The History of Antimalarial Drugs

Abstract

Physicians have diagnosed and treated fevers for thousands of years. Until Robert Koch, Louis Pasteur, and their contemporaries uncovered the “germs” that cause most febrile illnesses, fevers were considered diseases, not results of diseases. Fevers were treated with a variety of remedies, such as bloodletting or herbs, most of which were ineffective. Malaria-like febrile illnesses (with names like “the ague” or “paludism”) have been described since Hippocrates as fevers that were periodic and associated with marshes and swamps. The word “malaria” comes from the Italian “mal’aria” for “bad airs.” It was not until the 1880s and 1890s that Alphonse Laveran, Ronald Ross, Battista Grassi, and others were able to identify the malaria parasite and link the transmission of malaria to mosquitoes. Although the understanding of the mosquito cycle led to a number of new approaches in vector control in the early 20th century, malaria prophylaxis and therapy continued to draw on earlier remedies. Indeed, what is remarkable about malarial fevers is that two herbal treatments, cinchona bark and qinghao, were used to treat malaria effectively for hundreds of years prior to the understanding of the mosquito cycle. Today both quinine (derived from the cinchona bark) and artemisinin (from qinghao) remain of prime importance in the control of malaria.