Consider a disease with high mortality, severe morbidity, unknown pathogenesis, imprecise diagnostic features, and no known cure—in short, a condition with no hope. One can only offer soothing words and symptomatic remedy.

Then, there is hope. Anecdotal observations lead to a new hypothesis. A pilot trial indicates that 6 of 9 treated patients “unexpectedly recover.” Larger studies follow and show 30% to 50% improvement. On the basis of what was looked for, the treatment is considered safe, and compared with the desperate condition of the treated, the risks (if any) are deemed tolerable. People the world over begin to offer this exciting therapy. Could there be a Nobel Prize in the horizon for the discoverer?

What was the disease, and what was the cure? The disease was not stroke, hepatic coma, or neonatal encephalopathy. It was general paresis of the insane (GPI), the dreaded neurosyphilis, and the magical remedy was...

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