"China has achieved another remarkable feat! The number of malaria infections in China has decreased from 30 million in the 20th century to 0 today, which is very worthy of reference by all countries! ”
On 30 June 2021, the World Health Organization issued a bulletin to the world, highly praising China's "total elimination of malaria".
Malaria, which has accompanied human history for millions of years, is the oldest infectious disease. So, what is so terrible about this disease? What terrible role has it played in history? And how did we, the new China, wipe it out step by step?
Today, we will take a look at the history and prevention of malaria.
<h1 class="pgc-h-arrow-right" data-track="8" >1 Malaria broke out in the marching procession, and the Taoist priest used artemisia annua to treat diseases</h1>
In 317 AD, in the Lingnan region of China, an army was marching under the scorching sun.
"This is the southern tip of the Shenzhou land—Guangzhou!" Tao Kan, the new general of Guangzhou and Pingnan, wiped his sweat while riding his horse forward, and this time, he was ordered to come to the Lingnan region to suppress the rebellion.
"Yes, this place in Guangzhou is still a barbaric place, coupled with the high temperature and heat, and the frequent outbreaks of various plague and infectious diseases. Be sure to pay attention to your body! The guard reminded him from the side.
"Report! Great General, the vanguard troops are in trouble! A sentry rushed forward, "Since this morning, there have been soldiers who have fallen to the ground, and the symptoms are very peculiar -- the whole body is cold, but sweaty, gradually unconscious, and by noon, more than two hundred people have been in this situation!" ”
"There is such a thing! Take me to check it out. ”
The situation in front of him made General Tao's heart "cluck" and sink.
These soldiers who fell to the ground wrapped thick quilts around their bodies, and one by one, their faces were red, curled up in the quilts, and their mouths shouted: "So cold, so cold..."
"So cold?" General Tao suspected that he had heard wrongly, and looked up to see the scorching sun, such a hot weather in Guangzhou, sweating like rain, how could it be cold?
"Quick, give me some hot water, I'm chilling all over my body." A soldier screamed pitifully, his teeth still shivering.
"Here it comes, freshly boiled hot water, drink a little." His companions came to help.
However, the soldier had just taken a sip of hot water, but suddenly pushed it away: "It's so hot, it's so hot!" I can't get hot!" However, he kicked the wrapped quilt away, sweating profusely, in pain, and began to convulse.
General Tao was stunned and puzzled: "What is this disease?" ”
"General, they have malaria, commonly known as swinging." The guard explained.
"Swinging? How is it transmitted? Come and listen. ”
"The source of the infection is not known at present, but it is easy to erupt in hot areas, and it is said that there is too much miasma in the south. This disease will feel cold, high fever, alternate, people feel painful, severe will be comatose and die. ”
General Tao frowned, "Don't hurry up and call the military doctor!" So many soldiers get sick, and if it spreads, our ranks will collapse. ”
Unexpectedly, the military doctor was helpless, and he was sweating profusely: "General, malaria is a disease that has existed in ancient times and is the most difficult to treat!" However, the use of conventional herbs to boil soup, the effect is not good, patients often can only rely on their own immunity to resist, if the immunity of poor people, I am afraid it will not be able to save. ”
"General, the place we are passing through is called Luofu Mountain, and there is a Taoist monk living on the mountain, named Ge Hong. It is said that he was very skilled in medicine and often went down the mountain to see the local people. Can I ask him to heal? The guards asked.
"Go and ask Governor Ge Hong!"
Ge Hongdao, who was about sixty years old, with a strong spirit and a long beard, quickly inspected the condition of the soldiers around him, and explained: "The malaria they got needed to use an herb, called 'Artemisia annua', the outer leaves were narrow, needle-like, and the back was green and hairless. Everywhere in the wild on this mountain, soldiers can be ordered to go and pick it. ”
"Good! I immediately ordered people to pick more. "General Tao was overjoyed.
