Book Review: Bad Air

David Caruso

Leo B. Slater. War and Disease: Biomedical Research on Malaria in the 20th Century. New Brunswick, NJ: Rutgers University Press, ix + 249 pp, $45.95.

Malaria, a vector-borne infectious disease, is caused by a parasite that is widespread through most tropical and subtropical regions around the world. Hundreds of millions of people are infected with malaria parasites every year and close to three million people die from these infections. Historically, it has been one of our greatest killers, devastating populations, disrupting economic networks, and transforming the ways in which people have interacted with each other.

The disease itself, unlike the protozoan parasite, has been known for millennia and recognized by various civilizations from the Egyptians to the Chinese. The name malaria itself comes from medieval Italian: mal aria, or bad air, a term rooted in the miasmatic theory of disease causation and the general observation that there was a prevalence of this disease around odoriferous wetlands. Not until the late 19th century did Charles Louis Alphonse Laveran, a French physician working in a military hospital, identify the causative agent of malaria, a parasitic organism he named Oscillaria malariae.

Malaria was a scourge to the colonial expansion of the European (and the rising American) powers of the 19th century, inhibiting the exploitation of new places and populations. With the discovery of the mosquito vector of the parasite, research into disease prevention and treatment accelerated at a tremendous rate in order to help secure European (and American) control over new colonies. It was not until the 20th century that new discoveries in chemotherapeutic agents began to significantly affect the care of patients suffering from malaria and consequently the colonial enterprise. Progress in the field of malariology was slow but steady throughout the early part of the 20th century. But during World War II malaria met one of its greatest foes: the burgeoning American biomedical government-industrial-academic research complex.

Leo B. Slater’s book, War and Disease: Biomedical Research on Malaria in the 20th Century, is an excellent historical account of the role that combating malaria played in the scientific and organizational transformations to biomedical research in the United States during primarily World War II.

Slater’s book begins with a prehistory of malaria as a disease and the discovery of one of the most effective treatments against malaria: quinine, a derivative from the bark of the cinchona tree native to South America. From its outset the history of the treatment for malaria was merged with the goals and necessities of a colonial and military context: countries with access to quinine could more easily expand into and conquer the tropical and subtropical regions of the globe. Countries that did not have access to quinine were not willing to accept the morbidity and mortality associated with malaria and soon began to pursue alternative, synthetic chemotherapeutic agents to combat the disease.