The noble mission of Nobel Laureate Sir Ronald Ross

Abstract

INTRODUCTION July 25 is a Historic Day. On that day in the year 1603, James VI of Scotland was crowned by James of England Uniting Kingdom of England and Scotland. Malaria and Yellow fever, The deadly Mosquito borne diseases, compelled England and Scotland to form the Kingdom of Great Britain through Union Act 1707, to conquer these diseases to set up and spread their Colonies’ business. MALARIA HUNTERS Two legendary Scots, Sir Ronald Ross [Figure 1] (13.05.1857-16.09.1932), inspired and guided by his mentor Sir Patrick Manson (03.10.1894-09.04.1922), made the breakthrough to combat Malaria and Mosquito-borne diseases and thus saving the humanity from this veritable scourge. A French Army Physician and Scientist (Father of Protozoa) Charles Louis Alphonse Laveran (18.06.1845-18.05.1924) discovered “oscillaria Malariae” (Plasmodium) on November 6, 1880 responsible for Malaria at Constantine, Algeria proving the “Germ Theory” of disease propounded by Louis Pasteur (27.12.1822-28.09.1885), in 1870. Thus, it was proved that Malaria (mal aria-bad air in Italian) or Paludism (“means Marshy” in French) is due to parasite, not due to bad air or marshy, i.e., Miasmatic origin. Sir Patrick Manson (Father of Tropical medicine) was the author of “Mosquito Malaria theory.”Figure 1: Sir Ronald Ross (1857–1932)EPIC STUDY Sir Ronald Ross made the landmark discovery that female Anopheles mosquito is the Vector of Malarial Parasite in Secundrabad (August 20, 1897, calling MOSQUITO DAY) and the lifecycle of Malarial Parasite (Bird to mosquito to the bird cycle of malaria) at the Presidency General Hospital, Calcutta (established on April 22, 1770) now, known as SSKM Hospital, Kolkata, at the present Sir Ronald Ross Laboratory on July 4, 1898 (MALARIA DAY). Calcutta (Once Mecca of Medicine in India) is the BIRTH PLACE OF MALARIA LOGY (Covell, 1932). Sir Ronald Ross is revered as FATHER OF MALARIALOGY for his “Great and Epoch making Discovery.” Sir Ronald Ross was awarded the Nobel Prize in physiology and Medicine on December 10, 1902 and he was recognized as “One of Greatest benefactors of mankind.” In Nobel Citation, it was mentioned “for his work on Malaria by which he has shown how it enters the organism and thereby he laid the foundation for successful research on this disease and methods of combating it.” BIOGRAPHY Sir Ronald Ross was born at Almora, India. He was the eldest son of the ten children of Sir Campbell Claye Grant Ross, a General in British Indian Army (Bengal Staff Corps) and Matilda Charlotte Elderton. At the age of 8 years, he was sent to England to study. He completed primary school and secondary education. During school life, he developed intense interest in poetry, literature, music, painting and mathematics and devoted to pursue his passion. He was not very much attentive to his academic study or playing. His father was very tough to his son to be a medical doctor. Hence, he was enrolled at St. Bartholomew’s Hospital Medical Collage in London on October 29, 1874 and passed in 1881. As a Medical Student, he did not show any brightness and also failed in examinations because he devoted to his Passions-not to be a Medical Doctor. INDIA - HIS DREAM Ronald Ross joined Indian Medical Service (IMS) on April 2, 1881, and worked from 25 years at different places such as Madras, Burma, Baluchistan, Andaman Islands, Bangalore, Secunderabad, Calcutta, and Assam. Wherever he went, two things – one iron frame upright Piano and one microscope – always were essential items of his luggage. STUDY ON MALARIA Ronald Ross used to suffer as a child seeing the malaria attack of his grandfather Lt. Col. Hugh Ross. Ross was determined to find a cure of the disease. During course of his Medical School, he saw a female patient presenting with muscle ache and high fever with chill and headache. That lady came from Essex marshes. Ronald Ross thoroughly examined her and provisionally diagnosed as a case of Malaria. However, malaria was very common in south America and India. The patient became frightened to see the exhaustive examination of Ronald Ross. She was lost to follow-up. Hence, Ross could not prove the diagnosis. Ronald Ross’s interest in Malaria began in 1892. He got a Laveran’s masterpiece on Malaria (translated from French to English). It was a great inspiration to him. From 1892 to 1894, he could not find Laveran’s “Oscillaria malariae” (Malarial Parasite). He met Sir Patrick Manson on April 10, 1894, at Cavendish Square, London, who taught him how to see the malarial parasite under microscope. During his leave from June 1888 to May 1889, he obtained D.P.H. (Diploma in Public Health) in London. He was first recipient of D.P.H. in the world. He was trained by Prof. Emanuel Edward Klein (Father of British Microbiology) on Bacteriology for 2 months. He married to Rosa Bessi Bloxam on 1889. From 1894 to 1898, Ronald Ross was under the constant guidance of his mentor Sir Patrick Manson. 