The Miraculous Fever-Tree

by Fiammetta Rocco

  The next day, 29 October 1816, Francisco José de Caldas was executed with his back turned on the firing squad, as traitors are often made to do.

  Bolívar’s forces were threatening Bogotá once again, and a year later, on orders from Madrid, all the material from the Botanical Institute was taken to Spain. Some was lost, but in all 5190 coloured illustrations and 711 drawings, forty-eight boxes of botanical specimens, mostly of the cinchona tree, and a large number of manuscripts, including Mutis’s Herbarium, in which he had catalogued more than twenty thousand plants, were deposited in the cellars of the Jardín Botañico in Madrid. They were packed in 104 large wooden boxes, and while some of the work has been published in recent years, many of the catalogues that Mutis and Caldas prepared have never been opened.

  6

  To War and to Explore – From Holland to West Africa

  ‘Our stores were nearly empty, and little or no Peruvian bark – one of our most essential medicines – remained.’

  SIR JAMES MCGRIGOR, of the Army Medical Board, reporting to the House of Commons investigation of the Walcheren expedition, 1810

  The death of José Celestino Mutis in 1808 represented the end of the search for knowledge for knowledge’s sake in the story of the cinchona. Political rivalry, religious pressure, scientific one-upmanship and petty human jealousy had all had a part to play in the quest for the magical tree that produced the Jesuit powder which cured the ague or intermittent fever. But the principal inspiration, stretching over generations from Mutis back to la Condamine, de Jussieu, Sydenham and Sloane, had been the quest for knowledge. From the time of Mutis’s death, that driving force would change to a quest shaped by the growth of commerce and political expansion.

  In 1809, the year after Mutis died, Europeans would witness at first hand what malaria could do to an army unprepared. So many British troops died during the Walcheren expeditionary raid on Napoleon’s troops in Holland in the summer of that year that the word ‘Walcheren’ is still listed in some dictionaries as a byword for military blundering. The British Foreign Secretary, George Canning, strongly opposed the expedition, and challenged his cabinet colleague, the War Minister Lord Castlereagh, to a duel over it. When Canning lost, he was forced to resign.

  Those most affected by Walcheren were the Royal Navy and the British Army. But the forces of other countries could not fail to heed the warning. From the start of the nineteenth century onwards, finding a cure that was cheap and easy to administer would exercise many who saw at first hand how malaria affected both warfare and exploration.

  The Walcheren expedition took shape just as France was beginning to recover from the humiliation of its defeat at the Battle of Trafalgar in October 1805. By the spring of 1809, the French navy was well on the way to finishing the construction of its new fleet. As many as thirty-five freshly built ships lay at anchor as the spring sun returned to the Scheldt estuary on Holland’s south-west coast, with only a few still on the stocks at Antwerp waiting to be completed. Napoleon, who kept up with the latest news of this swelling arsenal less than forty miles from the British coast, described it as ‘a pistol held to England’s head’.

  In London it was realised that something had to be done, but no one was quite sure what. The cabinet was split, as were many of Britain’s most senior generals. Orders were issued and then countermanded. Nevertheless, by the end of July, forty thousand soldiers were ready to be conveyed to Holland. It was the biggest expeditionary force that Britain had ever sent abroad. To transport them, an imposing fleet of thirty-eight ships of the line, thirty-six frigates and over six hundred other vessels – small ships of war, gunboats and transports – was assembled off the English Downs. When at last they sailed away in three divisions, to the sound of massed bands playing the national anthem, it seemed to one observer that an entire forest of masts, bearing a single canopy of white canvas, was on the move. ‘Never will I forget the glorious sight,’ an unknown Scottish soldier wrote in his diary, ‘of the most powerful and numerous fleet which ever left the British shores. The sea looked as if it groaned under the weight of so many vessels, and as far as the eye could reach a wilderness of masts was seen.’

