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Imagine, for a second, that it's the early 1900s,
想象一下，在1900年代早期，
and you have an untreatable disease that leads to terrible mental and physical degeneration.
你患上了无法治愈的疾病并导致了可怕的精神及身体上的恶化。
Would you let a sketchy doctor trade it for a slightly less awful disease with a slightly better chance of a cure?
为了摆脱这种恶化，你会用一个渺小的治愈机会向一个半吊子医生换取一个没那么可怕的疾病么？
That was the logic behind pyrotherapy,
这就是发热疗法的治疗逻辑，
a risky technique that was used to treat neurosyphilis in the early 20th century.
发热疗法是一种20世纪早期用于治疗神经梅毒的冒险疗法。
Neurosyphilis can happen when you don't treat syphilis, an infection caused by the spiral-shaped bacterium Treponema pallidum.
当你没有及时治疗梅毒时，你就会患上神经梅毒——一种由螺旋状细菌梅毒螺旋体引起的感染疾病。
It's rare today, because we can treat syphilis with antibiotics.
如今这种疾病已经很稀少了，因为我们可以用抗生素治疗梅毒。
But penicillin, the first antibiotic, didn't come into widespread use until World War II.
但是，作为第一种抗生素，盘尼西林直到二战才被广泛运用。
Before then, there was no known way to kill the bacteria that causes syphilis.
在此之前，还没有能够杀死引发梅毒的细菌。
It was a terrible and stigmatized disease,
这是一种可怕的并饱受歧视的疾病，
typically spread by sexual contact because of sores that form around the genitals or mouth.
通常是由于生殖器或嘴部周围的褥疮而通过性接触传播。
The second stage of a syphilis infection involves a fever and a rash.
梅毒感染的第二个阶段是发烧和皮疹。
That didn't advance to the dreaded neurosyphilis stage in everyone, but it was a significant risk.
不是每个人都会发展到可怕的神经梅毒阶段，但这仍存在重大风险。
Neurosyphilis can occur decades after the initial infection, when the bacterium burrows into the patient's central nervous system
初期感染后，神经梅毒的潜伏期可达数十年，当细菌进入病人的中枢神经系统
and causes a variety of awful symptoms, including dementia-like decline and muscle paralysis.
并引发各种可怕的症状，包括痴呆性衰退和肌肉麻痹。
Even though there was no cure for syphilis, especially the late stage infection,
虽然在当时梅毒无法治愈，特别是后期感染阶段，
a Viennese psychiatrist named Julius Wagner-Jauregg noticed that
但是一位名叫 Wagner-Jauregg的维也纳精神病医生注意到
a neurosyphilis patient under his care showed a remarkable improvement after coming down with a fever.
在他照顾下的神经梅毒患者在染上发烧后有了显著的改善。
He thought the fever might have helped with the disease, but he didn't have a reliable way to cause a fever and test that idea.
他认为发烧或许有助于该疾病的治疗，但是他还没有可靠的方法验证这一想法。
So he conducted small, dangerous, non-consensual experiments with a protein involved in tuberculosis, typhoid vaccines,
因此他用肺结核、伤寒疫苗
and a strain of Streptococcus bacteria — without much success.
以及一种链球菌中的蛋白质做试验，却并未取得多少成功。
Then, in 1917, a soldier with malaria was sent to his psychiatric clinic by mistake.
1917年，一名患疟疾的士兵被错误地送到了他的精神病疗治所中。
And Wagner-Jauregg seized his chance to carry out another pretty shady experiment. Malaria is awful, too.
Wagner-Jauregg抓住了这次机会进行了另一场非常阴暗的试验。疟疾也是可怕的。
It's caused by protozoan parasites from the genus Plasmodium and is transmitted by certain mosquitoes.
这是一种由来自疟原虫身上的寄生性原生虫病所引起的疾病，并通过某种蚊子传播。
It causes repeated bouts of high fever, among other symptoms, and is often fatal.
疟疾会引发高烧的反复发作，在其他症状中，反复高烧通常是致命的。
But unlike syphilis, at the time there was a treatment for malaria in the form of quinine,
但和梅毒不同的是，那时已有一种奎宁治疗疟疾的方法，
an alkaloid derived from tree bark that's toxic to the malaria protozoa.
这是一种从树皮绉中剥离出来的生物碱，其对疟疾原生动物是有害的。
Quinine had been in use by Europeans since the 17th century,
自17世纪起，欧洲就一直使用奎宁，
and they got it from indigenous peoples from South America who had known about it long before then.
并且他们从那些早就知道这种治疗方法的南非土著民族那获取奎宁。
So Wagner-Jauregg took blood from the malaria-infected soldier and injected it into some of his neurosyphilis patients.
因此Wagner-Jauregg采用了患有疟疾的士兵的血液并将血液注射到一些神经梅毒患者体内。
Without their consent, of course.
当然，这并未经过患者们的同意。
Which we don't consider safe or ethical medical practice today.
现在在我们看来这种做法是不安全且不符合医疗实践道德的。
They came down with malaria and endured the cycles of high fever until he gave them quinine to stop it.
这些患疟疾的病人遭受了几轮高烧，直到Wagner-Jauregg给他们使用奎宁后才退烧。
Six of the nine patients he treated in this way recovered at least partially from their neurosyphilis.
在他治疗的9名患者中，有6名患者通过这种方法得到了恢复，至少他们的神经梅毒得到了一定程度的恢复。
When other syphilis patients learned there could be a cure,
当其他梅毒患者知道这种治疗方法后，
they asked to be infected with malaria, and doctors began regularly using the treatment.