Soon after, the soldiers recovered large quantities of artemisia annua. General Tao waved his hand: "Quickly prepare firewood and iron pots, boil these artemisia in soup, and give them to the sick people." ”
"Wait a minute! Don't do it! But Governor Ge Hong stopped it.
"Elder Dao, shouldn't these leaves of Artemisia annua be boiled into a soup of Chinese medicine?" General Tao was puzzled.
"Non-nor non-also, the treatment of malaria is different from the traditional method of boiling soup!" Ge Hong explained, "You must not boil it in boiling water, otherwise the medicinal properties of Artemisia annua will be destroyed." ”
General Tao was puzzled: "Since ancient times, all kinds of herbs to cure diseases have not been boiled with water soup to cook the juice?" ”
Ge Hongdao waved his hand: "Only this kind of artemisia cannot be used, if it encounters high temperatures, its medicinal effect will be destroyed." Only at room temperature, these artemisia leaves are mashed, twisted out of the juice, and let the patient drink directly, the effect can be effective. ”
"It is no wonder that my military doctor said that malaria is the most difficult to treat, and the ordinary method of boiling Chinese medicine is not effective at all."
"It's just that this method is extremely difficult to operate." Ge Hongdao also said, "Ten pounds of artemisia leaves can often only produce less than two or two juices, and now, it can only rely on simple manpower, and there is no better purification method." Therefore, the efficiency of treating patients is very low and not easy to promote. ”
"Then, my army of 30,000 people is all waiting for orders, under the unified command of the Dao Commander, and manpower is enough."
Finally, after the joint efforts of 30,000 soldiers, thousands of pounds of artemisia leaves were picked, and a sufficient amount of "artemisia juice" was finally obtained, and the patients were finally treated.
Before leaving, Ge Hongdao took out a book from his arms: "General, this is my medical book "Elbow Reserve Emergency Formula", which has a method for malaria, you are running around, you can use it." I also hope that this book can be passed on to future generations and benefit my Chinese descendants! ”
<h1 class="pgc-h-arrow-right" data-track="97" >2 Malaria spread in the early days of New China, Tu Youyou secretly decided to study</h1>
In the blink of an eye, a thousand years have passed.
In 1951, on a hot summer day at Peking University's medical school, teachers were lecturing to new students.
"Malaria is the oldest infectious disease in human history, whether in China or the West, there are a large number of records about it in the history books - as early as the ancient Roman period, soldiers died in large numbers because of malaria, resulting in insufficient military resources in ancient Rome, precarious; in the Chinese Han Dynasty, Emperor Wudi of han sent 100,000 soldiers to conquer the Lingnan region, but also because of malaria, and most of them died, and later dynasties and dynasties have had large-scale infection records, and even the Kangxi Emperor of the Qing Dynasty, when he was on the imperial conquest, was also infected with malaria , almost killed. ”
"Teacher, I would like to ask, malaria was so widespread in ancient times, there was no effective treatment?" A girl with glasses and braids raised her hand and asked.
"Tu Youyou, you asked this very well." The teacher nodded and explained, "In fact, the ancients thought of many ways to treat malaria. For example, in ancient Rome, people used 'bloodletting therapy' to treat diseases, but patients lost too much blood, but died faster; in the Eastern Han Dynasty of China, it was found in the "Treatise on Typhoid Fever" that using 'Changshan' this Chinese medicine, boiling water to take it has a curative effect, but the effect is not good, because the patient will have a vomiting reaction, which will cause other inflammations to get infected. ”
Tu Youyou is a high-achieving student just recruited by Peking University Medical College, she is known for "good at asking questions, asking the root of the matter", she listened to the teacher's explanation on the stage, while thinking, soon, she continued to ask new questions: "Teacher, in ancient times, these methods, is it because the real source of infection has not been found?" As far as I know, many epidemics in ancient times were described in large and condensed terms such as 'miasma' and 'miasma', and often attributed the disease to air infection, so the real source of malaria infection was not found. ”
"Very good, Tu Youyou, you asked the key." The teacher nodded unceasingly, "Indeed, the ancients did not understand that in fact, malaria is not transmitted through the air, but through mosquito bites, and the blood of people with malaria parasites is injected into the human body, thus getting sick." ”
"So, teacher, if we have discovered that 'malaria parasite' is the source of infection, have we found an effective treatment since modern times?" Tu Youyou asked the bottom line.
