The Miraculous Fever-Tree

by Fiammetta Rocco

  Religious and social turmoil abounded during the reign of Charles I and the nine-year rule of Oliver Cromwell which followed the King’s execution in 1649. There was little scientific advancement. People were frightened, and English Protestants were reluctant to import anything that smacked of Catholic knowledge. In 1702, more than four decades before Dona Pheliziana Barbara Garzan and her sister merchants were sending Peruvian bark in commercial quantities from South America to Europe, a large supply of the most effective variety of bark then known, Cinchona calisaya, unexpectedly found its way to London with the capture of the Spanish fleet at Vigo, in the Bay of Biscay. In addition to nearly five thousand pounds of silver, the British buccaneers who overran the fifteen battleships also made off with thousands of pounds of pepper, cochineal, cocoa, snuff, indigo, hides and Peruvian bark. Before that, the only way for feverish English patients to obtain the bark had been from travellers from the continent who made their way across the Channel with small supplies of it in their luggage, probably Roman Catholics who had bought it either in Rome or in Belgium, by then the unofficial northern European centre of the Jesuit order.

  These travellers were careful about selling the bark too openly because of its Catholic associations, yet the English, almost more than anyone in Europe, were in terrible need of the Peruvian remedy. If malaria was common around the Mediterranean, it was also prevalent in southern Britain in the seventeenth century. Kent, Essex, Somerset near Bridgwater, and parts of London, especially Lambeth and Westminster, were notorious for endemic malaria. ‘London Men of Pleasure’ went to Essex, wrote Daniel Defoe in the early eighteenth century, ‘for the Pleasure of Shooting; and often came home very well loaden with Game; and sometimes too with an Essex Ague on their Backs, which they find a heavier Load than the Fowls they have shot’. Marriage to an Essex farmer was risky. Census figures show that at any one time there were nearly 12 per cent more adult males than females in the marsh parishes of Kent and Essex, and remarriage was common. ‘All along this County,’ wrote Defoe, ‘it is very frequent to meet with Men that have had from Five to Six, to Fourteen or Fifteen wives; and I was informed, that in the Marshes, over-against Canvy Island, was a Farmer, who was then living with the five-and-twentieth; and that his Son, who was but Thirty-five Years old had already had about Fourteen … The reason, as a merry Fellow told me, who said he had had about a Dozen, was this, That they being bred in the Marshes themselves, and seasoned to the Place, did pretty well; but that they generally chose to leave their own Lasses to their Neighbours out of the Marshes, and went into the Uplands for a Wife: That when they took the young Women out of the wholesome fresh Air, they were clear and healthy; but when they came into the Marshes among the Fogs and Damps, they presently changed Complexion, got an Ague or two, and seldom held it above half a Year; or a Year at most. And then, said he, we go to the Uplands again, and fetch another.’

  Not that London itself was much healthier. The bill of mortality for the London area for the year 1665 included 5257 deaths from ‘fever and ague’, in a population of about 460,000. This was the year of the Great Plague, and deaths from that disease might have been deliberately concealed under a less fearful name. In any case, there is no need to search inaccessible records. Familiar books of the period, including Samuel Pepys and John Evelyn’s diaries and Jonathan Swift’s The Journal to Stella, as well as earlier works such as The Canterbury Tales and Shakespeare’s plays, give plenty of information on the subject. Pepys’ business was several times hindered by ‘my lord’s ague’, and one of his merry parties was interrupted by the ague-fit of a lady guest. Earlier in the century Sir Walter Raleigh, during his captivity in the Tower of London, adjacent to the Thames, had ‘prayed fervently to God that he might not be seized with an ague-fit on the scaffold, lest his enemies should proclaim that he had met his death, shivering with fear’.

  John Evelyn has a good deal to say about Charles II’s ague: he tells of one dangerous attack when the King insisted on having the new remedy ‘quinquina’. He also describes his own little son’s death from ‘a quartan ague’, and gives a full account of the popular cure—bathing the legs in milk as hot as could be borne and drinking ‘carduus posset’, a hot beverage made of thistle which, it was believed, would reduce fever, and with the help of which he cut short one of his own attacks of ague.

