The Fever Trail: In Search of the Cure for Malaria

Rating:
Summary: The True Cost of Things We Take for Granted
Review: "The Fever Trail" is a remarkable tale of the quest for a cure for malaria. Unfortunately the early and hard won triumphs of quinine have been somewhat short lived. Now malaria threatens us again throughout the warmer parts of the planet, but the quinine story is none the less riveting for that. Quinine is no longer the preferred treatment for the disease, but it made exploration of the tropics by Europeans possible, as well as making parts of Europe and North America more habitable. The difficulties and missteps involved in the development of quinine are echoed in just about every drug, food or other product that we now take for granted. Such items as honey, sugar, antibiotics, nuclear power, crop varieties, domestic animals, plastics, computers, etc., each have their own stories and at least some of these need to be more emphasized to make us all less complacent. The message is that knowledge is often hard won and needs to be respected. It can also (as in nuclear power) be a double-edged sword.

While the author often rambles, I did not find this too much of a distraction. Instead I was (as I say above) impressed by how human perseverance and even deviousness had managed to overcome huge obstacles to deliver the miracle drug quinine to the outside world. This part of the malaria story has been seldom told in a popular book until now and "The Fever Trail" is very noteworthy for this reason.

The later chapters cover discovery of the malarial parasite, the modern era of anti-malarial drugs, and the attempts to develop a vaccine, parts of the malaria story that several other authors have dealt with as well. The complexities of developing a vaccine are now more appreciated than they were when various researchers started working on the problem and made unsubstantiated and very rosy predictions which proved overblown. Malaria still threatens us and the long battle with this "tropical" disease is far from over. If nothing else, Mark Honigsbaum has reminded of this.

Rating:
Summary: The True Cost of Things We Take for Granted
Review: "The Fever Trail" is a remarkable tale of the quest for a cure for malaria. Unfortunately the early and hard won triumphs of quinine have been somewhat short lived. Now malaria threatens us again throughout the warmer parts of the planet, but the quinine story is none the less riveting for that. Quinine is no longer the preferred treatment for the disease, but it made exploration of the tropics by Europeans possible, as well as making parts of Europe and North America more habitable. The difficulties and missteps involved in the development of quinine are echoed in just about every drug, food or other product that we now take for granted. Such items as honey, sugar, antibiotics, nuclear power, crop varieties, domestic animals, plastics, computers, etc., each have their own stories and at least some of these need to be more emphasized to make us all less complacent. The message is that knowledge is often hard won and needs to be respected. It can also (as in nuclear power) be a double-edged sword.

While the author often rambles, I did not find this too much of a distraction. Instead I was (as I say above) impressed by how human perseverance and even deviousness had managed to overcome huge obstacles to deliver the miracle drug quinine to the outside world. This part of the malaria story has been seldom told in a popular book until now and "The Fever Trail" is very noteworthy for this reason.

The later chapters cover discovery of the malarial parasite, the modern era of anti-malarial drugs, and the attempts to develop a vaccine, parts of the malaria story that several other authors have dealt with as well. The complexities of developing a vaccine are now more appreciated than they were when various researchers started working on the problem and made unsubstantiated and very rosy predictions which proved overblown. Malaria still threatens us and the long battle with this "tropical" disease is far from over. If nothing else, Mark Honigsbaum has reminded of this.

Rating:
Summary: nearly very good
Review: Good God, when I consider the melancholy fate of so many of botany's votaries, I am tempted to ask whether men are in their right mind
who so desperately risk life and everything else through the love of collecting plants.
-Carolus Linnaeus, Glory of the Scientist

If you've ever read James Clavell's great novel, Tai-Pan--and if you haven't, shame on you--you'll recall that when Dirk Struan's beloved Chinese mistress, May-may, comes down with malaria, the proud Protestant trader is forced to go hat in hands to the Catholic bishop to secure a cure for her : cinchona bark. As Clavell renders the tale, only the Catholics, thanks to the presence of their missionaries in South America have access and no the secrets of this marvelous remedy.

