Friday, 17 February 2017

Nobel laureate Dr. Donald Ross, his work on malaria and colonial India connection!

Sir Ronald Ross.
Malaria has been a problem world over and in India, it has been around us for centuries. During the later parts of 19th and 20th  centuries, nearly one-fourth of India’s population was affected by  malaria, and the consequent economic slowdown due to the loss of man-days was estimated to be at Rs. 10,000 million per year in the mid-1930s. About 75 million people are believed to have been infected with malaria every year out of a population of 330 million at the time of August 1947 soon after independence. The direct mortality due to Malaria was estimated at 0.8 million annually.To eradicate the Malaria problem the Govt. of India launched the National Malaria Control Program in April 1953 and since then it has carried out successful programs in many Indian states.

 The entire humanity owes a lot to one colonial British Medical doctor who made a breakthrough discovery to get to the roots of this dreaded disease -Malaria. His name was  Sir Ronald Ross. How many of you know that he did his intense research here on the Indian soil during the colonial period for which he got a Nobel prize in 1902. You must know that this great man achieved this feat despite many odds and poor encouragement from the British Government.

Sir Ronald Ross  FRS FRCS (13 May 1857-16 September 1932),  was the first British Nobel laureate and the first born outside of Europe. He got the covetous award in Physiology or Medicine in 1902 and for his work on the transmission of malaria. It was he who discovered that malaria was transmitted by mosquitoes using a certain biological mechanism and paved the ways to fight the disease.  He was associated with the Indian Medical Service for 25 years and during this period, he came up with an epoch-making medical discovery that had a large positive impact on the human population living across the globe.
Ronald Ross, born in Almora, NW India,  was the eldest of ten children of Sir Campbell Claye Grant Ross, General in the British Indian Army, and Matilda Charlotte Elderton. He had his early education in  England and had a passion for maths, music, and literature. However, on his father's  strong advice, he joined St Bartholomew's Hospital Medical College in London, in 1874. In 1879, after passing the examinations of the Royal College of Surgeons of England, he entered the Indian Medical Service in 1881. Prior to that, he also successfully completed the mandatory Military Medical training that was a requisite for the military-related jobs.  Soon, in the following years, he received a Diploma in Public Health from the Royal College of Physicians and Royal College of Surgeons and took a course in bacteriology which was useful to him in the later part of his research work on Malaria.
His medical assignment between September 1881 to 1894 took him to various parts of India. In 1883, while working in Bangalore
as Garrison surgeon, he realized the possibility of controlling mosquitoes by limiting their access to water. After meeting his mentor  Sir Patrick Manson on 10 April 1894 in London, he seriously focused his attention to Malaria as soon as he landed in Secunderabad, India on 24 April, 1895. He began his work by visiting Clive Hospital in Bombay and collecting blood samples of  patients infected with Malaria and recorded the blood films. In May 1895,  he observed the early stages of the malarial parasite inside a mosquito stomach. His transfer to Bangalore did not enthuse him, however, on a visit to a place called Sigur Ghat near the hill station of Ooty (now in Tamil Nadu), he noticed a mosquito with odd posture on a wall and he called it "dappled-winged" mosquito, not knowing the species name. He visited the malaria-endemic region around Ooty and, in the aftermath, he was down with malaria. He came back to Secunderabad on transfer and in the next couple of years, he could not make any progress in his work.
Dr.Ross, his wife & others, Presidency hospital, Calcutta.

Undaunted, he continued his work on Malaria and in July 1897, he managed to culture 20 adult “brown” mosquitoes from collected larvae. He successfully infected the mosquitoes from a patient by the name of  Husein Khan. Now, Dr. Ross dissected the blood-fed mosquito and, to his surprise, observed an "almost perfectly circular" cell in the gut, which was positively not that of the mosquito. His pioneering work appeared in the 18 December 1897 issue of British Medical Journal.  In August 1898, he confirmed the presence of the malarial parasite inside the gut of the mosquito that  happened to be  "dappled-wings" (species of the genus Anopheles), the one he saw near Ooty. Again, it took another 21 days of keen observation and research to confirm his discovery.
 His transfer to Calcutta which was not a malarial area was not a happy one. However, upon his friend  Sir Patrick Manson's advice he used the birds for his clinical experiments and could see the results. He was with the Presidency Medical College, Calcutta in 1898. Ross discovered on 4 July  that the salivary gland was the storage sites of malarial parasites in the mosquito and by July he became fully convinced  the parasites are released from the salivary gland during biting. He later observed  the transmission of malarial parasite from mosquitoes (in this case Culex species) to healthy birds from an infected one, thus, establishing the complete life cycle of malarial parasite.

Ronald Ross revived  a Nobel Prize in 1902 for his discovery of the life cycle of malarial parasite, "dappled wings". But, it was shrouded in controversy because he failed to explain his concept of malarial transmission in humans, but only in birds, besides he did not come up with the right species of mosquitoes (being not a zoologist). Ross simply described  it as "gray mosquito with dappled wings. In 1897, an Italian medical scientist and a zoologist established the malarial transmission in humans and identified the species. Since Ross'  "maverick" concept was widely discussed long before, the final review committee headed by Prof. Robert Koch gave the credit to Ross for the major break-through.

Grave of Sir Ronald Ross,england
Ross had two daughters and two sons by his wife Rosa Bessie Bloxam. In his personal life, he was impulsive and highly egotistical and lacked good public administration. He did not have good relationship with the Liverpool administration either. He was killed at the Battle of Le Cateau on 26 August 1914 and buried at the nearby Putney Vale Cemetery, next to his wife.

The amazing aspect is he did his research with the same vigor unmindful of the poor support from the English government. 
Dr Ross's discovery  was a boon during the construction of the Panama Canal and other development projects in the tropical countries. During the American occupation of Havana, Cuba, regulations were put into effect by the United States Army for the control of yellow fever. Effective screening of houses, drainage systems, sewers, etc helped them eliminate the yellow fever and also malaria.