The Untold Story of Sir Ronald Ross by Stanton E Cope
It is highly likely that many of you have heard the name Ronald Ross, and perhaps you even know a bit about him. In the history section of almost any medical entomology class or textbook, we learn that Ross, a British physician of Scottish descent, is credited with the first successful demonstration of the transmission of malaria parasites (in birds), and that he was guided in his studies by Sir Patrick Manson, generally considered the Father of Tropical Medicine.
But who was this person? What did he really want to do with his life? And how did the confused son of a dominant father end up a Nobel Prize winner in a profession he avoided and loathed as a young man? Let’s find out. This article will not regurgitate all of the scientific and professional accomplishments of Ross, but instead, is intended to provide a snapshot of the unique and fascinating foundation upon which his career was built.
Ronald Ross was born in Almora, India, on the fringe of the Himalayan Mountains, on May 13, 1857. He was the eldest of 10 children of whom 9, remarkably, survived to adulthood. His father, Brigadier General Sir Campbell Clay Grant Ross, was stationed in India where the Ross Family had connections for over a century. Ross’s mother was Matilda Charlotte Elderton, of whom he wrote “like all mothers…ours was the best in the world.” Judging from his own account in his Memoirs written in 1923, Ross appears to have experienced the typical life of a British child in India.
EARLY EFFORTS AND FAILURES
In April of 1865, when he was nearly 8 years old, Ross was sent back to England for schooling. He lived with his father ’s sister and her husband, also an Army officer. For the next 9 years, Ross attended various schools, including a boarding school, where he was grounded in the classics, became proficient in mathematics, and studied drawing and music. He also indulged his interest in natural history, star ting a book “which should contain a description of every known species of animal.” He read the Bible and studied noted authors such as Pope, Milton and Shakespeare.
By age 17 (1874), Ross’s career goal s focused on being an artist or joining the Army or Navy. However, his father had other ideas for his eldest son. In Ross’s own words, “my father had set his heart upon my joining the medical profession and, finally, the Indian Medical Service, which was then well paid and possessed many good appointments….but I had no predilection at all for medicine and like most youths, felt disposed to look down upon it.”
Ross enrolled in medical school at St Bartholomew’s Hospital in London after being delivered to the front door by his father personally, but his academic efforts were diluted with writing drama and poetry, composing and playing music, and teaching himself to play the piano. In 1879, after 5 years of insincere effort, Ross failed to qualify in medicine. Then, he made a fateful decision. Threatened with losing his father’s financial support to continue his medical school efforts, Ross instead took a job as a Ship’s Surgeon, something that he had qualified for while in school.
During the next two years while crisscrossing the Atlantic, he was able to study for his medical exams while engaging with a cross-section of human it y bound for a better life in the United States. At one point, he performed an above-elbow amputation without any skilled help. Ross was so moved by this whole experience that he started writing a tale called ‘The Emigrants’ but he never finished it.
MARRIAGE AND EARLY STUDIES ON MALARIA
Ross finally joined the Indian Medical Service and served in India and Burma until 1888. By this time, pay in the Service was average or below and opportunities for promotion were scarce due to a plethora of junior officers. Also, the medical work was slow so Ross had plenty of time to devote to tennis, golf, writing dramas and studying mathematics and philosophy. This was not, however, Lieutenant Ross’s ‘cup of tea,’ and depression set in. In 1888 he returned to England on furlough. His life was about to change drastically.
Ross met and married Rosa Bessie Bloxam in 1889. After a brief honeymoon in Scotland, he really began to apply himself to his chosen profession and concentrated more and more on sanitation, as he had seen first-hand its importance in India. He received a Diploma of Public Health from a newly-established curriculum in London, the first member of the Indian Medical Service to do so. Also, he took a two-month course in the fledgling discipline called ‘bacteriology.’
Ross saw 1889 as a turning point in his life. Even though he was a romantic, he did not attribute it in any way to the presence of his new bride in his life. In fact, Ross rarely mentions her in his Memoirs. Instead, writing about the years immediately before he met Rosa, he states “ for six years, I had toiled outrageously at almost everything, sparing neither body nor mind; solitary toil which I never mentioned to my friends. Now [referring to his depression in 1888] had come the reaction…I could work no more – nor even play; my ponies browsed unsaddled, my books rested unread. Then, moreover, my faith died – the greatest of all faiths, the faith in labour; and I was overcome with the horror of the cui bono. What was the use of anything?” Cui bono is Latin for ‘ to whose benefit.’ The marriage produced 4 children; 2 boys and 2 girls. The eldest child, Campbell Ross, was killed in battle at age 19, shortly after the start of World War I.