173 letters were exchanged between them from 1895 to 1899. Ross observed early stages of Malarial Parasite in the stomach of a mosquito in May 1895. His total devotion was focused on mosquito and Malarial Parasite. It was interrupted when he was deputed to Bangalore as a Sanitary Officer to investigate the outbreak of Cholera. At Bangalore, there was no mosquito. Hence, Ronald Ross was very unhappy, but he worked hard to check cholera through proper massive sanitization (Drainages, Cleanliness, etc). Ross was an adroit environmentalist. Between 1895 and 1897, he made Bangalore in a clean and healthy city by dint of his meticulous planning and leadership. At Sigur Ghat, near Ooty, he saw “dappled winged” brown mosquitoes with peculiar posture. These dappled winged mosquitoes were species of the genus Anopheles. On August 20, 1897, he discovered that female anopheles mosquitoes were the vectors of Malarial Parasite at Secunderabad. He declared August 20, as Mosquito Day. He wrote a poem and sent to his wife Rosa Bessi Bloxam and Sir Patrick Manson On August 22: “This day relenting God Hath Placed Within My Hand A Wondrous thing, and God Be praised. At His command Seeking his secret deeds With tears and toiling breath, I find Thy cunning seeds 0 Million – murdering Death I know this little thing A myriad men will save 0 Death, where is Thy sting? Thy Victory, 0 Grave? This discovery was published in the Indian Medical Gazette on August 27, 1897, and subsequently on the December 18, 1897, Issue of British Medical Journal titled – ”on some peculiar pigmented cells found in two Mosquitoes fed on Malarial blood.” AGAIN INTERRUPTION IN RESEARCH WORK In September 1897, Ross was transferred to Malaria-free Kherwara in Rajputana (Rajasthan). He became angry and deeply frustrated. He threatened to resign from service, but due to Patrick Manson’s (Medical Advisor to Colonial Office) intervention, the Government arranged for his continued service and transferred to Calcutta “On a special duty” for 6 months under the Director General of IMS to investigate Malaria and Kala-azar (Visceral leishmaniasis). He joined the Presidency General Hospital (now SSKM Hospital) Calcutta on February 17, 1898. He was transferred to Calcutta on January 29, 1898. DISCOVERY OF LIFE CYCLE OF MALARIAL PARASITE At Presidency General Hospital, Calcutta Ross did his research on bird (purchased at his own cost) by grey Mosquitoes (Infected Culex Pipiens). His very obedient servant Mohammad Bux helped him a lot. His Laboratory Assistant was Dr. Kishori Mohan Bandhopadhyay. Due to plague in Calcutta at that time, human volunteers were not available; female Anopheles stephensi Mosquitoes do not cause Malaria in birds. Ross knew Danielewski’s studies on bird Malaria. Ross used birds as experimental model. ON July 4, 1898, he made the landmark discovery at D.D. Cunnigham’s Laboratory (at present Sir Ronald Ross Laboratory) of life cycle of Malarial Parasite proving the hypothesis of Laveran and Manson. RETIREMENT FROM INDIAN MEDICAL SERVICE Ronald Ross left Calcutta on August 13, 1898, to get rid of “Administrative Barbarism.” He submitted a report to the Government giving details of “Anti-Malarial weapons” including rational interventional strategies, as he thought to prevent, control, and eradicate malaria. WORK ON KALA-AZAR (VISCERAL LEISHMANIASIS) Ronald Ross submitted his report on the nature Kala-azar on January 30,1899, to the Director General of IMS. Ross named “Leishman-donovan bodies” as parasite of Kalaazar discovered by W. B. Leishman (06.11.1865-02.06.1926) and Charles Donovan (September 19, 1863–October, 29, 1951). Leishman discovered in 1903 but could not definitely identify; Donovan in 1903 in his research found the same but