Cinchona Bark

by Juliet Burba

Illustration of “Kinquina” from Pierre Pomet, Histoire generale des drogues. Paris: Jean Baptiste Loyson & Augustin Pillon, 1694, p. 132.

In 16th century Europe, the fevers of the common illness “ague” often resulted in death. No one was immune to the fevers — they indiscriminately killed peasants, kings, princes and popes. Although today it is commonly considered a disease of tropical lands, in the 17th century malaria affected vast parts of Europe, including Rome, Versailles and London. Early 17th-century ague patients had one principal cure available to them — bleeding. If bleeding was ineffective, the physician might try purging or the use of emetics. Even astrology might be employed as a cure, because the periodicity of malarial fevers suggested a connection with astronomical phenomena.¹ Some of the various names used for the fevers denoted their frequency of recurrence, such as tertian, quartan, semitertian, and double tertian.

      Although malaria was widespread and common, until the early 17th century European physicians had found no truly effective cure, and their patients continued to die. But in the 1630s a possible treatment was found in the forests of the Andes Mountains. In that decade, an Augustinian monk published a notice regarding the treatment, burying it in a work on the Augustinian Order. “A tree grows which they call ’the fever tree’ in the country of Loxa, whose bark, of the color of cinnamon, made into powder amounting to the weight of two small silver coins and given as a beverage, cures the fevers and tertiana; it has produced miraculous results in Lima,” wrote the monk, Antonio de Calancha.² Calancha was describing the bark of the cinchona tree; the bark contains the alkaloid quinine along with several other alkaloids effective against malaria.³

      Historians debate whether cinchona was an indigenous medicine or was discovered by Europeans. Evidence suggests that malaria did not exist in the New World before the arrival of the Spanish. Thus, according to one author, native people knew nothing about the medicinal use of cinchona bark. He supports his claim by stating that the bark did not appear in early Inca pharmacopoeias as translated by the Spanish, but does not cite a source for that information.⁴

      However, even if malaria was not indigenous to South America, many years passed between the first arrival of the Spanish (and, presumably, malaria) and the earliest writings about cinchona by Europeans. This would have allowed the native people time to have developed a cure. Such a view is supported by the historian Lucile Brockway and by the semi-popular author M.L. Duran-Reynals, who points to the vast array of medicinal plants used by native healers and the large number of these plants transplanted to Europe from South and Central America at this time. Native plant remedies were so much more effective than the techniques of European physicians, writes Duran-Reynals, that Pizzaro’s soldiers preferred treatment from native healers.^{5 6}

      According to Saul Jarcho, author of an exhaustive review of 17th and 18th century sources pertaining to the discovery and dissemination of cinchona, exportation of the “Peruvian” bark to Europe probably began in 1631 or 1632.⁷ The Jesuit Order was the strongest promoter of the bark, and it was sometimes called Jesuit’s bark or powder. One Jesuit in particular played an important role in the dissemination of informatin about the antimalarial.

      The Jesuit Juan de Lugo (made cardinal in 1643) was entrusted by Pope Innocent X to learn more about the bark. Lugo had it tested by Gabrielle fonseca, a physician to the pope. Around the same time, in the late 1640s, directions for the use of the bark were published as the Schedula Romana. Although Duran-Reynals states that the work was published by the Jesuits, Jarcho is more cautious about naming an author and publisher, noting that there were several different editions and translations published around the same time.⁸

      Despite positive results and the backing of the Vatican, the use of cinchona was not universally adopted in 17th century Europe. Many factors contributed to the delay in acceptance. First, the bark often did not work. Cinchona could not cure all fevers, only those of malaria, so if the drug was used on a patient afflicted with some other disease, it appeared to be ineffective. Furthermore, unscrupulous dealers might sell inferior bark or the bark of some other tree, and after the long journey from New Spain to Europe the bark sometimes arrived too rotten to use.

      The use of cinchona also contradicted the teachings of the ancient author Galen, whose work most physicians still used. According to Galen, a patient with ague needed to release humors, making bleeding, purging, and the use of emetics the preferred treatments. The use of a hot, bitter drink seemed to conflict with both Galenic medicine and common sense.⁹

      Finally, the support of the Vatican for the drug worked against its acceptance in some regions, particularly in England. The close association of the drug with Catholicism made many Protestants fear it was part of a “popish plot” against them.

