[This post has been written by Xavier Fernàndez-Busquets]
Perhaps no other disease has left a more conspicuous imprint on human history than malaria
Perhaps no other disease has left a more conspicuous imprint on human history than malaria: from Lucy and all our hominid ancestors who already were most likely bearing the pain inflicted by primitive plasmodia, through the millions of years of our species’ evolution, to the current age of modern medicine, where no less than five Nobel prices have been awarded to malaria-related works.
Reportedly, this ancient scourge might have been responsible for the death of about half of all people who have inhabited the planet; such a murderer would certainly make a good character for a thriller plot. But all tales are made of little stories that often reflect our bewildering humanity: funny, sad, dramatic, selfish, sweet, evil, tender. And this is what the (hi)story that follows is all about.
To fathom the origins of malaria we have to go way back in time, maybe down to Jurassic Park
To fathom the origins of malaria we have to go way back in time, maybe down to Jurassic Park. Although no evidence of the causing agent, the protist Plasmodium spp., has been found yet in dinosaur remains, the fact that the pathogen thrives in present-day birds and reptiles suggests that indeed Tyrannosaurus rex and its relatives might have suffered from the disease. So far, the oldest unambiguous evidence of Plasmodium has been parasite’s DNA isolated from mosquitoes locked in 30 million year-old amber.
Malaria entered the historic record as soon as we could scrawl a few words on any suitable piece of material. Thus, the symptoms of periodic fevers, headache, chills and an enlarged spleen have been found dutifully recorded in the Ebers Papyrus from Egypt, ca. 1570 B.C., on clay tablets of the Ashurbanipal library in Mesopotamia at around 2000 B.C., and in the Nei Ching Chinese medical text dating from 2700 B.C. References to the disease could possibly be traced much before, to the dawn of our orally transmitted tales, as some scholars have suggested that in the fable of Hercules and the Hydra this monster, living in a pestilent swamp, is no other than the impersonation of, by that time, the invisible threat of malaria.
The victims of Plasmodium in the antiquity would belong today in a Hall of Fame: King Tutankhamun in 1327 B.C., Alexander the Great in 323 B.C. and Genghis Khan in 1227 had in all probability been killed by this parasite. Its devastating impact in Ancient Egypt’s society might have been particularly remarkable; some hieroglyphs describe the extended use of rubbing garlic on the skin to repel mosquitoes, which were long suspected to have a direct relation with many fever-related diseases.
In the classical antiquity, it was Hippocrates (460-370 B.C.) in his Book of Epidemics who divided periodic fevers into quotidian (daily), one with recurrent fevers every third day (benign tertian) and another with fevers on the fourth day (quartan). At around 168 B.C. the herbal remedy Qinghao (Artemisia annua) came into use in China to treat female haemorrhoids, as described in the Wushi’er Bingfang (Recipes for 52 Kinds of Diseases). Today the alkaloid artemisinin derived from the same plant is one of the most effective antimalarial drugs; why it started its medical applications to treat varicose veins in the anus of women is anybody’s guess. By 100 A.D. the Roman Lucius Columella associated invisible animaculi with the fevers: “…during the heat a marsh throws up a noxious poison and breeds animals armed with aggressive little stingers, which fly upon us in very thick swarms… whereby hidden diseases are often contracted, the causes of which not even the physicians can ascertain.”
Francesco Torti named the disease “malaria” believing it to be air borne and emanating from the bad air (mal aria) rising from swamps and marshes
Then some first attempts at the so-called “scientific” method appeared. Francesco Torti (1658-1741) named the disease “malaria”, believing it to be air borne and emanating from the bad air (mal aria) rising from swamps and marshes (not a big progress yet there from the times of Hercules and the Hydra). For apparently no other good reason than a whimsical guess, in 1879 Corrado Tommasi-Crudelli and Edwin Klebs pushed forward the entirely imaginary bug Bacillus malariae as the causing agent of malaria, probably as a consequence of an overenthusiastic joining into the current of the exploding microbiological field led by Robert Koch, where every single bodily discomfort was blamed on bacteria. In 1882 Albert Freeman Africanus King was one of the earliest to suggest the connection between mosquitoes and malaria. Unfortunately, this clarity of discernment was lost when he proposed a method to eradicate malaria from Washington, DC: to encircle the city with a wire screen as high as the Washington Monument!
Laveran appended yet another wild and, at the time, ignored speculation: that malaria was transmitted by mosquitoes
Thank goodness the real scientific method finally arrived. Credit for the discovery in 1880 of the true causal agent of malaria belongs to Charles Louis Alphonse Laveran, a French army surgeon who was then stationed in Algeria. Laveran used to look at fresh blood samples, contrary to the current trend of the age when most physicians employed chemical fixatives that prevented the cellular structures from decomposing, but at the price of killing the movement of microbes. On that particular day Laveran left the microscope for a while and when he returned the slide from a malaria patient was packed with wriggling plasmodia, possibly male gametes who took the drop in temperature for a signal of having left the human body and being inside a mosquito, where they could find female gametes. Laveran appended yet another wild and, at the time, ignored speculation: that malaria was transmitted by mosquitoes.
Read the part 2: A Short (Hi)story of Malaria: The Discoveries that Brought Us Here
Read the part 3: A Short (Hi)story of Malaria: Darkness and Light