Well, comes now Mark Honigsbaum to reveal the remarkable true story behind cinchona bark, of its discovery, of the realization that the quinine that can be derived from the bark can cure malaria (though certain trees produce more quinine), of the attempts of the natives to maintain a monopoly on it, and of the colonial adventurers who set out to steal it from them. The bulk of the book is taken up with exciting expeditions into the Andes in search of the bark, led by men like Richard Spruce, Charles Ledger, and Clements Markham. But these stories eventually begin to run together and as they pile atop one another the feats performed no longer seem so remarkable. The author also has something of an axe to grind, referring to the eventual illicit exportation of the cinchona trees to Java and India which broke the South American monopoly as one of history's greatest robberies. this has the unfortunate effect of making the heroes of the book come across simultaneously as villains. Moreover, it seems a debatable point whether the "robbery" was justified, since the original bark exporters proved unable to meet demand and since for those with malaria access to the medicine it produces can be a matter of life and death.

Even today malaria still kills as many from one and a half to three million people a year and Mr. Honigsbaum ends with a section on the current science and the ongoing search for a cure. One of the more promising lines of research appears to involve a DNA vaccine, taking DNA from the mosquito-born parasite that causes malaria and injecting it into muscle in order to get the immune system to produce T cells that will attack the parasite when it appears in the body. this is all interesting enough, but has the feel of having been tacked on to flesh out the book.

Ultimately this seems a case where less would have been better. For instance, had Mr. Honigsbaum just told the story of one of the cinchona hunters. Or perhaps he might have gone the historical novel route and combined some of the characters. As it stands, while much of the background on malaria is fascinating and the various searches for cinchona are exciting, the narrative ends up being a bit too diffused. One never really has a sense that the author had a necessary end point he was trying to reach, and so he seems to be meandering. Some of the meanders prove worthwhile in their own rights, but the attention does begin to wander. It's a book worth reading but it's frustrating in that one suspects a better book lurks within.

GRADE : C+

Rating:
Summary: nearly very good
Review: Good God, when I consider the melancholy fate of so many of botany's votaries, I am tempted to ask whether men are in their right mind
who so desperately risk life and everything else through the love of collecting plants.
-Carolus Linnaeus, Glory of the Scientist

If you've ever read James Clavell's great novel, Tai-Pan--and if you haven't, shame on you--you'll recall that when Dirk Struan's beloved Chinese mistress, May-may, comes down with malaria, the proud Protestant trader is forced to go hat in hands to the Catholic bishop to secure a cure for her : cinchona bark. As Clavell renders the tale, only the Catholics, thanks to the presence of their missionaries in South America have access and no the secrets of this marvelous remedy.

Well, comes now Mark Honigsbaum to reveal the remarkable true story behind cinchona bark, of its discovery, of the realization that the quinine that can be derived from the bark can cure malaria (though certain trees produce more quinine), of the attempts of the natives to maintain a monopoly on it, and of the colonial adventurers who set out to steal it from them. The bulk of the book is taken up with exciting expeditions into the Andes in search of the bark, led by men like Richard Spruce, Charles Ledger, and Clements Markham. But these stories eventually begin to run together and as they pile atop one another the feats performed no longer seem so remarkable. The author also has something of an axe to grind, referring to the eventual illicit exportation of the cinchona trees to Java and India which broke the South American monopoly as one of history's greatest robberies. this has the unfortunate effect of making the heroes of the book come across simultaneously as villains. Moreover, it seems a debatable point whether the "robbery" was justified, since the original bark exporters proved unable to meet demand and since for those with malaria access to the medicine it produces can be a matter of life and death.

Even today malaria still kills as many from one and a half to three million people a year and Mr. Honigsbaum ends with a section on the current science and the ongoing search for a cure. One of the more promising lines of research appears to involve a DNA vaccine, taking DNA from the mosquito-born parasite that causes malaria and injecting it into muscle in order to get the immune system to produce T cells that will attack the parasite when it appears in the body. this is all interesting enough, but has the feel of having been tacked on to flesh out the book.

Ultimately this seems a case where less would have been better. For instance, had Mr. Honigsbaum just told the story of one of the cinchona hunters. Or perhaps he might have gone the historical novel route and combined some of the characters. As it stands, while much of the background on malaria is fascinating and the various searches for cinchona are exciting, the narrative ends up being a bit too diffused. One never really has a sense that the author had a necessary end point he was trying to reach, and so he seems to be meandering. Some of the meanders prove worthwhile in their own rights, but the attention does begin to wander. It's a book worth reading but it's frustrating in that one suspects a better book lurks within.