      In the late 17th century, the Englishman Robert Talbor used these fears to make his name as a “feverologist.” Regarded by English physicians as a quack, he claimed to have a secret remedy for ague, but agreed with the prevailing opinion that Jesuit’s powder should be avoided. After successfully curing Charles II of malaria, he was sent to France to aid the royal family. Louis XIV bought the recipe for the cure, under the condition that he not read it until after Talbor’s death. When the recipe was published in 1682, the secret medicine was revealed — it was, of course, cinchona.¹⁰

      Despite fears of popish plots, professional rivalries, and questions aout the effectiveness of the bark, importation began in the mid 17th century, and continued until the 19th century. The bark was harvested around what is now the Peruvian and Ecuadorian border. From there it was carried to Paita on the coast and transferred onto ships bound for Panama. Once in Panama, it was carried north across the isthmus to Portobelo during the dry season, or taken via the Chagres River during the rainy season. At Portobelo the bark was once again loaded onto ships and sent to Spain via Havana.¹¹ Occasionally, smuggling also took place, but rather than transport the bark via the western seaboard, smugglers carried it eastward, across most of the continent, following the course of rivers to the Atlantic.¹² Once in Europe, the bark was distributed by a variety of means. Jesuits often gave it away, merchants sold it, and the nobility sometimes used it as gifts. According to Jarcho, the Spanish presented it to the empress of Hungary, Pope Clement XIV, the Duke of Parma, the electress of Bavaria, and the general commissioner of holy places in Jerusalem during the period 1772-86.¹³

      By the mid-19th century the Dutch and English began claiming that the South American supply of cinchona was threatened by the non-sustainable cutting practices of the indigenous harvesters.¹⁴ As Brockway suggests, evidence did not necessarily back that claim. In 1839, William Dawson Hooker, son of the renowned botanist William Jackson Hooker, wrote his dissertation on cinchona. He claimed that completely cutting the trees, rather than harvesting pieces of bark, was a better method, because insects would attack cinchona plants that had simply been debarked. On completely cut (or “coppiced”) plants, new growth quickly appeared, and could be harvested again in 6 years. Years later it was also discovered that cut and regrown cinchona had higher levels of the effective alkaloids in its bark, and this method of harvesting became common on many plantations.¹⁵

      The efficacy of indigenous harvesting methods suggests that the transfer of cinchona culture by the Dutch and English to plantations located in Southeast Asia occurred because of a desire to control the trade, and not because Native American practices caused a decline in cinchona growth. Without a large, steady supply of quinine, British and Dutch imperialism in India and Africa might have failed — without the antimalarial drug, vast numbers of British and Dutch administrators, military personnel and merchants in these lands would have been stricken and possibly killed by the disease. The widespread use of cinchona came about because of the colonizing efforts of Europeans, and the drug, in turn, aided Europe in expanding its colonization even further.¹⁶

Notes

      1. M.L. Duran-Reynals, The Fever Bark Tree: The Pageant of Quinine (Garden City, NY: Doubleday, 1946) PP. 15-16.
      2. Quoted in Duran-Reynals, 24. According to Duran-Reynals, the work was written before 1633, but was published in Europe in 1639. Another author places publication in 1638 and suggests that the work was probably written in 1630. See Saul Jarcho, Quinine’s Predecessor: Francesco Torti and the Early History of Cinchona (Baltimore: Johns Hopkins University Press, 1993), p. 280 n. 10.
      3. Malaria is caused by a plasmodium that spends part of its life cycle in and is transferred by the Anopholes mosquito. The alkaloids in cinchona bark interfere with the reproduction of the malaria plasmodium. See Jarcho, p. xv.
      4. Norman Taylor, Cinchona in Java: The Story of Quinine (New York: Greenberg, 1945) p. 29.
      5. Duran-Reynals, pp. 25-26.
      6. See Jarcho, pp. 1-11 for a discussion of the earliest remarks about the appearance of cinchona in Europe.
      7. Jarcho. In particular, see p. 14. According to one story regarding the discovery of cinchona, the bark was used to cure the Countess of Chinchon, who was the wife of the Viceroy of Lima. She subsequently supported the exportation and dissemination of the bark in Europe. Linnaeus based his name for the bark on this story, but misspelled the name. The story has since been demonstrated to be false. See Jarcho and Duran-Reynals.
      8. See Jarcho, pp. 14-16 and Duran-Reynals, pp. 43-44.
      9. Jarcho includes an extensive chapter on the understanding of fevers during this time.
      10. See Duran-Reynals.
      11. See Jarcho.
      12. Jarcho, pp. 196-201.
      13. Jarcho, p. 203.
      14. Taylor and Klein both promulgate the view that cinchona was in danger of over-harvesting.
      15. Brockway, p. 111.
      16. On the link between botany and colonialism, especially in regards to Great Britain and the role of Kew Gardens, see Brockway.

Bibliography

Brockway, Lucile. 1979. Science and Colonial Expansion: The Role of the British Royal Botanic Gardens. New York: Academic Press.

Duran-Reynals M.L. 1946. The Fever Bark Tree: The Pageant of Quinine. Garden City, NY: Doubleday.

Jarcho, Saul. 1993. Quinine’s Predecessor: Francesco Torti and the Early History of Cinchona. Baltimore: Johns Hopkins University Press.

Klein, Richard. 1976. “The ’Fever Bark’ Tree,” Natural History 85. April: 10-19.

Taylor, Norman. 1945. Cinchona in Java: The Story of Quinine. New York: Greenberg.