Dobson M J
Wellcome Unit for the History of Medicine, Oxford, UK.
Parassitologia. 1994 Aug;36(1-2):35-60.
The marshlands of coastal southern and eastern England had unusually high levels of mortality from the sixteenth to the nineteenth century. The unhealthiness of the environment aroused frequent comment during this period and it was attributed to an endemic disease known as "marsh fever" or "ague". Marsh parishes were perceived both as a danger to the local inhabitants and as a deterrent to potential settlers. This paper traces the geography and history of the "marsh fever" in England and shows that the disease was, in fact, malaria transmitted by anopheline mosquitoes. Malaria, once endemic in the coastal marshes of England, had a striking impact on local patterns of disease and death. Yet this study also suggests that the species of malaria endemic in England were vivax and malariae and not the tropical strains of P. falciparum. The paper outlines a number of ways in which "benign" forms of malaria, acting either directly or indirectly, as well as in conjunction with other factors, could have given rise to the unusually high death rates experienced in early modern marshland England. The discussion concludes with an examination of the reasons for the clinical disappearance of malaria during the nineteenth century, its reappearance after the First and Second World Wars and the problem of imported malaria in Britain today.
从16世纪到19世纪，英格兰南部和东部沿海的沼泽地死亡率异常高。在此期间，环境的不健康状况引起了频繁的评论，人们将其归因于一种被称为“沼泽热”或“疟疾”的地方病。沼泽教区被视为对当地居民的一种危险，也是对潜在定居者的一种威慑。本文追溯了英格兰“沼泽热”的地理和历史，并表明这种疾病实际上是由按蚊传播的疟疾。疟疾曾在英格兰沿海沼泽地流行，对当地的疾病和死亡模式产生了显著影响。然而，这项研究还表明，在英格兰流行的疟疾病种是间日疟和三日疟，而不是恶性疟原虫的热带菌株。本文概述了一些方式，即“良性”形式的疟疾，无论是直接还是间接作用，以及与其他因素共同作用，可能导致了近代早期英格兰沼泽地出现异常高的死亡率。讨论最后考察了19世纪疟疾临床消失的原因、两次世界大战后疟疾的再次出现以及当今英国输入性疟疾的问题。
