Ancient History
Every nasty bug has schemed to plague me with disease,
The twin Gods of Illness bore holes in my chest and diaphragm
(“He’s old – why not kill him off?”),
Send vermin of darkness to release their poisonous venom.

The suffocating heat of my body has steamed my vitality away,
I quake as though struck by thunder;
Heaven and earth have become a gigantic two-part steamer
And all the gravy pours out of me.
But suddenly comes a chill to chase away the heat,
And I shiver as though drowning under ice,
Pile up more blankets of coverlets and quilts,
No end to the number I can take.

Why, in such a brief span of time,
Do Yin and Yang alternate so violently?
I cough and sneeze,
Tears running mixed with phlegm,
Toss and turn but can’t find peace
No matter how I rearrange pillow and mattress;
I have trouble whether I’m up or down,
For the slightest movement someone must support me,
So dizzy I confuse square and round,
Fall over all the time go black and pass out.

All my life I’ve eaten a vegetarian diet,
And it’s always suited my taste just fine:
So the five whole mullet they’ve set before me now
Taste about as appetizing as frozen quinine bark.
In the short while I’ve been confined to this hammock,
My scrawny body has turned to Jerky;
People passing by look in
Wondering if I’m not dead and just pretending to be alive.

All day groans issue from my mouth –
Whatever comes brings anger or terror.
Returning to consciousness, I compose myself:
A visitor from far across the seas,
No one knows my mind
Or has pity for a strange accent
                                                                                              
                                           -Chugan Engetsu (1300-1375 CE)
Writing in China in the 14th Century, the Japanese monk Chugan Engetsu describes the symptoms of a disease we can now identify as malaria. The disease had been known in China since at least 2700 BCE when it was described in the Nei Ching – the Canon of Medicine (edited by the Emperor Huang Ti). In the second century BCE, the first mention is made in Chinese medicine of a “cure” for the disease – the Quinhao plant (Sweet Wormwood – Artemisia annua), which is described in the medical treatise 52 remedies. It is from this ancient herbal remedy that the current antimalarial drug artemisinin and its derivatives have recently been developed, which offer one of the most promising new treatments for the disease. It is possible to speculate that Engetsu himself may have been treated with Quinhao, as it is known that he made a full recovery from his illness before returning to Japan. His intriguing reference to another ancient herbal cure for malaria – “quinine bark”, is, unfortunately, an elaboration by the poem’s translator who was attempting to introduce some continuity on the theme of malaria (David Pollack pers. comm.).

The disease has also been described outside of China since ancient times. Fevers associated with splenomegaly (two of the most characteristic symptoms of the disease) were described in the Egyptian Ebers papyrus - reputedly found between the legs of a mummy in the Assassif district of the Theben necropolis and dating from about 1550 BCE. It is also from ancient Egypt that the first mention is made of “bed-nets” in human history, with Herodotus (c. 490 - 431 BCE) describing how Egyptian fishermen would arrange their nets around them as they slept to protect themselves from mosquitoes (Schmidt and Roberts, 2004).

Hippocrates (c. 460-377 BCE) was the first person to differentiate between different types of malarial fever when he categorised the disease into “quotidian” (daily), “tertian” (alternate days) and “quartan” (three days apart) depending upon the fever periodicity. He also noted that the disease was common among those who lived near swamps (but attributed this to the drinking of stagnant water). Indeed, this association of the disease with swampy habitats has given us the name “malaria”, a contraction of the Italian “mala aria” which means “bad or evil air”, in reference to the foul vapours associated with swamps.
References

Schmidt,G.D. and Roberts,L.S. (2004). Phylum Apicompla: Malaria Organisms and Piroplasms. In Schmidt,G.D. and Roberts,L.S. (Eds.), Foundations of Parasitology, . WCB, Dubuque, IA, pp. 137-161.