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Ioannis Kardamatis (1852-1942): Pioneer of the Anti-Malaria Battle in Greece

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Ioannis Kardamatis (1852-1942): Pioneer of the Anti-Malaria Battle in Greece Le Infezioni in Medicina, n. 1, 104-107, 2020 104 INFECTIONS IN THE HISTORY OF MEDICINE Ioannis Kardamatis (1852-1942): Pioneer of the Anti-Malaria Battle in Greece Spyros N. Michaleas1, Theodoros N. Sergentanis2, Gregory Tsoucalas3, Lazaros Vladimiros4, Aristeidis Diamantis5, Nikolaos Tentolouris6, Theodore G. Papaioannou7 1Department of History of Medicine and Medical Deontology, Medical School, University of Crete, Heraklion, Crete, Greece; 2Department of Clinical Therapeutics, Medical School, National and Kapodistrian University of Athens, Athens, Greece; 3History of Medicine, Anatomy Department, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece; 4Historian of Medicine, Athens, Greece; 5Department of Cytopathology, Navla Hospital of Athens, Greece; 6First Department of Propaedeutic and Internal Medicine, Medical School, National and Kapodistrian University of Athens, “Laiko” General Hospital, Athens, Greece; 7Department of History of Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece SUMMARY Few scientists have contributed as much to medicine His studies have been published in both Greek and for- and society as Ioannis Kardamatis (1859-1942). Kar- eign journals. He is most notably remembered for his damatis was an important historical figure whose vast contribution to the battle against malaria in Greece. medical knowledge was recorded in a spectrum of med- ical publications, including monographs, bibliographic Keywords: Ioannis Kardamatis, malaria, history of in- reviews, books, and experimental and statistical studies. fectious diseases. n INTRODUCTION of the medical and historical events of the time. Malaria, derived from the Italian words «mala» he purpose of this study is to present the sci- (bad) and «aria» (air), is a disease transmitted Tentific work and major contributions of a lead- by an infective female Anopheles mosquito that ing scientist, Ioannis Kardamatis. Who was Ioan- causes fever and flu-like illness [1]. The disease nis Kardamatis and why was he important? Is it has infected and killed millions of people around relevant for the modern physician and historian the world. The anti-malaria battle in Greece lasted to learn the life and work of a physician who lived for many decades, from the beginning of the 20th a century ago? Why study a doctor from the past century to the definitive eradication of the disease who dealt mainly with a disease that has been in the late 1960s. Kardamatis holds a prominent eradicated in much of the world? The study of position among the most important leaders of Kardamatis’ life reveals many interesting aspects such an effort. The life and work of Ioannis Kardamatis Corresponding author Ioannis Kardamatis was born in Athens in 1859. Spyros N. Michaleas He studied medicine at the National University of E-mail: [email protected] Athens (in 1932, it was renamed to National and Ioannis Kardamatis: Pioneer of the Anti-Malaria Battle in Greece 105 Kapodistrian University of Athens) and special- Figure 1 ized in internal medicine and pediatrics in Paris The Greek physician, and Brussels. In 1889, he received his PhD in med- promoter of icine from the University of Athens. From the be- anti-malaria ginning of his career, he showed interest in scien- battle, Ioannis tific research and writing. Although he practiced Kardamatis medicine in a small village with few research ma- (1859-1942). Source: terials, he conducted basic clinical and drug trials. Vladimiros From 1892 to 1896, while practicing medicine in L. Ioannis the region of Messenia, he published several pa- Kardamatis pers in the journals Galen and Army Medical Ga- [in Greek] 2006. zette. He researched the use of methylene blue Eptalofos, Athens. in malaria treatment and presented his studies to the Athens Medical Society. Proper materials for manufacturing pills were unavailable and in order to administer the drug orally, Kardamatis improvised using thin cigarette paper. Later, he Figure 2 - Kardamatis I. Treatise on Marsh Diseases [in Greek], Athens, Leonis published his clinical observations [2]. Paraskevas, 1908. By the end of 1896, Kardamatis had settled perma- nently in Athens, where he participated in Greek and international medical affairs. In 1899, he was elected an honorary member of the International Figure 2 - Kardamatis I. Treatise on Marsh Diseases [in Greek], Athens, Leonis Committee for the Organization of the Interna- tional Congress of Medical Ethics and Occupa- Paraskevas, 1908. tional Medicine, which would be held the follow- ing year in Paris. He also served as vice president of the Medical Society of Athens from 1899 to 1901 and taught hygiene at the