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Reviewed by:
  • War and Disease: Biomedical Research on Malaria in the Twentieth Century
  • Derek S. Linton, Ph.D.
Leo B. Slater. War and Disease: Biomedical Research on Malaria in the Twentieth Century. New Brunswick, New Jersey, Rutgers University Press, 2009. x, 249 pp. $45.95.

The history of malaria has enjoyed a recent surge of interest. Numerous books and articles have treated the globalization of quinine production and efforts to eradicate mosquitoes from Panama to Italy. Little attention has been paid, however, to the creation of synthetic alternatives to [End Page 143] quinine. Although narrower than its title suggests, Slater’s monograph fills this notable gap. Central to his study is the U.S. government sponsored “kaleidoscopic” research project to provide troops with synthetic antimalarials during World War II when the Japanese Empire controlled most of the world’s quinine supply. Slater also examines the organizational and technical prerequisites for this project, many of which he traces to work undertaken by the Bayer Corporation in Germany after World War I. The author relies on a broad range of documents from the archives of Bayer, the Rockefeller Foundation, and Mansfield Clark’s papers at the American Philosophical Society.

Chapter one offers a brief overview of the history of quinine, early chemotherapeutic research, and environmental perspectives on malaria. In keeping with the recent recognition of the vital importance of animal models in biomedicine, Slater then turns his attention to the centrality of avian malaria for laboratory research. The key figure was Wilhelm Roehl, a former Ehrlich associate employed by Bayer, who tested synthetic compounds on canaries. Roehl solved several pressing problems including how to determine both effective and maximum tolerated doses. His methods were crucial for testing plasmochin, the first drug to make the transition from birds to humans. Although Roehl’s avian system was soon modified and extended, nonetheless, it prevailed until the 1950s. Chapter three takes up Bayer’s synthesis of plasmochin, atabrine, and sontochin during the interwar years, which depended on new conceptions of the relation between structure and activity that enabled chemists to identify a series of candidate drugs. Slater’s account is quite technical, but is aided by many structural diagrams. Both Bayer’s approach to drug synthesis and its research organization linking industry and university became models for researchers supported by the Rockefeller Foundation and was carried over into U.S. antimalarial research during World War II. Bayer’s marketing of atabrine in the U.S. via Winthrop Chemical is also highlighted. Although Winthrop won over influential supporters and both United Fruit in Central America and public health campaigns in the South deployed atabrine, a number of highly publicized cases of induced psychosis and negative campaigning by the Quinine Trust limited initial reception in the U.S.

The heart of Slater’s monograph is the wartime research project overseen by William Mansfield Clark, a physiological chemist at Johns Hopkins Medical School and chair of the National Research Council’s Chemistry Division. This project enlisted private chemical and pharmaceutical firms, universities, and government researchers and screened more than 14,000 compounds, eighty of which were tested on humans. Slater clearly endorses Clark’s “kaleidoscopic” organizational model. Clark assured chemical firms that proprietorial information would be [End Page 144] handled confidentially and believed that the smooth functioning of wartime research depended on maintaining trust and personal relations based upon shared professional values. Although Slater’s presentation is certainly clear, it is easy to become lost in the labyrinth of boards and panels. In part because of fears that pharmaceutical corporations would reap most of the benefits of taxpayer largesse, in 1944 A. N. Richards, chairman of the wartime Committee for Medical Research, moved toward a reorganization that resulted in a more centralized bureaucracy and legal and contractual relations, thereby prompting Clark’s resignation. One suspects that here Slater became the captive of his archival sources. The detailed account of Clark’s protracted agonizing over the reorganization is likely to grip only stalwart devotees of bureaucratic infighting.

Slater judges the wartime project a success. Its major achievement was the extensive clinical testing of atabrine under the supervision of James A. Shannon in close coordination with the military. The U...

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