  The most famous Briton to fall ill with a tertian ague in the 1650s was Oliver Cromwell. The Great Defender was born in the fens, the wet lowlands of East Anglia whose inhabitants shuttered themselves against the freezing northern winds from the North Sea in winter and suffered wave after wave of malaria in summer, when pools of stagnant water lay all around. He had spent much time in Huntingdon, in present-day Cambridgeshire, which was then recognised as being particularly malarious.

  Although Cromwell is known to have suffered several times from the tertian ague, malaria, there is no evidence that he died of it – his death was most probably due to kidney stones and an infection of the urinary tract – nor, as tradition relates, that he refused to take the Peruvian bark on the grounds that he did not want to be ‘Jesuited to death’. However, the fact that this myth is still widely believed to be true bears testimony to the strong feeling that abounded about the poisonous-tasting bark and its fervent Catholic supporters.

  In 1658, nevertheless, the year of Cromwell’s death, Londoners began to see discreet advertisements for the bark. On 24 June, for example, the Mercurius Politicus, the official publication Cromwell had approved three years earlier, included a notice which read:

  These are to give notice, that the excellent powder known by the name of the Jesuits Powder, which cureth all manner of Agues, Quotidian, Tertian or Quartan, brought over by James Thompsòn Merchant of Antwerp, is to be had at the Black-Spred-Eagle over against Black and White Court in the Old Baily, or at the shop of Mr John Crook, at the sign of the ship in St Pauls Churchyard, a bookseller, with directions for using the same.

  Notices published later that year added that the bark was approved by ‘Doctor Prujean, and other eminent Doctors and Physitians who have made experience of it’. Little is known of James Thompson, other than that he was an associate of Edward Somerset, Earl of Worcester, a leading Roman Catholic who was imprisoned in the Tower of London in 1652, but Sir Francis Prujean was the President of the Royal College of Physicians.

  Whether Prujean really was a promoter of the Jesuit powder, or had given permission for his name to be so blatantly used, is not known. But another name was soon to come to prominence that would seal the reputation of the Peruvian bark, though not before it had greatly angered Prujean and his fellow physicians.

  Robert Talbor was born in 1642 to a respectable family near Cambridge, close to where Cromwell was also born. His father worked for the Bishop of Ely, and his grandfather, James Talbor, had been the Registrar of Cambridge University. When he was still in his teens, Robert Talbor was apprenticed to an apothecary in Cambridge named Dent. One of young Talbor’s tasks in Dent’s apothecary was to study how better to administer the Peruvian bark as a cure for fever. At that time not much was known about how it should be prescribed, and many patients suffered from its side-effects, which can include tinnitus and, in pregnant women, nausea, headaches and vomiting.

  Not long after, Talbor moved to Essex, where intermittent fevers were especially prevalent in summer. It may have been there that he met Elizabeth Aylet, the young woman he would later marry, for she came from Rivenhall, not far from Colchester. Like many in the seventeenth century, the Talbors spelled their name in several different ways. They had one son, who became an officer in the army and was known as ‘Handsome Tabor’.

  While Talbor père was living in Essex he perfected his method of curing the fevers, and in 1670 he set up shop in London as a pyretiatro, a fever specialist. Talbor had no medical credentials, so he wrote a book. He had the title set in Greek letters to impress his readers with his learning, and he opened with a witty poem:

  The Learned Author in a gene
rous Fit

  T’oblige his Country hath of Agues Writ:

  Physicians now shall be reproacht no more,

  Nor Essex shake with Agues as before

  Since certain health salutes her sickly shoar.

