Mentions of malaria can be found in the ancient Roman, Chinese, Indian and Egyptian manuscripts and later in numerous Shakespearean plays. The belief that mosquitoes transmit disease also is an ancient one.
One of the oldest scripts, written several thousand years ago in cuneiform script on clay tablets, attributes malaria to Nergal, the Babylonian god of destruction and pestilence, pictured as a double-winged, mosquito-like insect. A few centuries later, the natives told Philistines settling in Canaan, on the eastern shore of the Mediterranean, of the god Beelzebub, lord of the insects. The evil reputation of this deity increased through the ages until the early Jews named him “Prince of the Devils.”
The connection between malaria and swamps was known even in antiquity and the evil spirits or malaria gods were believed to live within the marshes. This belief is likely the origin of the Greek fable of Hercules and Hydra.
The chinese Nei Ching (The Canon of Medicine), dated 4,700 years ago, apparently refers to repeated paroxysmal fevers associated with enlarged spleens and a tendency to epidemic occurrence, suggesting P. vivax and P. malariae infections.
Sumerian and Egyptian texts dating from 3,500 to 4,000 years ago refer to fevers and splenomegaly, suggestive of malaria. The Sumerian records apparently make frequent reference to deadly epidemic fevers, probably due to P. falciparum.
The Vedic (3,500 to 2,800 years ago) and Brahmanic (2,800 to 1,900 years ago) scriptures of Northern India (Indus valley) contain many references to fevers akin to malaria. They are also said to make reference to autumnal fevers as the “King of diseases”. The Atharva Veda specifically details the fact that fevers were particularly common after excessive rains (mahavarsha) or when there was a great deal of grass cover (mujavanta). The ancient Hindus were also aware of the mosquito’s harmful potential. In 800 B.C. the sage Dhanvantari wrote, “Their bite is as painful as that of the serpents, and causes diseases… [The wound] as if burnt with caustic or fire, is red, yellow, white, and pink color, accompanied by fever, pain of limbs, hair standing on end, pains, vomiting, diarrhea, thirst, heat, giddiness, yawning, shivering, hiccups, burning sensation, intense cold…” Charaka Samhita, one of the ancient Indian texts on Ayurvedic medicine which was written in approximately 300 BC, and the Susruta Samhita, written about 100 BC, refer to diseases where fever is the main symptom. The Charaka Samhita classifies the fevers into five different categories, namely continuous fevers (samatah), remittent fevers (satatah), quotidian fevers (anyedyuskah), tertian fevers (trtiyakah) and quartan fevers (caturthakah) and Susruta Samhita even associated fevers with the bites of the insects.
Malaria appeared in the writings of the Greeks from around 500 BC. Hippocrates, “The Father of Medicine” and probably the the first malariologist, described the various malaria fevers of man by 400BC. Hippocratic corpus distinguished the intermittent malarial fever from the continuous fever of other infectious diseases, and also noted the daily, every-other-day, and every-third-day temperature rise. The Hippocratic corpus was the first document to mention about splenic change in malaria and also it attributed malaria to ingestion of stagnant water: “Those who drink [stagnant water] have always large, stiff spleens and hard, thin, hot stomachs, while their shoulders, collarbones, and faces are emaciated; the fact is that their flesh dissolves to feed the spleen…” Hippocrates also related the fever to the time of the year and to where the patients lived.
The recurrence of malaria is a phenomenon that was known to the ancients and first recorded by Roman Poet Horace (December 8, 65 BC – November 27, 8 BC) in his third satire.
A number of Roman writers attributed malarial diseases to the swamps. In the first century A.D., Marcus Terentius Varro, the Roman scholar whom Caesar named director of the imperial library, suggested in his book on agriculture, De Rerum Rusticarum that swamps breed “certain animalcula which cannot be seen with the eyes and which we breathe through the nose and mouth into the body, where they cause grave maladies.”
By the age of Pericles, there were extensive references to malaria in the literature and depopulation of rural areas was recorded. By about 30 A.D., Celsus described two types of tertian fevers and agreed with the views expressed by Varro. 150 years later, Galen, a famed and influential physician in Rome, recognized the appearance of these fevers with the summer season and a jaundice in infected people. But he believed that malaria was due to a disorder in the four humors of the body. According to him, tertian fever was the result of an imbalance of yellow bile; quartan was caused by too much black bile, and quotidian by an excess of phlegm and a blood abnormality was the cause of continuous fever. Galen suggested that the normal humoral balance should be restored by bleeding, purging, or, even better, by both. These tenets were accepted without question for the next fifteen hundred years.
Dante [1265-1321] wrote this on malaria: “As one who has the shivering of the quartan so near,/ that he has his nails already pale/ and trembles all, still keeping the shade,/ such I became when those words were uttered.” (The Inferno) He died of malaria.
Artist Albrecht Dürer, who contracted malaria in 1520 during a trip to the province of Zeeland in Holland, sought medical advice by sending his physician a sketch showing the upper half of the his body, with an index finger pointing to a yellow spot over the spleen, noting that he felt hurt over that area.
William Shakespeare (1564–1616), mentioned ague (English word for malaria) in eight of his plays. For example, in The Tempest (Act II, Scene II), the slave Caliban curses Prosper, his master: “All the infections that the sun sucks up/ From bogs, fens, flats, on Prosper fall and make him / By inch-meal a disease!” Later, Caliban is terrified by the appearance of Stephano, who, mistaking his trembling and apparent delirium for an attack of malaria, tries to cure the symptoms with alcohol: “…(he) hath got, as I take it, an ague . . . he’s in his fit now and does not talk after the wisest. He shall taste of my bottle: if he have never drunk wine afore it will go near to remove his fit… Open your mouth: this will shake your shaking . . . if all the wine in my bottle will recover him, I will help his ague.”
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