With his new wife, new diploma and new training in tow, Ross returned to India with renewed enthusiasm, and he dove right in. He took with him several bacterial cultures and he began to study mosquitoes. One of Ross’s weaknesses, however, was his ignorance of the published literature. In 1880, a French Army physician named Alphonse Laveran first observed malaria parasites in human blood, and his discovery was widely known.
Strangely, Ross soon began to preach on two themes regarding malaria: (1) that the vast majority of supposed malarial fevers were really intestinal in origin (referred to by Ross as ‘intestinal auto-intoxication’); and (2) that Laveran’s so-called ‘parasites’ were really nothing more than blood cells misshapen by faulty techniques used to examine them! This was quite a brash statement from one who only recently became relatively proficient at microscopy.
The year 1894 arrived, and with it a year’s furlough to London for Ross, his wife, and two daughters. On April 10th, Ross met Sir Patrick Manson. It was the beginning of a relationship in science and friendship that both men needed and from which the world benefitted. Manson’s contributions to Ross’s efforts may be summarized as follows:
First, he convinced Ross of the correctness of Laveran’s observations, even showing him malaria parasites on several occasions. Second, he spoke with Ross many times about his theory that malaria parasites were somehow transmit ted by mosquitoes. Third, and most importantly, through an extensive and well-preserved series of letters between the men, which in their own right are a literary epic, he helped to sustain, guide and challenge Ross through more than three years of frustrations, discoveries and difficult conditions in India.
Manson harnessed Ross’s unique talents, curiosity and insatiable appetite for work to a significant purpose, and kept him focused on the ‘main thing.’ Also, he knew that others were close to revealing the secrets of malaria transmission, and he pushed Ross to succeed, and soon. The following quotation from one of Manson’s letters illustrates this nicely:
“I was terribly disappointed for I thought you had fallen sick, or that you had got a check, or that you had given up the quest. Above every thing, don’ t give it up. Look on it as a Holy Grail and yourself as Sir Galahad, for be assured you are on the right track. The malaria germ does not go into the mosquito for nothing, for fun or for the confusion of the pathologist. It has no notion of a practical joke. It is there for a purpose, and that purpose, depend upon it, is its own interests – germs are selfish brutes.”
THE GREAT DISCOVERY AND THE NOBEL PRIZE
After leaving Manson and returning to India, Ross began his quest with a handicap that would have easily overtaken a lesser man – ignorance of almost everything he needed to know! As previously mentioned, he had taken a short course in bacteriology. He was self-taught in microscopy and did not know the literature so he was unaware of a new staining procedure that would have likely saved him hundreds of hours. As serious as these deficiencies were, they were trivial compared to his total lack of knowledge concerning mosquitoes!
His task was simply stated – to study Plasmodium, not in humans, but in mosquitoes – but incredibly complicated, and he encountered almost every possible obstacle. His major contributions over the next three years may be summarized as follows:
First, he demonstrated that volunteers who drank water contaminated with infected mosquito adults and larvae failed to contract malaria. Second, on August 20, 1897 he observed developing human malaria parasites and their characteristic black pigment in the stomach wall of Anopheles mosquitoes, which he cal led “dapple-winged.” For years after, Ross referred to this date as ‘Mosquito Day.’ The third and most significant contribution made by Ross came about courtesy of the British Army, for about one month after Mosquito Day, he received orders to an area where there was no human malaria. Ross was incredibly disappointed and frustrated by this at first. Some months later, however, this ever-resourceful scientist was able to demonstrate the full avian malaria life cycle using sparrows and Culex mosquitoes.
Ross’s experimental career ended in 1899 when he retired from the Indian Medical Service, perhaps so that he would not have to be away from his daughters, who likely would have been sent back to England for schooling. I shall have more to say about this later.
Ross was nominated for the Nobel Prize in Medicine in 1901, but he did not win. He was nominated again in 1902, and it was suggested by some that he share the award with Laveran, but Laveran did not receive his Nobel Prize until 1907. Ross was one of 42 well-qualified candidates, a list that was pared to 3 finalists. They were Ross, Pavlov of ‘Pavlovian response’ fame, and Niels Finsen, who worked on phototherapy of tuberculosis. Ross won, and his monetary award amounted to 141,846 Swedish crowns, then equivalent to about 7,880 pounds sterling, which was a considerable sum in 1902. Ross received his Nobel Prize on December 10, 1902, in Stockholm from the King of Sweden, Oscar the 2nd.