  Talbor was careful in Pyretologia, or A Rational Account of the Cause and Cure of Agues to disabuse anyone of the notion that he was a promoter of the Catholics’ Peruvian bark. He cleverly disparaged it, saying: ‘Beware of all palliative Cures and especially of that known by the name of Jesuit’s Powder … for I have seen most dangerous effects follow the taking of that medicine.’ In this he appeared to be conforming to the prevailing medical opinion, though he then contradicted himself by adding: ‘Yet is this Powder not all together to be condemned; for it is a noble and safe medicine, if rightly prepared and corrected, and administered by a skilful hand …’

  In its tone, Talbor’s Pyretologia lies somewhere between a salesman’s pitch and an objectively argued scientific report. He did not want to be seen to be giving credence to a Roman Catholic remedy, yet he also wanted to promote his own cure, which he insisted on keeping a secret from his fellow physicians and the public. It consisted, he said, of two ingredients from England and two from abroad. He refused to disclose any more, though he claimed it worked like a charm.

  While Talbor hid behind this apparent medical conservatism, the cause of the Peruvian bark received a fillip in 1676 when no less a personage than Thomas Sydenham, known as the Hippocrates of English medicine, dwelt on the subject of the new drug in his Observationes medicae. Sydenham had begun to practise medicine in Westminster in about 1655, and before long he was one of the most influential physicians in London. He was obsessed by ‘the fevers’. What were they? What caused them? In some cases they were accompanied by other symptoms, such as respiratory or intestinal difficulties. But then there was what was known as a ‘pure’ fever, where a patient who had previously been well suddenly began to shiver and shudder, then grew hot with fever, but had no other symptoms. What was that?

  Sydenham was an important thinker, but he was also cautious. Initially, he was sceptical about the Peruvian bark, but in the second half of the 1650s his friend and colleague Robert Brady, Regius Professor of Physic at Cambridge, began to use it. Gradually, Sydenham came to have more confidence in the treatment; later that same year he wrote to Brady: ‘The Peruvian bark has become my sheet-anchor,’ and insisted that it was the sole remedy for the quartan fever.

  Supported by Sydenham, Talbor’s practice was soon very fashionable. He charged fabulous fees, and refused to divulge the secret of his remedy. One can just see him, smiling and boasting, happy to have put one over the Royal College of Physicians, whose members continued to regard him as a quack – which of course is what he was. Yet, as Sir William Osler, the famed doctor and Professor of Medicine at Oxford University in the early twentieth century once observed, ‘The trouble with quacks is that they cure people.’

  In 1678 Talbor was summoned to treat the King. Charles II was a cynical soul. He had lived by then through the worst and best of times, and he knew that those around him would sell their mothers if they thought it would help enhance their influence at court. Years later, John Evelyn recounted how Richard Lower, the King’s physician, had tried to have Talbor forbidden from administering his secret remedy to the monarch. But King Charles sent for Dr Short, to have ‘his opinion of it privately, he being reputed a papist … he sent him word, it was the onely thing could save his life, and then the King injoyn’d his physitians to give it to him, and was recovered’. Ever happy to retail gossip, Evelyn went on to add that when Short was asked by the King why the other doctors would not prescribe it, ‘Dr Lower said it would spoile their practise or some such expression’.

  The Royal College of Physicians was even more distressed when, not long after, it received a letter from Lord Arlington, the King’s Secretary of State, which read: ‘His Majesty, having received great satisfaction in the abilities … of Dr Talbor for the cure of agues has caused him to be admitted and sworn one of his physicians; and, being graciously inclined to give him all favour and assistance … for the public good, has commanded me to signify his pleasure unto you and the rest of the college of physicians that you should not give him any molestation or disturbance in his practice.’ That was only the beginning of the College’s discomfort and of Talbor’s extraordinary success: on 27 July 1678, King Charles knighted him at Whitehall.

  Soon after, Talbor left London for France. Whether he decided to abandon the city where the alleged ‘Popish Plot’ had just been revealed and anti-Catholic sentiment was growing steadily, or whether he was despatched by the King, who heard that the Dauphin, the only surviving son of Louis XIV, was dying of fever, is not known. Nonetheless, Talbor was soon busy in Paris curing the French notables of the fever that plagued their city nearly as much as it did London. When the Queen of Spain fell ill, he was sent by Louis XIV to the Spanish court. Having cured her, he returned to Paris to much acclaim; his secret remedy became the great vogue of the day, and he was addressed as ‘Chevalier’.

