Laveran: "Nature parasitaire des accidents de l'impaludisme" - Eng. translation.
To read the following document in the original French go to Laveran (1922)
Alphonse Laveran was founder of the:
Société de pathologie exotique
Institut Pasteur
25, rue du Docteur-Roux,
75724 PARIS Cedex 15
Founded in 1908
by Alphonse Laveran, Nobel Prize winner 1907
Obituary which appeared in the "Bulletin de la Société de Pathologie exotique" in 1922 (p.373)
written by A. Calmette; translated from the French by Dr.M.Kudrati MBBChProfessor A. Laveran
The death of our founder and honorary President, which occurred on the 18th. May, is an immense cause of sorrow for all of us who had for this illustrious master a profound admiration, mixed with patriotic pride and a devout respect.
For twelve years, lending this place the authority of his great name, he directed our work. If our society has prospered rapidly, and acquired an incontestable prestige in the worlld of learning, and in the eyes of the public, it is to him that we owe this. We have benefited from his glory.
The grief which affects us so painfully is at the same time that of all of humanity since the works of Laveran, especially his great discovery of the haematozoite of paludism, have made a powerful contribution towards an improvement of the conditions in which people live.
Millions of people owe to him their ability to live, to work, and to exploit the riches of the earth in tropical regions where these riches had previously been inaccessible for them. Thanks to him, huge areas became, from then on, open for colonisation. Before him, no-one had suspected a pathogenic rôle for haematozoites, to the extent that it is no exaggeration to say that the work of Laveran appears today to be of the greatest importance in medicine and in hygiene after that of Pasteur.
This work, admirable in its unity and in its continuity, had its origin and its harmonious development described by Laveran himself at the conference which he had in Stockholm when the Swedish Academy of Sciences awarded the Nobel Prize in Medicine to him in 1907.
It is impossible to render an account of one of the greatest discoveries of modern times with more truth and simplicity.
In 1878, he tells us, after having finished my term for 'agrégation' at the military medical school of Val de Grâce, I was despatched to Algeria and put in charge of running a hospital at Bône. A large number of my patients were affected by marsh fever and I was naturally led to study these fevers of which, in France, I had only seen rare and benign forms.
...I had the opportunity of performing autopsies on subjects who had died of pernicious fevers and of studying the melanaemia (1), that is to say, the formation of black pigment in cases attacked by marsh fever. The melanaemia had been described by many investigators, but no one had any clear idea about either the invariability of this alteration in paludism, or of the causes which led to the production of the pigment.
I was struck by the peculiar characteristics that these grains of pigment presented, particularly in the capillaries of the liver and the cerebro-spinal centres, and I tried to follow the formation of this pigment in the blood of patients attacked by marsh fever. I found leucocytes in the blood, more or less laden with pigment, but beside the melanin-bearing leucocytes, spherical, pigmented bodies of variable size, endowed with amoeboid movements, free or linked to the erythrocytes, corpuscles without pigment forming clear spots in the erythrocytes; lastly, pigmented elements with a crescentic shape attracted my attention; I conjectured from then on that they it was a question of parasites.
In 1880, in the military hospital at Constantine, I discovered at the
edges of
the spherical pigmented bodies in the blood of a patient stricken by
marsh
fever filiform elements resembling flagella which were shaking with great
vivacity
and displacing the neighbouring erythrocytes; after that, I had no further
doubt
about the parasitic nature of these elements which I had discovered; I
described the principal forms in which the haematozoite of paludism
shows
itself in notes addressed to the Académie de Médecine and the
Académie des
Sciences (1880-1882) and in an article entitled :
"Nature parasitaire des accidents de l'impaludisme, description d'un
nouveau
parasite trouvé dans le sang des malades atteints de fièvre palustre",
Paris
1881.
These first results of my researches were received with a great deal of scepticism.
In 1879, Klebs and Tommasi Crudeli had described under the name of Bacillus malariae found in the soil and the water of marshy localities, and a good number of Italian investigators had published works confirming the findings of these authors.
The haematozoite which I submitted as the agent of paludism did not resemble Bacteria; it showed itself as a unique entity; in a word, it stood out from the class of known pathogenic microbes, and many of the researchers, not knowing where to classify it, found it simpler to place its existence in doubt.
In 1880, techniques for the examination of blood were, unfortunately, very imperfect, and this contributed to prolonging the arguments relating to the new haematozoite. It was necessary to perfect this technique and invent new procedures for staining in order to visualise the structure of the haematozoite.
Research confirming my findings, rare at first, began to multiply more and more, at the same time as intracytic parasites bearing a great analogy to the haematozoites were discovered in different animals. By 1889, my haematozoite had been rediscovered in the majority of marshy regions; one could no longer place its existence in any doubt, nor its rôle as a pathogen.
Before me, a number of researchers had tried without success to discover the cause of paludism; I, too, would have failed if I had contented myself with an examination of the air, water and soil of these marshy localities, as had been done until then; I had taken, as the base of my researches, the anatomical pathology and the study of palustral blood in vivo, and it is thus that I had been able to achieve the goal.