  The slow and haphazard way in which the expedition had been organised through the early summer of 1809 meant that news of its impending departure had, inevitably, reached Napoleon’s ears even before it set sail. The French Emperor’s reaction was characteristically insouciant. He knew all about Walcheren and the fever that reappeared there every summer among the polluted polders, slimy, oozing ditches and dykes, and marshy dunes. ‘Do not attempt to come to blows with the English,’ Napoleon wrote to one of his commanders. ‘Your National Guards, your conscripts, organised into provisional demi-brigades, huddled pêle-mêle into Antwerp with no officers for the most part and with an artillery half-formed … will infallibly be defeated. We must oppose the English with nothing but fever, which will soon devour them all. In a month the English will be obliged to take to their ships.’

  Not even the most trusted of his commanders knew that when the time came, Napoleon himself would usher in the worst epidemic of malaria that Europe had ever seen by ordering that the dykes be breached to flood the whole of the Scheldt estuary with rank, briny water, the perfect environment for the mosquito larvae to hatch.

  The expedition set off with a braggardly confidence, but little thought had been given to provisions and medical supplies. This was not unusual. Military medicine then was a ragbag affair. There was no Army Medical Corps. Physicians held no military rank, and most of those who followed the army combined their trade with a more lucrative private practice at home. Surgery was a grim, rough-and-ready business, and army surgeons had no more prestige than barbers. Medicines were often bad and dear, and apothecaries amounted to little more than energetic hawkers. There was no ether, no chloroform and certainly no modern antibiotics. Wounds to the limbs were dealt with mostly by amputation, and nearly two-thirds of surgical patients died either from loss of blood or from infection. Despite those terrible figures, by far the biggest killer at the end of the eighteenth century was not injury sustained in battle or on the operating table, but disease, particularly dysentery, typhoid and malaria.

  The medical provisioning of the Walcheren expedition was shoddy even by the standards of the day. Neither the Physician-General, nor the Surgeon-General or the Inspector-General of Army Hospitals was consulted about how best to equip the fleet. Because the troops were travelling only a short distance, the duelling Lord Castlereagh informed the Military Secretary that there would be no need for hospital ships. For forty thousand men there were only thirty-three medical staff with any training, and just thirty untrained assistants to attend them.

  Medical supplies too were virtually non-existent, which was all the more extraordinary considering that the British Army knew at first hand about the intermittent fevers that were endemic to the Zeeland coast. Nearly a century earlier, Sir John Pringle, an army physician whose public support of Captain Cook’s campaign against scurvy had made him the father of military medicine, saw four-fifths of the army fall sick in the Lowlands campaign during the War of the Austrian Succession.

  John Webb, a physician who accompanied the Walcheren expedition, described the unhealthy Zeeland environment in some detail:

  The Bottom of every Canal that has communication with the Sea is thickly covered with an Ooze, which when the Tide is out emits a most offensive and Noisome Effluvia; every Ditch is filled with Water, which is loaded with animal and vegetable Substances in a state of Putrefaction … The Endemic Diseases of the Country, remittent and Intermittent Fevers begin to appear about the middle of August … It is computed that nearly a third of the Inhabitants are attacked with Fever every sickly Season.

  Webb’s report notwithstanding, the troops sailed for Walcheren with barely a day’s dose of Peruvian bark, one of the essential medicines for fighting the intermittent fever. Some ships carried no bark at all. One of those for whom there was no treatment was
Webb himself. Within a few days of arriving he had succumbed to the fever, which hastened the end of his army medical career.

  Among those who crossed the Channel to Holland was a young rifleman, John Harris, who had been much impressed by the send-off given the fleet from England, and who had his first glimpse of the sandy banks of the Dutch coast through the dawn mist on the morning of 29 July 1809.

  Rifleman Harris was a Dorsetshire sheep-boy who in the long winter nights in the West Country had learned the art of making shoes. He had been drawn by ballot into the army, but lost his heart shortly afterwards to the dashing appearance of a detachment of the green-jacketed 95th Rifles. On catching sight of them – ‘as reckless and devil-may-care a set of men as ever I beheld, before or since’, he would write later – the young soldier immediately volunteered, carrying his tools and leather with him as the battalion’s cobbler.