  Five years before Talbor reached Paris, Molière had staged Le Malade Imaginaire, which attacked Antoine Daquin, the King’s private physician, and the rest of the French medical establishment. He ridiculed the mannerisms of the physicians – their wigs, their fancy clothes, their speech – but also the mummified Galenic ideas to which they clung. And the people laughed. The court laughed. They laughed most of all at the final mocking scene, in which the doctor is conferred with his degree: ‘Dost thou swear to follow the advice of the ancients whether good or bad? Dost thou swear not to use any other remedy but those used by the Faculty [of Medicine of Paris] even if the patient should die?’ With his unorthodox medical ideas—his secret remedy and his refusal to purge or draw blood – ‘Chevalier’ Talbor was the living negation of that medicine that Molière, in his genius, mocked so successfully. ‘The remedy of the Englishman makes them quite contemptible with all their bloodletting. It is to take life itself away from them to take fevers from their domain,’ wrote Madame de Sévigné, commenting on the discomfort of the physicians at Talbor’s success. ‘If only Molière were alive.’

  Having witnessed how successful Talbor was at curing the sick, the French King offered to buy his secret remedy. Talbor agreed, but only on condition that the King maintain the mystery until after Talbor’s death. The doctor was awarded three thousand gold crowns and a substantial pension for the rest of his life. Two years later, he died at the age of thirty-nine.

  In January 1682 Louis XIV had a book published revealing Talbor’s secret. The English Remedy; or, Talbor’s Wonderful Secret for Cureing of Agues and Feavers was immediately translated into English, and became a bestseller. Talbor’s formula, it turned out, was made up of six drachms of rose leaves, two ounces of lemon juice and a strong infusion of Peruvian bark, all of it administered in wine. Talbor was careful always to change the wines he used, in order to disguise the identity of his cure. His real secret was to administer a weaker dose than patients had hitherto been accustomed to, and to repeat it often if necessary.

  Two years before Talbor died, another advertisement, this time in the London Gazette, stated that ‘the infallible Medicine of Sir Robert Talbor, for cure of Agues and Feavours, being in his absence rightly prepared by his Brother … is to be had when he is out of Town, at Mr Lords a Barber in St Swithings-lane … The price a guinea two doses.’ That Talbor could charge such high prices in London, where once he had been laughed off as a quack by the medical establishment, was a sign of the extent to which the Peruvian bark had become an established and successful remedy in England.

  Shortly before he died, Talbor erected for his family a monument in the churchyard at Trinity College, Cambridge, on which he described himself as the ‘most honourable Robert Talbor, Knight and Singular Physician, unique in curing Fevers of which he delivered Charles II King of England, Louis XIV King of France, the Most Serene Dauphin, Princes, many a Duke and a
large number of lesser personages’.

  His enemies still referred to him as ‘a debauched apothecary’s apprentice’, a ‘seller of secrets’ and an ‘ignorant empiric’. Whether they disliked the ease with which he moved in Roman Catholic circles, or whether they just disliked him, the fact remains that it was Talbor, more than anyone else, who single-handedly ensured that the Jesuit bark would never be forgotten in England. Many were now prepared to try it on any fever, especially if no previous medicament had worked. Nowhere was this more evident than in the last days of King Charles II’s life when, with their monarch racked by fever and in great pain, the royal physicians were willing to try almost anything.

  The King had awoken on Monday, 26 January 1685 pale and feeling shaky. His barber came into his room to shave him, but no sooner had he attached a towel to one side of the monarch’s face and was passing behind his chair to fix the other than the King collapsed with a seizure. Help was at hand, though. It was the custom that no one, on pain of death, was permitted to bleed the King without the consent of his senior ministers. But his doctor, Sir Edmund King, defied tradition and insisted he be bled at once. Sixteen ounces of blood were removed from a vein in the King’s right arm. He remained in the barber’s chair, his teeth held forcibly open to prevent him biting his tongue, while his numerous other physicians were called. They ordered cupping glasses to be applied to his shoulders before proceeding to scarify him, by which they removed another eight ounces of blood.