"In modern times, Western medicine has invented the drug 'chloroquine', which is specifically designed to kill pathogens, that is, malaria parasites. However, this drug, usually only by oral administration, can not be overdose, and its onset is relatively slow, so it is usually targeted for mild and moderate malaria. ”
"I think I must develop a special medicine to treat malaria in the future!" Tu Youyou stared at the medical equation on the blackboard and said so.
1951 was the first year that Tu Youyou became a medical student, and it was also the first year of "epidemic group prevention and group treatment" carried out since the founding of New China.
At that time, China was in ruins and waiting to be revived, and the poor sanitary conditions in the vast rural areas produced a large number of infectious diseases, especially in the southern region, due to the hot climate and mosquito-infested areas, malaria outbreaks were very frequent. According to statistics, at that time, there were 1782 malaria-endemic areas and counties in the country, and there were about 25 million cases of infection, especially in the southern provinces of Yunnan, Guangxi, Guangdong and Hainan, which were the most serious.
In 1955, Tu Youyou graduated from medical school and personally went down to the grass-roots frontline with the leaders of the epidemic prevention station to learn how to prevent and control malaria.
When she went to the south, she saw many women and children in the village lying sick in bed, and she felt shocked:
"This patient, who has had a high fever repeatedly for three days, is severely dehydrated and is currently maintained with glucose..."
"This patient, infected with plasmodium ovale, has produced an enlarged spleen, which has triggered inflammation of the meninges, and is currently under medication and is still under close observation."
"This patient, infected with plasmodium falciparum, is very serious and will be sent to the province for rescue in the afternoon."
"This patient, whose symptoms were milder, was repeatedly infected three times because his living environment was so bad that it was obviously caused by mosquitoes and ticks."
Tu Youyou felt very heart-wrenching.
"In fact, the organization has worked very hard to prevent and control the epidemic. In the face of financial constraints, the province has also allocated millions of dollars for malaria prevention and control. ”
"So, what are the main methods we have now?" Tu Youyou listened while taking notes.
"First of all, we carry out large-scale clean and sanitation campaigns to clean up dirty ponds and swamps to prevent large-scale reproduction of mosquitoes; then, for mild patients, we usually use oral chloroquine, rest at home, and infusion to alleviate symptoms; for severe patients, we treat them according to infectious shock, give corticosteroids, scopolamines, heparin, etc.; if they are the most serious patients, they must be urgently sent to the provincial hospital for rescue." The leaders of the grass-roots epidemic prevention stations elaborated on this.
"So, what is the biggest difficulty we encounter in the specific treatment process?"
"The biggest problem is that resistance is generated! In the early days, the cure rate of chloroquine for malaria patients was close to 95%, and the effect was very good! We were even able to clear malaria at one point. However, in recent years, we have found that malaria has rebounded in many areas! Why? Because the malaria parasite has developed resistance to chloroquine, especially in some rural areas such as Guangxi and Hainan, the cure rate has dropped to 21%. The leaders of the grass-roots epidemic prevention stations expressed embarrassment.
Resistance! Resistance! ——Tu Youyou's young heart has been thinking back to these three words. She was secretly determined to develop a special drug that could get rid of the resistance of the malaria parasite without any side effects.
<h1 class="pgc-h-arrow-right" data-track="98" >3 Thousand years of ancient books highlight the special effect of Artemisia annua, and malaria was cleared in China in the century</h1>
On May 23, 1967, the State Science and Technology Commission held a meeting.
