Book Review

An Illustrated History of Malaria

N Engl J Med 2000; 342:1844June 15, 2000

Article

An Illustrated History of Malaria
By Charles M. Poser and George W. Bruyn. 165 pp., illustrated. New York, Parthenon, 1999. $75. ISBN: 1-85070-068-0

This elegantly written book is a useful introduction to the medical history of malaria in the past half-millennium. The authors, who are neurologists, have read and digested a broad range of European and American works, sometimes quoting them at length so that readers directly encounter the wide variety of opinions regarding the efficacy of various cures for malaria. Accompanying nearly every chapter is a gallery of portraits of leading figures in the history of malaria, as well as reproductions of the title pages of works deemed particularly important by the authors and other relevant illustrations. A strong bibliography and a list of nearly 350 persons mentioned in the text, with birth and death dates, add to the usefulness of the book.

Unfortunately, despite the title, one should not purchase this book expecting a visually pleasurable experience. The illustrations are often muddy, and several appear to have been poorly cropped. Whether the fault lies in the printing or in the reproduction of many of the illustrations from other medical histories is not readily apparent. The source cited for many of the illustrations from the 17th and 18th centuries is simply a repository, such as the Countway Library, rather than the original source.

The authors apparently recognize that their book has some textual shortcomings, because a foreword by David A. Warrell frankly identifies what he believes are particular errors of evidence and interpretation, as well as the limited relation of this work to much of the current scholarship in the field. Readers should take seriously Warrell's reservations, as well as his pointers on issues in modern malariology.

Fundamentally, the book seems out of step with modern thinking on malaria. It focuses largely on the history of medical treatment, particularly the discovery of quinine, the identification of successful treatment regimens, and the development of successors to quinine in the 20th century. But the appearance of treatment-resistant strains of malaria in recent decades has changed the game considerably, so that a wide variety of other, largely nonmedical, strategies have become important in attempts to reduce the 2 million deaths due to malaria and the millions of infections that occur each year. The book barely mentions the vast mosquito-control campaigns of the past century and does not touch at all on the global malaria-eradication campaign (heavily based on the use of dichlorodiphenyltrichloroethane [DDT]) initiated in 1955 by the World Health Organization. Warrell notes that in recent years, insecticide-impregnated bed nets have been a valuable antimalaria tool.

History itself is a not insignificant tool in the fight against malaria because, without a vaccine and without the expectation that any particular treatment regimen will be effective for long, we must understand cultural and social features and trends as important elements in our antimalaria armamentarium. An Illustrated History of Malaria will open the door for persons new to the field, but reading beyond the specifically medical history of the disease represented by this book is necessary for anyone who wants to be well informed about the background of the situation we are in today with respect to malaria.

Darwin H. Stapleton, Ph.D.
Rockefeller University, Sleepy Hollow, NY 10562