The Places of Mal'aria and the Causes of Malaria

Abstract

According to the Hippocratic medicine remittent and intermittent fevers were caused by bad air (mal'aria) and bad water of marshes, which produced miasmata affecting people living near these environments. This wrong theory was remarkably stable and persistent until the end of the last century, being in fact quite adequate to decribe the epidemiology of malaria in Mediterranean areas, where the transmission of the para-site depended on mosquitoes breeding mainly in marsh ecosystems. The theory was even reinforced with the spreading of severe malaria due to Plasmodium falciparum (more closely associated with warm marshy areas) and when a specific remedy, quinine, came into the picture, im-proving the distinction of malaria from other fever diseases. After the di-scovery of the true causes of malaria infection and transmission, scien-tific medicine developed completely new definitions of malarious envi-ronments based on their stratification in terms of transmission risk and several parameters were introduced which provide a measure of the vec-torial capacity. This paper focus on the most relevant historical events that have brought to the present knowledge of malarious environments, examining at the same time the effectiveness and limits of the Hippo-cratic view on the etiology of malaria.