GRADE : C+

Rating:
Summary: The Quest for Quinine
Review: Malaria is still with us and getting worse. The story of the complicated, centuries-long battle against the disease that kills about a million people a year in Africa alone is well told in _The Fever Trail: In Search of the Cure for Malaria_ by Mark Honigsbaum. It is a story of astonishing human hardship in the effort (not always inspired by riches) to get understanding and control of the disease, but it is sadly clear by the end of the tale that despite the optimism of individual researchers, the tiny parasites borne by mosquitoes all over the world are simply too complicated for us to control any time soon.

Much of the effort to cure malaria was sparked as Europeans spread over the world and found their lives in jeopardy from it. The Jesuits learned (perhaps from the Indians) about the bark from the cinchona tree, and the church recommended its use. Physicians in northern Europe, however, were deeply suspicious of such a papist and Jesuitical drug; Cromwell, according to legend, refused the "Popish remedy," and died. Even-tually the efficacy of the drug triumphed over religious bigotry. Much of The Fever Trail has to do with the nineteenth century race to steal specimens and get them to plantations owned by Europeans. In particu-lar, the efforts of three Englishmen, who in independent efforts, suffered unbelievable deprivations on the trail which are well described here. Strangely, the British efforts amounted to little. The Dutch bought seeds for £20 from one of the explorers, and they happened to be the very best specimens. They went to Java, grown in scientifically designed plantations, and the Dutch cornered the market on quinine.

If quinine were a real cure, malaria might now be as dead as smallpox. However, the parasite that causes the disease has a complicated life cycle within mosquitoes and humans, and is not so easily banished. It has become resistant to quinine and the other antimalarial drugs derived from quinine. The attempt by the World Health Organization to use DDT to blitz the mosquito forever from the Earth was a failure that showed just how resourceful evolution could be in making mosquitoes resistant as well. What is needed is a foolproof vaccine, but although we have vaccines against various viral illnesses, no one has been able to invent one that works against a parasite. The attempts to develop a vaccine, the complicated finances of making drugs that can be used in impoverished countries, and the advantages of the mosquito net (whose inventor, David Livingstone said, deserved a statue in Westminster Abbey) are all covered in a fascinating book that reads like dispatches from a long, losing war. With the prospect of global warming extending the reach of the mosquitoes, it may be that the worst of the war is yet to come.

Rating:
Summary: The Quest for Quinine
Review: Malaria is still with us and getting worse. The story of the complicated, centuries-long battle against the disease that kills about a million people a year in Africa alone is well told in _The Fever Trail: In Search of the Cure for Malaria_ by Mark Honigsbaum. It is a story of astonishing human hardship in the effort (not always inspired by riches) to get understanding and control of the disease, but it is sadly clear by the end of the tale that despite the optimism of individual researchers, the tiny parasites borne by mosquitoes all over the world are simply too complicated for us to control any time soon.

Much of the effort to cure malaria was sparked as Europeans spread over the world and found their lives in jeopardy from it. The Jesuits learned (perhaps from the Indians) about the bark from the cinchona tree, and the church recommended its use. Physicians in northern Europe, however, were deeply suspicious of such a papist and Jesuitical drug; Cromwell, according to legend, refused the "Popish remedy," and died. Even-tually the efficacy of the drug triumphed over religious bigotry. Much of The Fever Trail has to do with the nineteenth century race to steal specimens and get them to plantations owned by Europeans. In particu-lar, the efforts of three Englishmen, who in independent efforts, suffered unbelievable deprivations on the trail which are well described here. Strangely, the British efforts amounted to little. The Dutch bought seeds for £20 from one of the explorers, and they happened to be the very best specimens. They went to Java, grown in scientifically designed plantations, and the Dutch cornered the market on quinine.

If quinine were a real cure, malaria might now be as dead as smallpox. However, the parasite that causes the disease has a complicated life cycle within mosquitoes and humans, and is not so easily banished. It has become resistant to quinine and the other antimalarial drugs derived from quinine. The attempt by the World Health Organization to use DDT to blitz the mosquito forever from the Earth was a failure that showed just how resourceful evolution could be in making mosquitoes resistant as well. What is needed is a foolproof vaccine, but although we have vaccines against various viral illnesses, no one has been able to invent one that works against a parasite. The attempts to develop a vaccine, the complicated finances of making drugs that can be used in impoverished countries, and the advantages of the mosquito net (whose inventor, David Livingstone said, deserved a statue in Westminster Abbey) are all covered in a fascinating book that reads like dispatches from a long, losing war. With the prospect of global warming extending the reach of the mosquitoes, it may be that the worst of the war is yet to come.