Patrick Manson Biography (1884-1922)
Born in Aberdeen, Scotland, Patrick Manson worked in China for 23 years. Hisinterest in tropical parasites made him a pioneer in the founding of the specialty of tropical medicine. Manson earned his MD from Aberdeen Medical Schoolin 1865. His first medical appointment, as assistant medical officer at Durham County Mental Asylum, lasted one year. Manson's older brother was workingin Shanghai and persuaded him to travel.
Manson was posted to Formosa (Taiwan) as medical officer for the Chinese Imperial Maritime Customs in the southwestern port of Takao (Kaohsiung). It was Manson's responsibility to inspect ships and treat crews, which gave him ampleopportunity to observe tropical diseases. He kept a careful diary and described elephantiasis, leprosy (Hansen's disease) and what he thought was heart disease but later learned was beriberi.
At end of 1870, Manson was caught in between a political dispute between Japan and China and on the advice of the British consul, he left Formosa in early1871 to settle at Amoy (Xiamen), a port on the Chinese mainland. At Amoy, Manson had a post with the Baptist Missionary Hospital and a private practice,giving him experience with a large number of cases. He continued to see manycases of elephantiasis and developed a surgical method for removing the copious extra tissue that is part of the disease. His records show that he removedone ton of tissue over a three-year period.
Manson returned to Great Britain for a one-year leave at the end of 1874 andhe scoured the libraries for more information on elephantiasis. In the British Museum, Manson found material from surgeon Timothy Lewis speculating that the parasite Filaria sanguinis hominis (FSH) was the immature form of alarger worm discovered by Thomas Lane Bancroft. Lewis suspected FSH embryossomehow caused elephantiasis, but he could not identify the method. Manson pored over these studies and developed his own theory of mosquito transmission.
When he returned to Amoy, Manson was so caught up in this scientific problemthat he spent all of his spare time on it. He asked two medical students to look for FSH in blood samples. One of the students could only work at night, and he observed many more positive samples than the day observer. From this phenomenon, Manson suspected that there was a recurring pattern in the FSH lifecycle. In the next phase of his research, Manson trained two men whose bloodcontained FSH to examine one another at three-hour intervals over a period of six weeks. This proved the embryos were present in the blood in higher numbers at night than during the day. Manson also showed that the embryos were enclosed in a sheath and they could escape the sheath when the blood was cooledin ice. From this step, Manson theorized that the embryos or embryonic wormscould develop outside the human body, perhaps in the body of the common brown mosquito of Amoy. Again, Manson sought a human model and asked his gardener, whose blood was infected with FSH, to allow mosquitos to feed on him. Manson dissected a newly fed mosquito and was able to find parts of the FSH worm inside the mosquito.
During this period, 1877 through 1878, there was no scientific literature onthe life cycle of mosquitos and Manson's work was held back by several mistaken assumptions. He thought mosquitos ate only one blood meal before dying, and he thought humans caught FSH by drinking water contaminated with larvae.
Despite these setbacks, Manson's work was significant because it was the first time anyone had proven the role of an arthropod (essentially, an insect with feet) in the life cycle of a parasite. This preliminary research eventuallyled to the discovery of vast numbers of parasites that require an arthropodas part of the life cycle. However, when Manson presented his work to the Linnean Society of London in 1878, no one understood the significance of his work. Manson continued his research and clinical work in Asia until the depreciation of the Chinese dollar in 1890, when he returned to London to work at theSeamen's Hospital.
There were many examples of tropical diseases at the Seamen's Hospital and Manson looked at the relationship between mosquitos and malaria, publishing a paper in 1894. With colleague Ronald Ross, he further examined the mosquito-malaria theory. Through the India Office, Manson arranged for Ross to investigate this theory in India. Ross and Manson were in close communication during this research, and their correspondence has been published. In August of 1897,Ross dissected a mosquito that had bitten a malaria patient and found evidence of malaria in the wall of the mosquito's stomach. Ross sent specimens to Manson, who confirmed the findings.
At this point, Ross was sent to an area where there was no human malaria, butthat actually benefited his research. He studied a malaria parasite in sparrows and this helped Ross and Manson reconstruct the complete life cycle of the mosquito. These findings were presented to the British Medical Association.In 1898, an Italian scientist was able to replicate the discovery. Manson was credited with publicizing the research, explaining its significance and eventually helping to control malaria. One portion of his research showed that sleeping in a mosquito-proof hut could save lives while unsheltered people were dying of malaria.
Manson was involved in many aspects of tropical medicine, studying parasitessuch as flukes, ringworms, and guinea worms, and tracing their life cycles. He helped found the College of Medicine at Hong Kong and served as its first dean. He advocated specialized training for doctors planning to work in the tropics. Manson helped set up the world's first school of tropical medicine inLiverpool and was an organizer in the founding of the London School of Tropical Medicine in 1899, at a time when some practitioners thought medical specialization cheapened the profession. Manson helped found the Royal Society of Tropical Medicine in 1907 and served as its first president. He advised the Colonial Office for 20 years. Manson published his best known work, TropicalDiseases: A Manual of the Diseases of Warm Climates , in 1898 and it became a classic textbook, running to 17 editions. The Royal Society elected Manson a fellow in 1900 and he received a knighthood in 1903. He taught at the London School of Tropical Medicine until 1914. After retiring, Manson frequently traveled to Ceylon (Sri Lanka), Rhodesia (Zambia and Zimbabwe), and SouthAfrica. He last addressed the London School two weeks before his death at age77.