Ross, Ronald

ROSS, RONALD

(b. Almora, Nepal, 13 May 1857; d. Putney, London, England, 16 September 1932)

medicine.

Ross, the eldest of ten children of a British army officer serving in India, received an English dame and boarding school education. Subsequently he studied medicine at St. Bartholomew’s Hospital, London, but with little enthusiasm. Although he had bowed to his father’s wish that he not become an artist, his passionate interest in the arts took up much of his time. Ross published plays, short dramas, romances, fables, and poetry, much of which received the approbation of John Masefield. He was married in 1889 to Rosa Bloxam and had two sons and two daughters. He was elected to the Royal Society in 1901 and knighted in 1911.

Apart from the arts, Ross had an abiding interest in mathematics, much of his self-education in the subject being undertaken while he was serving in the Indian Medical Service (1881–1888). Ross, whose complex personality can be surmised though hardly delineated from his manifold activities, apparently became more and more conscious of medical problems the longer he remained in India. Later he wrote: “I was neglecting my duty in the medical profession. I was doing my current work, it was true; but what had I attempted towards bettering mankind by trying to discover the causes of those diseases which are perhaps mankind’s chief enemies?”

Unlike most of his colleagues in the Indian Medical Service, Ross was research-minded. In 1888, during his first furlough in England, he earned the newly established Diploma of Public Health and took a course in bacteriology under E. Emanuel Klein. On returning to India, he studied malaria, initially believing that it was caused by intestinal auto-intoxication.

During Ross’s next furlough in England (1894) his successful, far-reaching malarial studies were initiated. This was due in large measure to the influence of Patrick Manson, for three reasons a key figure in Ross’s contributions to the unraveling of the life history of the malarial parasite. First, Manson demonstrated convincingly to a skeptical Ross the correctness of Alphonse Laveran’s pioneering observations of 1880: that the blood of malarial patients contained pigmented bodies of parasites. Second, Manson propounded a theory that mosquitoes transmitted malaria (“On the Nature and Significance of the Crescentic and Flagellate Bodies in Malarial Blood,” in British Medical Journal [1894], 2 , 1306–1308). Third, through an extensive exchange of correspondence with Ross, he helped to sustain the latter’s researches in India during more than three years of difficulties that arose not only from problems of technique and of obtaining volunteer patients, but also from regimental duties and unsympathetic superiors.

In essence the problem Ross set himself—to prove Manson’s hypothesis that mosquitoes transmitted Malaria—was enormous, for he had to contend with two variables: a variety of mosquitoes and a variety of parasites. The questions were which mosquito was the vector and which parasites were the malarial parasites (now known to be species of Plasmodium ). The main points in Ross’s contributions to the problem during 1895–1898 can be summarized as follows.

First, Ross demonstrated that volunteers who drank water contaminated with infected mosquitoes (including larvae) failed to contract the disease. This, along with his earlier doubts that aerial and water contamination provided a ready explanation for the epidemiology of malaria, did much to direct his attention to the possibility that transmission might be via mosquito bites, a point of view expressed by A. F. A. King in 1883. Ross apparently was ignorant of King’s work until 1899; and in fact he met continual problems because of a shortage of scientific literature in India, above all in connection with identifying and classifying mosquitoes.

Second, Ross’s studies on the parasites in mosquitoes involved learning how to identify mosquitoes and to dissect their internal organs. From the beginning Ross was especially concerned with the “motile” parasitic filaments found in mosquito stomachs. The question was what happened to them. While he failed to recognize that the filaments were gametes (a point first appreciated by W. G. MacCallum in 1897), Ross’s supposition that they developed into another stage stood him in good stead, for it ensured that he spaced out his examination of individual mosquitoes from groups that had fed on malarial patients. Even so, it was not until 20 August 1897 (later to be called “Mosquito day” by Ross) that he observed in the stomach wall of a type of mosquito he had not hitherto encountered (a malarial vector Anopheles, rather than the Culex and Stegobium he had been investigating for over two years) a cyst containing granules of black pigment similar to the pigmented bodies initially observed by Laveran.

Third, owing to the administration of the Indian Medical Service, Ross was unable to continue his studies on this stimulating find, which he had immediately recognized should lead him to unravel the complete life cycle. Some months later, however, he was able to study malaria in caged birds and to demonstrate the parasite life cycle, including stages in mosquito salivary glands. He also was able to demonstrate that mosquitoes could transmit malaria directly from infected to healthy birds.

The demonstration that the life cycle of the human malarial parasite was identical was accomplished by Italian workers, but a bitter priority dispute arose. The award of the Nobel Prize to Ross in 1902 laid to rest much of the recrimination.

