Artemisia annua and malaria: treatments from ancient China found in unearthed tombs

Artemisia annua, not unlike the specimen seen below from China, has been used in Chinese herbal medicine for thousands of years to treat malaria. The specimen seen below was collected by George Forrest in Yunnan, near the Mekong Valley in China, in 1917. This plant holds great significance in the fight against malaria, as it has for thousands of years.

Syntype of Artemisia annua L. forma macrocephala Pamp., collected by George Forrest in 1917 in the Mekong Valley in China.

Artemisia annua: The History

Artemisia annua has been used in China for thousands of years to treat many illnesses, including malaria. The first known mention of using Artemisia annua for malaria treatment dates back to about 200 BC in a text called Fifty-Two Prescriptions (Wushi’er Bingfang, 五十二病方), which was actually unearthed in a tomb. Documenting how advanced the ancient Chinese were in both ethnobotany and documenting scientific discovery, the book lays out, methodically, 52 different treatments for 52 different ailments. It was only discovered in 1973 during the excavation of the Ma Wang Dui tomb in Changsha, Hunan.

Reading like something out of a movie, when the archaeologists uncovered the tombs they discovered numerous drugs found in sachets, two of which were clutched in the hand of a skeleton. No, really. The drugs contained in these sachets include a regular medicine chest of herbs and spices, including:

• Qinghao [Artemisia annua L.]
• Magnolia flower bud [Magnolia spp.]
• Licorice [Glycyrrhiza spp.]
• Huangqi [Astragalus spp.]
• Ginger  [Zingiber officinale (Willd.) Rosc.]
• Aconite [Aconitum carmichaeli Debx.]
• Fangfeng [Ledebouriella divaricata (Turcz.) Hiroe]
• Shaoyao [Paeonia lactiflora Pall.]

As well as the silk scroll copy of the book the Prescriptions for the Fifty Two Diseases, which outlined the use of Artemisia annua to treat malaria. What diseases and ailments were being treated, you ask?

• Skin ulcers
• Urinary problems
• Hernia
• Wounds and injuries
• Frostbite
• Snake bite
• Warts/tumors
• Hemorrhoids (both internal and external)
• Poison arrow wounds (a common enough phenomena to decipher a cure for it)
• Male sexual disease (see witty aside above)
• Mad dog bites (repeat witty aside)
• Infantile convulsions (not the metaphorical kind)
• Malaria

All of this inscribed on a silk scroll found in a cave from over 2000 years ago.

Public domain image of “The Prescription for fifty-two kinds of diseases” from Prof Ying Li, Chinese Academy of Science.

However spectacular that skeleton clutching story is, since the book was only discovered in 1973, the Chinese were drawing from a different text for centuries in their use of Artemisia annua. And this book was named the Shennong Herbal (神农本草经), completed in the 1st-2nd centuries AD. It is this text that was used when treating malaria. Unfortunately, as best my research has indicated, there were no skeletons involved. This book was read with renewed interest after the Chinese Army in the 1960s attempted to find a good treatment for malaria based on Chinese traditional medicine (which had recorded over 5000 different treatments for malaria recorded over the centuries).

Ultimately, the reason Artemisia annua was chosen was because it worked faster and more effectively than the other remedies, removing the parasite faster. Also, it is an extremely common plant found naturalized throughout the world in great supply, but native to Asia.

Naturally, the drug extracted from the plant, Artemisinin, is in great demand and (short supply). It has been used effectively to treat malaria in several African nations as well as throughout Asia, but there is some evidence that malaria is building a resistance to this treatment.

If you are interested in learning more about this powerful plant, I suggest a few of the following articles. Most of these are older, but still do a good job introducing how Artemisinin is being used to treat malaria:

• Klayman, D. L. (1985). Qinghaosu (Artemisinin): An Antimalarial Drug from China. Science , New Series, Vol. 228, No. 4703 (May 31, 1985), pp. 1049-1055
• Hermans, M.; Akoegninou, A.; & van der Maesen, J. (2004). Medicinal Plants Used to Treat Malaria in Southern Benin. Economic Botany , Vol. 58, Supplement (Winter, 2004), pp. S239-S252.
• Enserink, M. (2005). Source of New Hope against Malaria Is in Short Supply. Science , New Series, Vol. 307, No. 5706 (Jan. 7, 2005), p. 33.