  Harris served during the bombardment of Copenhagen in 1807 and in the terrible campaign in Spain, where the men found themselves with ‘beards long and ragged; almost all were without shoes and stockings; many had their clothes and accoutrements in fragments, with their heads swathed in old rags, and our weapons covered in rust’.

  A few months after returning to England at the beginning of 1809, Harris was called upon to go to war again. He was looking forward to a quieter time of it in Holland. As the expedition made its way up the shallow, winding forty-mile gap that separated Antwerp from the sea, the helmsmen manoeuvred with caution to avoid running aground upon the sandbanks of Walcheren island at the mouth of the estuary. Soon the smaller ships’ boats were able to begin towing flat-bottomed craft towards the beaches. The soldiers leapt out into the shallow water, each man burdened with sixty rounds of ammunition, two spare flints, three days’ rations of bread and cooked pork, an allowance of rum, a canteen and a rolled overcoat.

  For a while Rifleman Harris thought he had found the quiet place he was looking for. One officer, dashing up the empty beach, saw outstretched before him a whole fertile island, ‘a flat fen turned into a garden’. So taken aback were the officers and men alike who joined him that there was a chorus of ‘How beautiful!’ Another officer wrote home of the island’s capital, Flushing: ‘It is a very pretty little town and, like everything in this island, so clean and new that it gives you more the idea of the model of such a place, made of paste-work, than the town itself.’ As Harris too later recalled, ‘The Rifles occupied a very pretty village, with rows of trees on either side its principal streets, where we had plenty of leisure … The appearance of the country was extremely pleasant, and for a few days the men enjoyed themselves much.’

  Appearances were misleading, though, and the mood soon changed when the weather broke. In the first week of August it began to rain. Gales blew in from the North Sea, rain fell hard and steadily as the men worked to build huts with wood and straw in which to shelter. Transporting the troops ashore had taken so long that there had been little time to follow up with the equipment they needed. Many were ill prepared against the weather, with no blankets or change of linen. Sporadic gunshots, fired during light skirmishes against the enemy, occasionally pierced the air. But for the most part the English troops were looking to take care of themselves.

  On 10 August, on Napoleon’s orders the French breached the sea dyke. By nightfall the water in the ditches where the English were building gun and mortar platforms had risen by three feet. The rain helped the flooding, and the sluices on the east side of the island had to be opened to let out as much water as possible. But at high water sticks were still needed to mark the firm ground. The whole island seemed to have been engulfed. In the ditches the men, wearing their greatcoats, were hot and soaked through. They worked round the clock, slapping about through the mud and water in shoes with rotten uppers. ‘The leather is like so much brown paper, and tears off the sole after it has got one or two wettings,’ wrote one soldier. Rifleman Harris, with all his cobbler’s expertise, could do nothing to help them. His tools and leathers had been left on board ship.

  The Walcheren fever took hold suddenly. As Harris recalled:

  At the expiration of (I think) less than a week, an awful visitation came suddenly upon us. The first I observed of it was one day as I sat in my billet, when I beheld whole parties of our Riflemen in the street shaking with a sort of ague, to such a degree that they could hardly walk; strong and fine young men who had been but a short time in the service seemed suddenly reduced in strength to infants, unable to stand upright – so great a shaking had seized upon their whole bodies from head to heel.

  The company I belonged to was quartered in a barn, and I quickly perceived that hardly a man there had stomach for the bread that was served out to him, or even to taste his grog, although each man had an allowance of half a pint of gin per day. In fact, I should say that, about three weeks from the day we landed, I and two others were the only individuals who could stand upon our legs.

  The sickness cut through the whole army. ‘You would think that the rot was amongst them were you to see how they drop off,’ wrote another soldier. ‘Every hour three or four are announced to have departed.’ Many a soldier panicked in advance, and those who had not yet succumbed to the fever lived in hourly dread of it. Morale was not helped by the sight of wagons laden with coffins creaking through the streets, or by the news that every carpenter on the island had been set to making more of them. To reduce the panic caused by so many burials, commanders ordered that they be carried out under cover of darkness with no candles or torches, and that the fusillades that usually accompanied a soldier’s farewell be dispensed with altogether. Bands playing music were also forbidden.