"Today, we are going to arrange a secret scientific research task! Taking today's date as the code name, called the '523 Project', the central government has drawn more than 500 people from all over the country to form a scientific research team, the purpose of which is to develop a new type of drug-resistant malaria drug! ”
Tu Youyou, 37 years old at the time, served as the leader of the first group of the project as a worker at the Beijing Institute of Chinese Medicine. However, the opinions of different experts in the venue broke out into controversy, but she fell into contemplation.
"Why develop new drugs for malaria? Can't the current world-wide conventional drugs be used anymore? ”
"Conventional drugs are becoming more and more resistant, and many patients simply can't be treated..."
"However, the development of new drugs, not every few decades, is difficult to produce results ..."
"The United States and other developed countries are also in progress, they have spent hundreds of millions of dollars to develop more than 30 kinds of compounds, but the effect is not good, we China's current financial resources and manpower, can we achieve the effect of the United States?"
Experts disagreed and took a stand.
At the conference, Tu Youyou also expressed her own opinion: "On the level of scientific research, we are not as good as Western countries, so I think we can find another way to find a special medicine for the treatment of malaria from the traditional medicine of the motherland, that is, the theory of Chinese medicine." ”
Unexpectedly, as soon as her voice fell, she was questioned by many people:
"It's easy to say, but chinese medicine and Western medicine, the system is completely different, how to do it?"
"Chinese medicine is backward, Western medicine is advanced, this female comrade, your idea is too naïve."
"In terms of treating malaria, there was no good formula in ancient China..."
Tu Youyou ignored the discussion of the crowd, and after receiving the task, she organized her own team the next day to carry out project research.
Little by little, time passed. In two years, Tu Youyou wrote 530 draft drugs, experienced more than 320 failures, and spent days and nights of difficult exploration with her colleagues.
Until 1971, when she was consulting ancient books, she stumbled upon an ancient book!
This is written by ge Hong, a Taoist priest of the Jin Dynasty, "Elbow Reserve Emergency Fang", which records that when malaria broke out in Guangzhou that year, the army suffered serious losses, and Ge Hong suggested that the soldiers treat it with artemisia annua. Moreover, the method is not the traditional boiling water to boil the soup, but: artemisia annua in one hand, stain with two liters of water, twist the juice, and serve it. ”
Tu Youyou was excited, and as if he had found a treasure, he and the group members discussed:
"Why not boil it in boiling water?" Could it be that the elements in it will be destroyed? ”
"It is to twist the juice at room temperature and then take it directly, it seems that the temperature is very critical."
"There must be something in Artemisia annua that targets malaria, and we can try to extract it!"
In this way, in 1972, Tu Youyou and her colleagues extracted a colorless crystal with the molecular formula C15H22O5 from Artemisia annua, an active ingredient that can quickly kill the malaria parasite, and they named it - artemisinin!
A thousand years ago, the Taoist Ge Hong left a cure for malaria; a thousand years later, scientific experts have realized this into modern technology!
Since then, the process of treating malaria in China has accelerated! Artemisinin, a special drug, does not produce drug resistance, and at the same time has an excellent effect on killing malaria parasites, which can be described as "killing two birds with one stone"!
Let's look at a set of data comparisons: in the 1950s, there were 20 million malaria cases in the country, and by 1990, the number of malaria cases in China plummeted to 120,000, and the number of deaths fell by 98%!
Moreover, since the 1990s, China has built a system of "malaria vector surveillance and malaria parasite resistance surveillance", formulated a working strategy of "clue tracking, inventory and extraction", and an efficient "1-3-7" working model - that is, case reporting within 1 day, case review and circulation within 3 days, and investigation and disposal of epidemic sites within 7 days, which has become a global work model for malaria elimination, officially written into WHO technical documents and promoted globally.
By 2021, China has successfully achieved "zero malaria" and has become a typical benchmark for epidemic prevention and control worldwide! This great achievement relies on the wisdom left to us by the ancient Chinese people, and it is also the result of the continuous self-improvement of today's Chinese people, as well as the prevention and control system created by thousands of grass-roots organizations!
——END——
Author: Ju Jia
Topic: Kaka
Edited by: Yayu
Typography: Mu Xi