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1902年諾貝爾醫學獎——羅納德·羅斯——發現蚊子傳播瘧疾的途徑

2022-08-01由 嶽文昌醫生 發表于 歷史

1902年第二屆諾貝爾生理學或醫學獎授予了英國醫生羅納德▪羅斯,表彰其發現蚊子傳播瘧疾的途徑。

1902年諾貝爾醫學獎——羅納德·羅斯——發現蚊子傳播瘧疾的途徑

羅納德·羅斯出生在印度的阿爾莫拉,為英屬印度陸軍將軍坎貝爾·羅斯爵士的十個孩子中的老大。八歲時,他被送回英國,與他的姑姑和叔叔一起住在懷特島,後續在英國完成學業。羅納德·羅斯對藝術充滿興趣,但父親仍然讓羅斯選擇了醫學。由於對醫學缺乏興趣,導致其在醫學生階段並不出色。

畢業後,羅斯於 1881 年 9 月 22 日乘坐軍艦前往印度工作。1883 年,他被派往班加羅爾擔任駐軍代理外科醫生,在此期間,他注意到透過限制蚊子取水來控制蚊子數量的可能性。

1894 年 3 月,與家人一起回倫敦休假,結識了帕特里克·曼森爵士。曼森向他介紹了瘧疾研究中的真正問題,並堅信印度是最適合研究瘧疾的地方。

羅斯於 1895 年 3 月 20 日返回印度,正式開始了他對瘧疾的研究。在他的行李在海關清關之前,他就直奔孟買民用醫院,尋找瘧疾患者並開始製作血片。

1895 年 5 月,羅斯觀察到蚊子胃內瘧原蟲的早期階段,這是發現蚊子傳播瘧疾的重要一步。然而,隨後他被派往班加羅爾調查霍亂,他的研究熱情與計劃也被打斷。

1897 年 7 月,羅斯設法從收集的幼蟲中培養出 20 只成年“棕色”蚊子,並且讓這些蚊子成功地吸取瘧疾患者的血液,隨後他解剖了蚊子。

1897 年8 月 20 日,他證實了蚊子腸道記憶體在瘧原蟲,他最初將其鑑定為“斑翅”(後來證明是按蚊屬的一種)。 8 月 21 日,他證實了瘧原蟲在蚊子體內的生長。這一發現於 1897 年 8 月 27 日在印度醫學公報上發表, 12 月在英國醫學雜誌上發表。

1902年諾貝爾醫學獎——羅納德·羅斯——發現蚊子傳播瘧疾的途徑

1897 年 9 月,羅斯被轉移到一個沒有瘧疾的地方工作,因此他的研究也中斷了。

1898年2月17日,羅斯抵達加爾各答,在總統府總醫院工作。羅斯立即開展了瘧疾和內臟利什曼病(也稱為黑熱病)的研究。但後續的研究並沒有成功,因為患者總是立即得到藥物治療。後來曼森說服他使用鳥類作為研究模型。

最後確定受感染的麻雀為適合的研究模型,到 1898 年 7 月,羅斯確定了庫蚊作為禽瘧疾中間宿主的重要性。7月4日,他發現唾液腺是蚊子體內瘧原蟲的儲存場所。 7 月 8 日,他確信寄生蟲是在咬人時從唾液腺中釋放出來的。他後來證明了瘧原蟲整個傳播過程,蚊子將瘧原蟲從感染的麻雀傳播給健康的麻雀。

1902年諾貝爾醫學獎——羅納德·羅斯——發現蚊子傳播瘧疾的途徑

羅納德·羅斯因發現鳥類瘧原蟲的生命週期而獲得諾貝爾獎,他沒有在人類中建立他的瘧疾傳播概念,而是在鳥類中。羅斯是第一個證明瘧疾寄生蟲是透過受感染的蚊子叮咬傳播的,在他的案例中是禽瘧原蟲。1897 年,義大利醫生和動物學家喬瓦尼·格拉西和他的同事們確定了瘧原蟲在按蚊體內的發育階段;第二年描述了惡性瘧原蟲、間日瘧原蟲和瘧疾瘧原蟲的完整生命週期。

當考慮 1902 年諾貝爾生理學或醫學獎時,諾貝爾委員會最初打算由羅斯和格拉西分享該獎項,但羅斯指責格拉西故意欺詐,最終有羅斯獨享這一獎項。

現在我們都已經瞭解瘧疾的傳播路徑,瘧疾是由瘧原蟲組的單細胞微生物引起的。它透過受感染的按蚊叮咬傳播,蚊子將唾液中的寄生蟲引入人的血液中,從而導致人類的感染。瘧原蟲隨著血液迴圈到達肝臟並在那裡成熟和繁殖。