他们要求被感染疟疾，医生们开始使用这种治疗方法。
It called pyrotherapy because the goal was to raise the body's temperature, and "pyro" comes from the Greek word for "fire".
这种方法被称为发热疗法，因为其目的是提升身体的温度，“pyro”是希腊语“火”的意思。
Overall, pyrotherapy cured about half of all the people who underwent it, although an estimated 15% or so died from the malaria instead.
总的说来，发热疗法治愈了近一半神经梅毒患者，虽然据估计有15%左右的神经梅毒患反而死于疟疾。
And in 1927, despite his unethical experimentation, Wagner-Jauregg won a Nobel prize in medicine for his discovery.
1927年，虽然Wagner-Jauregg进行过不道德的试验，他还是因这项发现而获得了医学诺贝尔奖。
When World War II rolled around, the need for antibiotics was massive,
二战爆发时，对抗生素的需求非常大，
leading to the development and widespread distribution of penicillin.
从而导致了盘尼西林的发展和广泛使用。
Antibiotics cured syphilis without having to infect people with a dangerous disease that might kill them anyway,
抗生素能够在不让患者感染可致命的危险疾病的情况下治愈梅毒，
so at that point pyrotherapy fell out of use.
因此发热疗法逐渐被弃用。
And then another thing happened around World War II, which is that Wagner-Jauregg applied to join the Nazi party.
此时，在二战期间还发生了另一件事，Wagner-Jauregg申请加入纳粹党。
He was a eugenicist and an advocate for racial purity.
Wagner-Jauregg是一名主张改良人种者，他提倡种族的纯粹性。
The fact that the Nazis rejected him is not enough to make him even remotely an okay dude,
纳粹党拒绝了他的申请，这远不足以让他成为一个还不错的人，
and the Nobel he was awarded has gone down in history as a regrettable one.
并且他所获的诺贝尔奖已被载入史册，成为了人们无法挽救的千古恨。
But pyrotherapy did help some people while it was in use.
但发热疗法的使用确实帮助了一些人。
And another unexpected benefit was that having malaria on hand to treat people led to a better understanding of how it grows and spreads.
另一个意想不到的收获是利用疟疾治疗使我们对疟疾的发展与传播有了更好的了解。
Even though it's malaria that's a global scourge today, without pyrotherapy we could have been a little worse off in our knowledge.
虽然疟疾如今成了一种全球性灾难，但没有发热疗法，我们可能无法更好的了解这一疾病。
Although, here's the thing: we're not even entirely sure why pyrotherapy worked.
虽然，可以说：我们甚至并不完全确定发热疗法有效的原因。
When the treatment was discontinued, so was any study of its effects.
当治疗被中断时，有关其效果的任何研究也会被中断。
Our best guess is that it burns the syphilis bacteria right out of you, because fever is a part of our innate immune systems —
我们最好的猜测是发热疗法将梅毒细菌烧出体内，因为发烧是我们先天免疫系统的一部分——
it heats us up to temperatures that are more difficult for infectious agents to tolerate.
它能够让我们发热到一定温度使致病原难以忍受这种灼热。
But as far as we can tell, the syphilis bacterium is actually fairly heat-tolerant, which doesn't support this hypothesis.
但至少我们知道，梅毒细菌是非常耐高温，这一点就无法支撑这种假设。
It could be that the repeated bouts of fever from malaria are simply too much for it, though.
也可能只是因为梅毒细菌无法忍受反复的高烧。
We just don't know, and there's not much appetite in the scientific community to find out.
我们只是不知道罢了，科学界也没有多少想一探究竟的欲望。
And you can't really blame them.
而且你还不能真的责怪他们。
The other strange thing is that if pyrotherapy works because of the heat hypothesis,
另一件奇怪的事是如果加热假设成立，发热疗法真的有用的话，
it shouldn't work on anything besides infections — and neurosyphilis involves mental illness.
除了传染病，发热疗法不应该对其他任何疾病有效，并且神经梅毒还涉及精神类疾病。
But, strangely, there are anecdotes going back to the Greek physician Hippocrates that
但奇怪的是，在希腊内科医师希波克拉底时期还有许多奇闻异事，
that fever could treat a variety of brain-related illnesses, like epilepsy.
发烧可以治疗各种与大脑相关的疾病，如癫痫。
And at least one recent case in the medical literature, from 2007, shows fever improving symptoms of psychosis.
至少2007年的一个近期案例显示发烧能改善精神病症状。
But these cases don't amount to any clear scientific understanding.
但这些案例仍无法得出确切的科学理解。
And if we want to find out whether heat can help ease any mental or physical illness,
如果我们想要查明加热是否能够帮助缓解任何精神或生理疾病，
we'll need scientific rigor and clear, informed consent of patients — things that weren't on Wagner-Jauregg's radar.
我们需要严谨的科学理论并征得患者同意，而不是像Wagner-Jauregg那样对患者隐瞒。
Thanks for watching this episode of SciShow, which was brought to you by our patrons on Patreon.
感谢收看这些的科学秀，本期科学秀由Patreon赞助商为您呈现。
If you want to help support this show, you can go to patreon.com/scishow.
如果你想支持科学秀，你可以登录patreon.com/scishow。
And don't forget to go to youtube.com/scishow and subscribe!
不要忘记去youtube.com/scishow订阅我们的频道！
