Ge Hong's Handbook of Prescriptions for Emergencies

Ge Hong (284 to 363) was a Chinese physician who compiled a book of remedies for emergencies, known in English as A Handbook of Prescriptions for Emergencies. It dates from the Eastern Jin dynasty, which began in 317. One short recipe dealt with periodic fevers, the fevers and chills of the disease now called malaria. It told the reader to take one bunch of qinghao, soak it in two sheng of water (about 2.2 liters), wring it out and drink all of the juice.

Qinghao was already an old medicine. A silk text from the Mawangdui Han tombs of 168 BCE, the earliest written record of its use, gave it for hemorrhoids, and Sheng Nong's Herbal Classic, the oldest Chinese herbal, listed it for the itch of scabies, malignant sores and lice. Ge Hong's handbook is the first record of it for periodic fevers. Later books of the Song, Yuan and Ming dynasties described qinghao soups, pills and powders for malaria, and Li Shizhen recorded his own use of it for fevers and chills in his Compendium of Materia Medica.

The name was loose. Qinghao is a general Chinese name for herbs of the Artemisia genus, and the old texts said little about which species or which part of the plant to use. There are at least six species under the name, and only one, Artemisia annua, or sweet wormwood, contains meaningful amounts of the drug later found in it.

More than 1,600 years after Ge Hong, the recipe mattered again. In 1971 a team led by Tu Youyou at the Academy of Traditional Chinese Medicine in Beijing, working for the secret malaria program called Project 523, was testing qinghao extracts in infected mice with results that could not be repeated. Rereading the literature, Tu found Ge Hong's recipe, and it gave her the idea that the heat of the usual extraction might be destroying the active substance. In September 1971 the team switched to extraction with ethyl ether at a lower temperature. On 4 October 1971 their sample No. 191 was fully effective against malaria in mice. Tu cited Ge Hong's handbook in her Nobel lecture in December 2015.