.....After the discovery of the parasite of paludism in the blood of patients an important question remained to be resolved: in what state does the haematozoite exist in the external environment and how does it lead to the infection? The solution to this problems necessitated long and laborious research.
After having attempted vainly to uncover the parasite in the air, water and soil of these marshy localities, and trying to culture them in a many different media, I reached the conviction that the microbe was also to be found outside the human body in a parasitic state, and very probably as a parasite of mosquitoes.
I expressed this opinion in 1884, in my "Treatise on Palustral Fevers" and I harked back at it on many occasions.
In 1894, in a report of the International Congress of Hygiene held at Budapest on the aetiology of paludism, I wrote; and I quote; "The failure of attempts at culture had led me to believe that the microbe of paludism lived in the external environment as a parasite, and I suspected of mosquitoes, which abound in all these marshy areas and which already play a very important part in the propagation of filariasis."This opinion on the rôle of the mosquitoes was considered at that time, by most of the researchers, to be highly unlikely.
Having left the marshy areas, it was not possible for me to verify the hypothesis which I had made. It is to Dr. Ronald Ross (2)that the merit reverts, for having demonstrated that the haematozoite of paludism and an avian haematozoite very close to the Hoemamaeba (Haemamoeba) malariae accomplished many stages of their evolution in the Culicids and were propagated by these insects.
R. Ross, whose noble and patient research was justly recompensed in 1902 by the Nobel prize in Medicine, well-recognised, in many of his writings, that he had been usefully guided by my inductions, and by those of P. Manson.
Nowadays, the transformations which the haematozoite of paludism undergoes in mosquitoes of the genus Anopheles are well-known, and no doubt is possible any more of the part played by these insects in the propagation of paludism.
....Before the discovery of the haematozoite of paludism, nobody knew of any intracytic, pathogenic haematozoites; today, the Haemocytozoa constitute an important family in terms of the numbers of genera and species, and by the part played in human and veterinary pathology by some of these Protozoa.
The study of these intracytic haematozoites, in drawing the attention of doctors and vets to the examination of blood in tropical areas, enabled the discovery of diseases due to trypanosomes which constitute in their own right, also, a new and very important chapter in pathology.
The recognition of these new, pathogenic agents cast a sharp light on to a great number of questions, obscure not so long ago. The progress achieved shows once again how right the celebrated axiom is, formulated by Bacon :
'Bene est scire, per causas scire'.
I made a point of reproducing these pages. Any commentary, any analysis would have altered their undying beauty.
Other work which Laveran pursued wholly in his laboratory at the Pasteur Insitute on sanguicolous protozoa, and in particular, on the trypanosomes, merely served to increase his renown of as a scrupulous, persevering, knowledgable investigator and perfect technician.
Our bulletin had the first of a certain number of them. Much was done with his excellent collaborator, Professor Mesnil, of whom the election to the Academy of Science was his latest joy.
A few weeks before his death, when, for a long time, he harboured no illusions about the inexorable end of the disease with which he seemed to be affected, he still worked, keeping in touch through his faithful Léon Breton, and through his pupil, Dr. Franchini, with the laboratory he lacked the strength to go to.
The life of Laveran was altogether one of labour. His story is tied up with that of his work. Those among us whom he honoured with his friendship know that underneath an exterior a little reserved and distant, he concealed a great sensitivity of heart. He had the character of an inflexible correctness, speech slow and meditated, and always with well-chosen words which never came with any solemn gestures. His countenance, his clear gaze, reflected the serenity and the honesty of his intellect. He surrounded his researches with a discreet silence, just until the moment when he decided to publish them.
Journalists knocked vainly at his doors, for he never gave interviews. Thus, the public hardly knew him, not that he cared for it much.
He suffered for a long time the indifference, the hostility or the scorn with which his discoveries were greeted. The ignorance and the ingratitude of military chiefs who obstinately barred his access to higher ranks in the army was for him especially hard. Nevertheless, he had his revenge, and how glorious! The Pasteur Institute offered him a laboratory, the Academy of Sciences, the Royal Society in London, all the scientific associations of the world rushed to receive him, and honour him. The Caroline Institute bestowed upon him the Nobel Prize and the Academy of Medicine wished him to become the President of its centenary.
Scientists of the future will pay even greater homage to his memory because his work will appear more splendid and more fertile with the hindsight gained over centuries.
As for us, my dear colleagues, who formed, along with the admirable company of our Master, the sister whom he adored, and the Pasteur Institute, his true family, the immortal name of A. Laveran will remain the raison d'être of our existence. His spirit will live close to us. For the host of successors who, in the future, will have to gather the harvest, the seed of which we owe to him, he will remain as a torch which one follows across the darkness, gropingly, in order to seek the truth.
A. Calmette
Notes:
Laveran: "Nature parasitaire des accidents de l'impaludisme" - Eng. translation
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