called it a parasite. Ronald Ross solved this dispute and named this parasite as “Leishman-Donovan Bodies.” ROSS JOINED LIVERPOOL SCHOOL OF TROPICAL MEDICINE, UK Returning from Calcutta, Ronald Ross joined as Lecturer with a very poor pay. He worked from 1899 to 1926 at different positions. He retired as Alfred Jones’ Professor and Director of Tropical Medicine. HEROIC EXPEDITIONS During his service at LSTM, he made expedition to Freetown, capital of Sierra Leona (1899 and 1901), Mian mir Lahore (1901), Lagos (1901), Ismailia at Egypt (1902), Panama (1904), Greece (1906), Mauritius (1907–1908), Alexandria (1914–18) to control, prevent, and eradicate Malaria. AWARDED NOBEL PRIZE IN PHYSIOLOGY AND MEDICINE (DECEMBER 10, 1902) Ronald Ross was the First Indian to get the Nobel Prize in Physiology and Medicine. Malaria known as Modern Plague or Deadly Fever (Mrityujwar by Sushruta, 800 BC-700 BCE) is now defeated by Ronald Ross. Sir Ronald Ross was a man of immense versatility; even within malaria, at least three streams of subsequent work flow from his original contribution; in parasitology-work on the life cycle, best known but perhaps not his greatest work, although crucial to all the rest; in epidemiological models which was 20 years ahead of his time and in sanitation or hygiene, in promoting the prevention of Malaria and other diseases by Environmental means. -David J Bradley Director, Ross Institute, London ROSS INSTITUTE AND HOSPITAL FOR TROPICAL DISEASES This institute was inaugurated in 1926 in Putney Heath by the Prince of Wales as a memorial to and in recognition of Ronald Ross’s work. It was dedicated to study of the nature and treatment, propagation and prevention of tropical diseases. In 1926, Ronald Ross became the Director-in-Chief of this institute till his death in 1932. After his death, it was incorporated by the London School of Hygiene and Tropical Medicine. HONOR TO SIR RONALD ROSS After his death on September 16, 1932, The Times, London, paid tribute to him “He slew the Dragon and delivered mankind from immortal bondage.” Dr. W. C. Gorgas said “Dr. Ronald Ross had dug the Panama canal with the help of microscope.” Calcutta honors Sir Ronald Ross. Barkley Bronze Medal by the Asiatic society of Calcutta on May 20, 1903 Gate of Commemoration unveiled by Lord Lytton, in the presence of Sir Ronald Ross at PG Hospital Campus on January 7, 1927. Ronald Ross Building was established at PG (SSKM) Hospital Kolkata in 1954. Ronald Ross oration (yearly) was established at IPGM and R (Institute of Post Graduate Medical Education and Research) in 1956. PG (SSKM) hospital was declared as a Heritage precinct and Sir Ronald Ross Laboratory Building as a Heritage Building by Calcutta Municipal Corporation on January 6,1991 due to appeal of Dr. Ranen Dasgupta. Sir Ronald Ross Sarani (Erstwhile Hospital Road) was declared by the Calcutta Municipal Corporation on the 09.01.2001, in response to appeal of Dr. Ranen Dasgupta Sir Ronald Ross Memorial Malaria Clinic (24 h) at Sir Ronald Ross Laboratory at SSKM Hospital was sanctioned by Government of West Bengal and Kolkata Municipal Corporation in response to appeal of Dr. Ranen Dasgupta, which was inaugurated on February 05, 2004. Sir Ronald Ross Park was established at SSKM Hospital on January 16, 2006. due to my endeavor. CONCLUSION Sir Ronald Ross was a remarkable man who contributed immensely not only in Malaria Research but also as a Mathematician, Epidemiologist, Sanitarian, Editor of Science Progress, Dramatist, Poet, Musician, Composer, Artist, and Author. He was a Polymath. Above all, he was a Medical Missionary. Earnest appeal To Commemorate his glorious attachment to PG SSKM Hospital Calcutta, The IPGME and R (Institute of Post Graduate Medical Education and Research) should be renamed as SIR RONALD ROSS INSTITUTE OF POST GRADUATE MEDICAL EDUCATION and RESEARCH. A MEDICAL MUSEUM should be established at the allotted land for the second campus of PG (SSKM) HOSPITAL at New Town, Kolkata, where foundation stone was laid on 11th November, 2010, to Showcase Calcutta, as MECCA OF MEDICINE and PG HOSPITAL AS PRIDE and GLORY OF BENGAL. The History of Malaria contains a good lesson for humanity. We should be more scientific in our habits of thought and more practical in our habits of Government. -Sir Ronald Ross Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.