Dr Livingstone: missionary, explorer and medical pioneer
Dr David Livingstone, born 200 years ago, is known for exploring Africa, and as a missionary who campaigned against slavery, but he also made a lasting contribution to combating tropical diseases.
In Victorian Britain, parts of Africa were nicknamed the "white man's grave" because so many missionaries died of malaria and other diseases.
But when Livingstone led his expeditions, they had a far lower death rate. The difference was that he worked out an effective treatment for malaria based on how much quinine you needed and the answer was quite a lot.
"His breakthrough was the medical implementation of quinine to treat malaria," says Mike Barrett, Professor of Parasitology at Glasgow University, who has studied Livingstone's medical work. "He brought chests full of it with him on expeditions. He would have died 100 times over without it."
Livingstone contracted malaria many times on his trips. But he did not realise, as we know today, that mosquitoes were spreading the disease.
"Livingstone held the common view of the time that you caught malaria from breathing the putrid air of swamps," says Barrett. "The word comes from the Italian 'mala aria', meaning bad air.
"Livingstone never made the connection to say the disease was carried by mosquitoes, but he noticed you were more prone to catch malaria in areas where they were present."
"Quinine kills the malaria parasite. But he thought his recipe was cleansing the system of malaria by clearing the bowels. At the time Livingstone didn't know the real reason it was working, but his diligent note-taking helped those that came after him."
Livingstone's malaria remedies were known as "rousers" by his travelling companions as they would get them back on their feet when they fell ill.
- 6 to 8 grains of resin of jalap
- the same of rhubarb
- three each of calomel and quinine
- made up into four pills with tincture of cardamoms
Following Livingstone's success with the medicine, the pharmaceutical company Burroughs-Wellcome sold a quinine-based medication based on his recipe. They marketed it as "Livingstone's Rousers" and it remained on sale until the 1920s.Medical training
Livingstone trained as a doctor at Anderson's University in Glasgow, which has since become the University of Strathclyde.
He began his studies in 1836 at the age of 23. He funded his education from years of hard work at a cotton mill in nearby Blantyre, where he was born.
He had always shown a strong desire to learn. His father taught him how to read and write. The mill provided school lessons in the evening and he enjoyed reading about natural sciences and religion.
What is malaria?
- Caused by a parasite called Plasmodium, which is transmitted via the bites of infected mosquitoes
- In the human body, the parasites multiply in the liver and then infect red blood cells
- If not treated, malaria can quickly become life-threatening by disrupting the blood supply to vital organs
- In many parts of the world, the parasites have developed resistance to a number of malaria medicines
It was religious belief that drew Livingstone to Africa. After completing his training in London, he joined the London Missionary Society. In 1840 he sailed for Cape Town in South Africa.
Livingstone would travel far to preach, learned tribal languages and was highly respected for his medical work. He specialised in obstetrics and ophthalmology.
While Livingstone's early years in Africa focussed on his work as a medical missionary, his later journeys were about exploration. In 1849 he became the first European to cross the Kalahari Desert to Lake Ngami, and in 1851 he reached the upper Zambezi river.Sleeping sickness
Back in Britain, Livingstone published his best-selling 'Missionary Travels and Researches in South Africa'.
It was more than just an account of his adventures. It revealed important discoveries that helped scientists develop treatment for deadly 'African trypanosomiasis', also known as sleeping sickness.
The disease has animal and human forms. Livingstone suspected the disease in animals was transmitted by the bite of the tsetse fly.
Professor Barrett says his notes were "hugely influential" when human sleeping sickness was identified later.
End Quote Prof Mike Barrett Glasgow University
Arsenical drugs are still used in treatment today. The thread runs right back to Livingstone and his observations”
He added: "Livingstone wrote about how he treated a horse that had fever after being bitten by a fly. He used a solution containing arsenic and the horse recovered temporarily.
"Researchers could read his notes 50 years later and determine that arsenic had an effect. By tinkering with the chemical structure they could develop drugs to treat human trypanosomiasis. Arsenical drugs are still used in treatment today. The thread runs right back to Livingstone and his observations."Later life
Livingstone's breakthroughs did not come without a cost. He returned to Africa in 1858 to explore the Zambezi region. His wife Mary joined the expedition but in 1862 lost her life to malaria.
When Livingstone led his final expedition in 1866 to seek the source of the River Nile, he also fell seriously ill.
He died in present-day Zambia in 1873, at the age of 60, suffering from malaria and dysentery. He never succeeded in finding the source of the Nile.
Thirty years after his death, fellow Scot David Bruce was able to identify the cause of sleeping sickness. Another Scottish scientist, Ronald Ross, would be awarded the Nobel Prize for proving the link between mosquitoes and malaria.
Livingstone could not have realised how important his medical notes would be to the future researchers.
Many patients receiving their treatment today will be unaware of the debt medical science owes to Livingstone and his first steps into the unknown.