Malaria is a parasitic disease transmitted from one human to another by the bite of infected anopheles mosquitoes. When a human is bitten by a female mosquito looking for a blood meal, the Plasmodium falciparum protozoa (the most common bacteria associated with malaria in American history) enter the bloodstream and travel to the liver, where they multiply. When the protozoa reemerge into the bloodstream, symptoms such as fever, headache, back pain, chills, sweats, nausea, vomiting, diarrhea, and cough appear. By the time a patient shows symptoms, the parasites have already reproduced, clogged blood vessels, and ruptured blood cells. An untreated Plasmodium falciparum infection ultimately can lead to renal failure, pulmonary edema, coma, and even death.

The periodic fevers characteristic of malaria were initially associated with climate and geographic location. Many European writers believed that the effluvia, or exhalations, from marshes and swamps caused the disease. These atmospheric poisons came to be called by the Italian term mal’aria, or “bad air.”

Malaria’s seasonal nature was not lost upon the colonists, who recognized that the disease would flare up annually in almost epidemic proportions. In 1723, a missionary wrote that the malarial illnesses held “one from the beginning of August to the latter end of December.” By the middle of the century, those wealthy enough to afford it began to travel during the fever months to places such as the more salubrious seaside city of Newport, Rhode Island. However, this practice may have been more hazardous, because it did not give such individuals an opportunity to acquire any immunity. Native Americans also had little immunity to the disease, because malaria was unknown in the Americas prior to the arrival of Europeans. Along with smallpox and measles, malaria was the major killer of Native Americans during the colonial period.

Malaria itself, however, usually does not cause death on its own. More often, the disease weakens the individual’s resistance to other diseases that he or she otherwise would have warded off if healthy. Anemia, loss of energy, susceptibility to infection, and chronic invalidism are common characteristics of victims of malarial fever. Although the majority of those infected probably did not die directly of malaria, being weakened from periodic malaria attacks would have made them especially susceptible to other, more lethal diseases.

As with other diseases, malaria also preys on those who are most vulnerable. In the colonial period, infant mortality rates were very high due to their early exposure. Furthermore, young women who contracted malaria often suffered miscarriages and premature labor.

The specter of malaria had a profound impact upon the social, cultural, and political development of the early colonies. Of primary importance was the establishment of a plantation economy in the Southern colonies and the growing dependence of the region’s population upon slave labor. The sudden rise of profitability in rice planting had encouraged the importation of slaves to the New World. Unfortunately, African slaves brought with them not only experience with rice culture but also a less deadly form of malaria, Plasmodium vivax, which in combination with the already virulent Plasmodium falciparum resulted in worsening health conditions for the white population in the Southern colonies.

In the last decades of the seventeenth century, the white population actually experienced a decline in population, while the black population began to become self-sufficient and stable. This population growth, coupled with the fact that black slaves who possessed only one copy of the gene for sickle-cell anemia had greater resistance to malaria (as opposed to individuals who had two copies of the gene and frequently had symptoms of the anemia itself), further justified slavery on a massive scale in those colonies that practiced plantation agriculture.

Though there is no cure for malaria, the primary means of combating the symptoms is the administration of quinine. During the colonial era, the effects of quinine on malaria were not fully understood, though Peruvian bark or cinchona bark, which is a source of quinine, was one of the treatments used if not always effectively.

Dr. Benjamin Rush, a signer of the Declaration of Independence and a member of the Constitutional Convention, experimented with cinchona bark but wrote that “in every case in which I prescribed the bark, it was offensive to the stomach … [it produced] a paroxysm of the fever so violent as to require the loss of 10 ounces of blood to moderate it.” As this suggests, other treatments applied included bleeding, as well as opiates and mercury. In many cases, the treatments were almost worse than the disease. Jeffrey Heeren See also: Death and Dying; Disease; Smallpox. Bibliography Cassedy, James H. Medicine in America: A Short History. Baltimore: Johns Hopkins University Press, 1991. Numbers, Ronald L., and Todd L. Savitt, eds. Science and Medicine in the Old South. Baton Rouge: Louisiana State University Press, 1989. Poser, Charles M., and George W. Bruyn. An Illustrated History of Malaria. New York: Pantheon, 1999.

Drug-Resistant Malaria Spreads, Scientists Hunt Down Genetic Causes

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