ROSS vs GRASSI
I would like to briefly examine the rift (to put it mildly) that developed between Ross and the Italian investigators, particularly Giovanni Battista Grassi. The Italians began work on transmission of human malaria in the middle of July 1898. By this time, Ross’s proof was complete and partly published. The Italians were well aware of what he had done and they knew that two main tasks remained: (1) demonstrate that the parasite of human malaria had a cycle in the mosquito similar to what Ross had shown; and (2) identify the mosquito that transmits human malaria parasites.
Essentially, the Italians followed Ross’s exact line of investigation, but used Anopheles mosquitoes and human parasites. When their work was published, Ross was stung to anger as he felt he was not given adequate credit. And in my opinion, he was right. But once the quarrel escalated, the simple truths were cloaked and twisted by pas s ion and jealousy. Here is the essence of the turmoil: 1) Ross might have completed his proof with human malaria, but he did not – the Italians did. 2) Ross speculated that the “dapple-winged” mosquito probably was the culprit – the Italians proved it. 3) Ross was the first to demonstrate the entire life cycle of the malaria parasite. 4) Ross is not entitled to the whole credit for the whole proof because he did not finish it in humans.
To quote Gordon Harrison from his book ‘Mosquitoes, Malaria and Man,’ “…it makes no sense or justice to couple the names of Ross and Grassi together as co-discoverers – as is often done – without noting the very large difference between the explorer at the helm and those who rode his decks and helped make a landing.”
Space does not permit us to examine the last 30 years of Ross’s life, but here are some of the highlights. After retirement, he returned to England and became a lecturer at the new school for tropical medicine at Liverpool, where he championed tropical medicine education in Britain. He later held the Chair in Tropical Medicine. In 1911, he was knighted, and in 1912, he moved to London to take up a consulting practice.
Much of the rest of his life was concerned with public health programs against malaria. His efforts to improve public health in general were unending. He traveled extensively to undertake malaria prevention campaigns, and during World War I he was appointed consultant in malaria to the War Office. His abrasive personality of ten got in the way of progress, however. In 1926, the Ross Institute of Tropical Hygiene was opened. The aim was to promote research on tropical medicine and to stimulate control measures for malaria. Ross was its first director, and remained so until his death.
Sir Ronald Ross passed away on September 16, 1932, at the age of 75. The cause of death was listed as “ illness.” Imagine that! He outlived all 6 of his younger brothers and one of his 3 sisters. Lady Ross died from heart disease almost one year before her husband. Ronald did not attend her funeral, as he was likely distraught and definitely very feeble, having suffered a stroke. Sir Ronald and Lady Ross were inter red in Putney Vale cemetery in southwest London.
So how should the world remember Ronald Ross? How should we, in the mosquito control profession and field of public health, think of him? The answer, although complicated, is clear in my opinion. He was a dedicated, highly intelligent scientist who made great discoveries. He was a renaissance man, for sure, schooled in the arts and music. He was passionate, inquisitive, and romantic. He could be cantankerous and difficult with friends and others, without a doubt. Even his relationship with Manson cooled over the years, in par t due to Ross ’s feud with Grassi.
Rightly so, he fiercely defended his character and scientific achievements. Despite receiving many awards and honors during his life, he felt embittered that he did not receive monetary reward from his country for his malaria work and he petitioned the British government on this subject and on behalf of other scientists. He wrote three novels, numerous poems, dramas and other literary works. He was a mathematician, a musician, and he loved nature. He was an epidemiologist and sanitarian. Sir Ronald Ross found his professional niche later in life, and once comfortable there, he excelled in his work and sought affirmation of what he had accomplished. Likely, we would all do the same under similar circumstances. I would like to end with the poem that Sir Ronald drafted on Mosquito Day, and finalized a few days later, after realizing the importance of what he had just seen under the microscope:
This day relenting God Hath placed within my hand A wondrous thing; and God Be praised. At His command, Seeking His secret deeds With tears and toiling breath, I find thy cunning seeds, O million-murdering Death. I know this little thing A myriad men will save. O Death, where is thy sting, Thy victory, O Grave!
Harrison, G. 1978. Mosquitoes, Malaria and Man: A History of the Hostilities Since 1880. EP Dutton, New York. 314 pp.
Ross, R. 1923. Memoirs: with a Full Account of the Great Malaria Problem and its Solution. John Murray, London. 547 pp.
All quotations are taken from this book except where noted.
Disclaimer: The views contained herein are solely those of the author and do not necessarily reflect the views of the Department of Defense or the Department of the Navy.
I thank Dr Graham White for providing much of the background literature and FB for encouragement in completion of the manuscript.