If you told me someone with a Nobel Prize was working in Traditional Chinese Medicine (TCM), I would bet money they had a case of nobelitis. This is the affliction that hits when someone gets a Nobel Prize and starts believing in the rosy scent of their own bowel movements. Given the long history of Traditional Chinese Medicine (TCM) treating, more or less, fuck all, it’s an easy assumption to make.
As it goes in life so it goes in the lab, assumptions are tricky.
Today’s Moment of Science… A traditional malaria cure from modern China.
After a mosquito drops off a few parasites into your system, without treatment it’s almost certainly a matter of time until a light case of death. Parasites from the genus Plasmodium cause malaria, and quinine was the first major breakthrough in treating it. This bitter extract from the bark of the cinchona tree, native to South America, changed everything. Beverages and eventually tablets made with quinine were in such high demand that access to the supply in South America was closely guarded.
Then the original gentrifying hipster, a guy who moved to Peru from London to farm alpacas, sold the seeds to the Dutch. He largely got away with it. In an act of “fucking of course that happened,” the servant who retrieved the seeds for him was beaten to death by locals.
Other medications related to quinine were developed, including chloroquine and hydroxychloroquine. Then, as happened with so many microscopic annoyances, the little parasites evolved.
I told you that story to tell you this story.
The Vietnam War was, and I cannot stress this enough, bad. Between agent orange, tropical diseases, and the Henry Kissinger of it all, there were a few pests to deal with.
Malaria ravaged the North Vietnamese soldiers. Ho Chi Minh called up Mao on the Throatpunch Imperialism Hotline and was like “workers of the world, unite to fuck up these diseased bloodsuckers. Uh, by which I was definitely referring to the mosquitoes.” This was some dioxin apocalypse grade malaria, resistant to treatment with chloroquine. It was time to try something new.
Mao Zedong established Project 523, a secret project to research a new cure for Malaria. More than 500 researchers were involved from over 60 organizations.
Tu Youyou was born in China in 1930. After completing an undergraduate education in pharmacology in 1955, she trained in TCM for two years, and continued research through the 1960s in TCM. She was assigned to head one of the groups searching for a treatment for chloroquine-resistant malaria. Armed with a bachelor’s degree, Tu, her team, and hundreds of other scientists examined centuries of texts for a clue.
A researcher in another group named Yu Yagang performed statistical analysis from old texts to find which herbs (and potential compounds) were most frequently used in malaria treatment historically. This led Yu to qinghao, aka green-blue wormwood, and an extract that had decent efficacy in killing the parasites in rodents. A lot of reporting leaves Yu’s work out of the record though. A quick glance at the internet gives the impression that Tu’s reading of The Handbook of Prescriptions for Emergency Treatments, a text from 340CE, was the sole source of this whole revelation.
In truth, Yu Yagang was reassigned to another research effort after their initial discovery, passing the work with qinghao over to Tu and her team. When they had difficulty replicating the high potency of Yu’s results, that’s likely when they consulted the ancient handbook. The book recommended a cold water soak for the herbal medicine. As the story goes, Tu suggested trying the cold soak and solvent with a low boiling point to preserve the active component.
There were like six more steps at least, but presto bingo bongo, artemisinin based parasite-fucker-uppers are still in use to this day.
As isn’t uncommon, the Nobel Prize was awarded for artemisinin decades after the work was done. The Nobel can be split, max, three ways. The 2015 award in medicine was indeed split three ways- the other two guys discovered some obscure drug called ivermectin.
Tu became the Nobel laureate from amongst everyone involved in Project 523. There have been arguments that Yu Yagang deserved a chunk of Nobel’s blood money, or perhaps the scientists who worked on synthesizing derivatives of the medication should have been considered.
Tu Youyou, a scientist with “just” a bachelor’s degree, would be unlikely to argue with you. The woman who saw it as her responsibility to volunteer to be the first human test subject for artemisinin said “I think the honor not only belongs to me, but also to all Chinese scientists.”
This has been your Moment of Science, checking out my favorite herbs for the treatment to boredom.
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It would have been even more interesting to put a little detail into the amount of work put in to alter the original molecule to make it more bioavailable, more efficient and more stable. The TCM component was only about finding something that traditionally worked on febrile illnesses and whittling this list down to items that might work on malaria. Great story. I love your prose.
I write about the parts I find interesting.