HISTORICAL INTRODUCTION TO THE 
SYMPOSIUM ON MALARIA 
By MARK F. BOYD 
INTERNATIONAL HEALTH DIVISION, ROCKEFELLER FOUNDATION, TALLAHASSEE, FLORIDA 
Definition 
In current usage of the past century the 
word malaria has come to designate any 
member of a group of chronic infections 
of vertebrates produced by several species 
of protozoan parasites belonging to the 
family Plasmodidae. Parasites of this 
family are known from a wide variety of 
hosts, including various species of lizards, 
birds and mammals. Not to any species 
included in the last group of hosts are 
these infections more important than to the 
human, in which they are the cause of 
widespread morbidity and mortality. The 
human infections are attributable to three 
or more species of these parasites, which 
for precision should be distinguished by the 
name of the causative parasite as falci¬ 
parum malaria, vivax malaria and malariae 
malaria, although for euphony it is desir¬ 
able to substitute quartan malaria for the 
last term. 
Derivation 
During most of the past century these 
diseases were generically known as malarial 
fevers, the term malaria (Italian, mal 
aria = bad air), as well as miasma, being 
used to designate the supposed exciting 
agent of these as well as other diseases. 
In this sense the former word was intro¬ 
duced into English medical literature by 
Macculloch (1829) who states: “It has long 
been familiar to physicians that there was 
produced by wet lands, or by marshes and 
swamps, a poisonous and aeriform sub¬ 
stance, the cause, not only of ordinary 
fevers, but of intermittent; and to this un¬ 
known agent of disease the term marsh 
miasma has been applied. . . . This is the 
unseen, and still unknown, poison to which 
Italy applies the term that I have borrowed, 
Malaria. ’ ’ Perhaps the best, as well as one 
of the last, expressions of the old viewpoint 
is afforded by the following quotation from 
Sternberg (1884) : “The various types of 
intermittent and remittent fever which are 
cured by quinine are by common consent 
recognized as due to malarial poisoning, 
and ... we must insist that the preva¬ 
lence of periodic fever be taken as the test 
of the presence of malaria.” 
Synonymy 
The antiquity of the association of the 
human race with malaria has brought this 
disease under the observation of countless 
generations of physicians, many of whom 
left a record of their astute observations in 
a rich literature. Unfortunately students 
of modern medicine are but slightly if at 
all conversant with the older writers, par¬ 
ticularly those preceding Laveran, and 
thus fail to appreciate the substantial char¬ 
acter of the contributions which have come 
down to us from the past. In extenuation 
it must be admitted that with the introduc¬ 
tion of modern scientific methods to the 
study of biology, the theory of medicine 
became revolutionized. These changes find 
their expression in medical terminology, so 
that it is often difficult for the physician 
with modern training to grasp fully the 
significance of the older writings. A brief 
consideration of nosological synonymy may 
therefore be useful. 
The different kinds of malarial infection, 
designated according to the modern etio¬ 
logical classification previously given are 
more or less closely represented by the fol¬ 
lowing equivalents in the older literature: 
Vivax malaria: Tertian fever, benign 
tertian fever, simple intermittent fever, 
paroxysmal fever, tertian ague, chills and 
fever, fever and ague. 
1 
