted the same clinical event and then deliberately induced erysipelas as a form of treatment for patients with malignancies. He described disease-free survival from one to seven years in ten of 34 patients with inoperable carcinomas or sarcomas, but was undecided whether to attribute these remissions to the fever induced or to some effect of bacterial toxins. Later, the use of local heat and of pyrogenic bacterial toxins was also evaluated in patients with tumors. Occasional successes then prompted the induction of fever therapy for infectious diseases (syphilis and gonorrhea)