Maraslio Teaching School. He was a member of the Pediatric Society of Paris and Barcelona Medical Academy. He also was a curator of the University Pediatric Clinic at the Municipal Nursery. Professor Nikolaos Pezo- poulos (1859-1911), head of the Municipal Nurs- ery from 1902 to 1904, also collaborated with Kar- damatis on malaria research at the Pathology Lab- oratory of the University of Athens. Kardamatis’ participation as a special rapporteur on swamp diseases at the Panhellenic Medical Conferences of 1901, 1903, and 1906 was crucial for informing the medical community about malaria. As a mem- ber of the Conference Committee, he was respon- sible for publishing the conference proceedings in 1901 and 1903. He published an edited volume containing 1,290 pages while serving as general secretary of the Medical Conference in 1906 [3]. Kardamatis’ prolific writing includes mono- graphs, research and experimental papers, statis- tical studies, peculiar cases, book reviews, leaf- lets, books, and studies of medical history. His works have been published in Greek and foreign Figure 2 - Kardamatis I. Treatise on Marsh Diseases [in medical journals. His research on hemoglobinu- Greek], Athens, Leonis Paraskevas, 1908. 11 11 106 S.N. Michaleas, T.N. Sergentanis, G. Tsoucalas, et al. ric fever with jaundice, a severe complication of Kardamatis’ literature review of trypanosomi- malaria, was published in 1900. This work com- asis, or “sleeping sickness”, was published in prised of 325 pages discussing 4,022 cases, as three issues of Medical Progress and compris- well as reviews of the foreign literature and clin- es 19 pages with illustrations. This review was ical observations on the transmission of malaria enriched by his observations of certain disease by mosquitoes to humans. Kardamatis translat- forms that appeared in animals, which he had ed many of the chapters into French for publica- described in a previous article. The editor of the tion in French medical journals. In his early pub- journal, Ioannis Foustanos (1856-1933) notes in lications, Kardamatis emphasized the relation his introductory commentary that “the author between mosquitoes and malaria by imparting talks about sleeping sickness and Trypanosomi- this valuable knowledge to Greek physicians. asis in details that honor his knowledge” [9]. Kardamatis cited his sources carefully, including Kardamatis’ experimental laboratory study with those by his Greek colleagues. He believed that Pezopoulos on congenital malaria was signifi- in the study of any scientific field, proper credit cant. It was common for babies to develop ma- should be given whenever possible. When other laria within a few months of their births, so doc- researchers published studies without mention- tors believed that malaria was transmitted from ing his contribution, Kardamatis wrote letters to mother to child during pregnancy. Kardamatis the journals complaining that they were “ignor- and Pezopoulos conducted a series of laborato- ing the existing studies” [5]. ry studies and, based on their microscopic and At several medical conferences in the early 20th microbiological findings, they disputed this century, Kardamatis announced a series of orig- view, pointing out that there was no congenital inal works At the 1901 conference, he described transmission of malaria from the mother to the his research on the mental disorders associated newborn. They studied six cases and examined with malaria, which he compiled from medical blood samples from the mother and newborn, texts spanning from Hippocrates (460-377 BC) to as well as the umbilical cord and placenta. They the beginning of the 20th century [6]. At the 1903 also conducted histological examinations in two conference, he and Pezopoulos presented find- cases where newborns died from other patholog- ings from a laboratory study on the Anopheles ical causes. They collected samples from the ma- mosquitoes and the 1901 malaria epidemic in ternal and fetal surfaces of the placenta and con- Athens. At that conference, he gave two lectures ducted pathology exams of the liver and spleen on malaria and one on nutrition. At the 1906 con- to search for malaria plasmids. In babies whose ference, he and Dr. Lambros Diemesis, an assis- mothers had confirmed malaria diagnoses, no tant in the Laboratory of Pathological Anatomy, malaria plasmids were found in the blood or tis- presented an extensive 30-page statistical and sues of the newborns. Kardamatis and Pezopou- laboratory study of the malaria epidemic that los thus concluded that malaria cannot be trans- struck Attica and Boeotia in 1905, infecting about mitted from the pregnant mother to the fetus by one-third of the population [7]. Moreover, he and the placenta [10]. Today, the medical evidence Pezopoulos presented on the issues of congenital confirms their findings,
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