症狀通常在被受感染的蚊子叮咬後十到十五天開始出現。 瘧疾引起的症狀通常有發燒、疲倦、嘔吐和頭痛。嚴重的情況下,它會導致黃疸、癲癇、昏迷,甚至死亡。如果治療不當,人們可能會在數月後復發。在那些最近從感染中倖存下來的人,再感染引起的症狀較輕。如果該患者沒有持續接觸瘧疾,這種部分抵抗力會在數月至數年內消失。

1902年諾貝爾醫學獎——羅納德·羅斯——發現蚊子傳播瘧疾的途徑

English version:

The second Nobel Prize in Physiology or Medicine in 1902 was awarded to the British physician Ronald Ross for his discovery of the way mosquitoes transmit malaria。

Ronald Ross was born in Almora, India, the eldest of ten children of British Indian Army General Sir Campbell Ross。 At the age of eight, he was sent back to England to live with his aunt and uncle on the Isle of Wight, where he completed his studies。 Ronald Ross was interested in art, but his father still let Ross choose medicine。 Due to lack of interest in medicine, it is not very good at the medical student stage。

After graduation, Ross went to work in India on a warship on September 22, 1881。 In 1883, he was sent to Bengaluru as an acting garrison surgeon, during which time he noticed the possibility of controlling mosquito populations by restricting their access to water。

In March 1894, he returned to London with his family on vacation and met Sir Patrick Manson。 Manson introduced him to the real problems in malaria research and was convinced that India was the best place to study malaria。

Ross returned to India on March 20, 1895, to formally begin his research on malaria。 Before his luggage cleared customs, he headed straight to the Mumbai Civil Hospital to look for malaria patients and start making blood films。

In May 1895, Ross observed the early stages of Plasmodium in the stomach of mosquitoes, an important step in the discovery that mosquitoes transmit malaria。 However, his enthusiasm and plans were interrupted when he was dispatched to Bangalore to investigate cholera。

In July 1897, Ross managed to grow 20 adult “brown” mosquitoes from the larvae he collected, and had them successfully suck the blood of malaria patients, before dissecting the mosquitoes。

On August 20, 1897, he confirmed the presence of Plasmodium in the mosquito gut, which he initially identified as “Spotted Wing” (which later turned out to be a species of Anopheles)。 On August 21, he confirmed the growth of Plasmodium in mosquitoes。 The discovery was published in the Indian Medical Bulletin on August 27, 1897, and in the British Medical Journal in December。

In September 1897, Ross was transferred to work in a malaria-free location, so his research was discontinued。

On February 17, 1898, Ross arrived in Calcutta to work at the Presidential General Hospital。 Ross immediately began research on malaria and visceral leishmaniasis, also known as kala-azar。 But follow-up studies were unsuccessful because patients were always given the drug right away。 Manson later persuaded him to use birds as research models。

Finally identifying the infected sparrow as a suitable model for the study, by July 1898 Ross had identified the importance of the Culex mosquito as an intermediate host for avian malaria。 On July 4, he discovered that the salivary glands serve as storage sites for the malaria parasite in mosquitoes。 On July 8, he was convinced that the parasite was released from the salivary glands when it bit people。 He later demonstrated the entire process of Plasmodium transmission, in which mosquitoes transmit the parasite from infected sparrows to healthy sparrows。

Ronald Ross, who won the Nobel Prize for his discovery of the life cycle of the avian malaria parasite, established his concept of malaria transmission not in humans, but in birds。 Ross was the first to show that the malaria parasite was transmitted by the bite of an infected mosquito, in his case Plasmodium fowl。 In 1897, Italian physician and zoologist Giovanni Grassi and his colleagues determined the developmental stages of Plasmodium in the Anopheles mosquito; full life cycle。

When considering the 1902 Nobel Prize in Physiology or Medicine, the Nobel committee originally intended that the prize be shared by Ross and Grassi, but Ross accused Grassi of deliberate fraud, and Ross ended up with the prize alone。

Now we all understand the transmission route of malaria, which is caused by the single-celled microorganisms of the Plasmodium group。 It is transmitted through the bite of an infected Anopheles mosquito, which introduces the parasite in its saliva into a person‘s bloodstream, causing infection in humans。 Plasmodium circulates through the bloodstream to the liver where it matures and reproduces。

Symptoms usually begin ten to fifteen days after being bitten by an infected mosquito。 Symptoms of malaria usually include fever, tiredness, vomiting and headache。 In severe cases, it can cause jaundice, seizures, coma, and even death。 If not treated properly, people can relapse months later。 In those who had recently survived infection, reinfection caused milder symptoms。 If the patient does not have ongoing exposure to malaria, this partial resistance disappears within months to years。

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