Ross’s experimental career ended in 1899, when he retired from the Indian Medical Service. His autobiography, published in 1922, entitles the remaining part of his life “The Fight for Life,” reflecting bitterness at the lack of help and recognition he received in India, and also perhaps an egotistical facet of his personality. When he returned to England, he soon became lecturer at the new school for tropical medicine at Liverpool, where his influence was important in its success in pioneering tropical medicine education in Britain. Later Ross held the chair in tropical medicine at Liverpool, and in 1912 he moved to London to take up consulting practice.

Much of the rest of Ross’s life was concerned with public health programs against malaria. They were of outstanding importance, for, at least initially, he had to fight a widespread belief that malaria was caused by effluvia or miasmas, especially those emanating from marshes. His inaugural lecture at Liverpool, “The Possibility of Extirpating Malaria From Certain Localities by a New Method” (destruction of mosquitoes), was an initial broadside that was followed by a range of publications, most of them written for laymen. In 1899 the first monograph of the Liverpool School of Tropical Diseases appeared, a short pamphlet of fourteen pages entitled Instructions for the Prevention of Malarial Fever for the Use of Residents in Malarious Places. It succinctly set out information on such topics as how to avoid being bitten and how to destroy mosquitoes. Other publications on the same theme were Mosquito Brigades and How to Organise Them (London, 1902) and the much more extensive The Prevention of Malaria (London, 1910), which included surveys of conditions in many countries by various contributors. Ross himself traveled fairly extensively to undertake malarial prevention campaigns. During World War I he became consultant in malaria to the War Office. His missionary zeal stood him in good stead in this work, though a pugnacious streak in his personality often aroused hostility and created difficulties which others might have avoided.

Ross’s name and work were perpetuated during his lifetime through the opening in 1926 of the Ross Institute of Tropical Hygiene, the aim of which was to promote research and to stimulate malarial control measures. Ross was its first director, and continued to write on malaria and to encourage others. One of the more interesting notes he wrote while at the Institute was the foreword to M. E. Macgregor’s Mosquito Surveys. A Handbook for Anti-malarial and Anti-mosquito Field Workers (London, 1927). The Ross Institute still exists, adding further interest to the famous emotional verses Ross penned on 21 August 1897, almost immediately after his discovery of the pigmented cyst in the mosquito wall. These verses appeared in his long poem “Exile.”

Before Thy feet I fall,
Lord, who made high my fate;
For in the mighty small
Thou showed’st the mighty great.
Henceforth I will resound
But praises unto Thee;
Tho’ I was beat and bound
Thou gavest me victory.

BIBLIOGRAPHY

I. Original Works. The main printed source of information is Ross’s Memoirs With a Full Account of the Great Malaria Problem and Its Solution (London, 1923); the MS material from which the book was partly compiled is at the Ross Institute and the London School of Hygiene and Tropical Medicine. The Memoirs include a full list of Ross’s writings up to 1922; a complete bibliography has been compiled by M. J. Rees in an unpublished dissertation for the Diploma in Librarianship and Archives (University of London, 1966).

Apart from Ross’s publications noted in the text, three others deserve mention: “On Some Peculiar Pigmented Cells Found in Two Mosquitoes Fed on Malarial Blood,” in British Medical Journal (1897), 2 , 1786–1788 (observations were added by “Dr. Thin, Mr. Bland Sutton and Dr. Patrick Manson”); Report on the Cultivation of Proteosoma, Labbe, in Grey Mosquitoes (Calcutta, 1898); for a more accessible report, see P. Manson, “Surgeon-Major Ronald Ross’s Recent Investigations on the Mosquito-Malaria Theory,” in British Medical Journal (1898), 1 , 1575–1577; and “Researches on Malaria,” his Nobel Prize lecture, in Journal of the Royal Army Medical Corps, 4 (1905), 450–474, 541–579, 705–729, also privately reprinted separately. See also Nobel Lectures Including Presentation Speeches and Laureates’ Biographies. Physiology or Medicine 1901–1921 (London, 1967), 21–119. Some of the points in the Nobel lecture are corrected by Ross in his Memoirs.

II. Secondary Literature. Many articles and notices have appeared on Ross, but a scholarly account written against a background of the times is still lacking. Obituary notices of particular value are in Obituary Notices of Fellows of the Royal Society of London, 1 (1932–1935), 108–114; British Medical Journal (1932), 2 , 609–611; and Lancet (1932), 2, 695–697.

An interesting account of Ross’s malarial work is in P. H. Manson-Bahr and A. Alcock, The Life and Work of Sir Patrick Manson (London, 1927). It treats some of the questions that were raised as to whether Manson deserved as much credit as Ross, insofar as he suggested the mosquito hypothesis and sustained Ross with ideas. Manson, however, always gave Ross entire credit for overcoming the tremendous practical problems and for refining the hypothesis.

J. K. Crellin