  Some efforts were made to stop the disease from spreading, although it was far too late. Officers explained to their men about the dangers of eating unripe fruit, of sleeping out of doors, and of fishing and wading in the ditches. Observing that the local population smoked heavily – many soldiers wrote home of their surprise at observing the heavy-bottomed women sitting on their front steps enjoying a long pipe or two – officers recommended smoking at night and in the early morning. The full ration of spirits was issued, and one general counselled his battalions to drink four glasses of brandy every day – on rising, at breakfast, after dinner and in the evening. The sailors, who slept on board the ships that were anchored at a cable length or two offshore, succumbed less quickly, but in the end they too fell ill. ‘Towards morning we found ourselves wrapped in that chill, blue marshy mist rising from the ground that no clothing could keep out, and that actually seems to penetrate to the inmost frame,’ one soldier wrote.

  Another added:

  The night was clear and chill; a thin white vapour seemed to extend around as far as I could see; the only parts free from it were the sand heights. It covered the low places where we lay, and was such as you see early in the morning, before the sun is risen, but more dense. I felt very uncomfortable in it; my two hours [on watch] I thought never would expire; I could not breathe with freedom. Next morning I was in a burning fever, at times; at other times, trembling and chilled with cold: I was unfit to rise, or walk upon my feet. The surgeon told me, I had taken the country disorder. I was sent to the hospital; my disease was the same as that of which hundreds were dying.

  By 27 August, barely a fortnight after the disease first broke out, 3400 men were sick. According to the words of a poem published in Edinburgh the following year:

  All fruitless victims to the cruel air,

  The climate slaughters whom the sword would spare.

  Whole battalions became incapacitated, and at one stage three of them were struck off duty altogether because they had not a single man who was not in hospital. By 17 September the fever had affected 8200 soldiers, and 250 men were dying every week. Another poem, ‘The Knight of Walcheren’, went:

  Choice hearts! Whose welfare we should cherish,

  Not send in foreign swamps to perish.

  According to Harris, the 95th Rifles had 560 men on the sickli
st in early September. It became increasingly difficult for the overworked regimental surgeon to attend to all of them. The sick were so scattered that Harris and a companion named Brooks were obliged to set themselves up in a sort of ‘watch-box’ on the quayside, where they ‘served out pills and boluses to those who came for them, which they did on the alternate days of the fever’. Whenever the bark became available they doled that out too, mixed with wine to mask the bitter taste and served in little horn cups.

  To Harris, being one of the survivors started out as a matter of honour:

  It was rather extraordinary that myself, and Brooks, and a man called Bowley, who had all three been at Corunna, were at this moment unattacked by the disease, and, not withstanding the awful appearance of the pest-ship we were in, I myself had little fear of it. I thought myself so hardened that it could not touch me.

  It happened, however, that I stood sentinel – men being scarce – and Brooks, who was always a jolly and jeering companion, even in the very jaws of death, came past me, and offered me a lump of pudding, it being pudding-day. At that moment I felt struck by a deadly faintness, shaking all over like an aspen, and my teeth chattering in my head so that I could hardly hold my rifle.

  Brooks looked at me for a moment, with the pudding in his hand, which he saw I could not take. ‘Hallo,’ he said, ‘why, Harris, old boy, you are not going to begin, are you?’

  I felt unable to answer him, but only muttered out as I trembled, ‘For God’s sake get me relieved, Brooks!’

  ‘Hallo?’ said Brooks, ‘it’s all up with Harris! You’re catched hold of at last, old chap.’

  It is difficult, nearly two centuries on, to diagnose exactly what the Walcheren fever was. ‘The miserable, dirty, stinking holes some of the troops were of necessity crammed into was more shocking than it is possible to express,’ wrote one brigadier after a tour of inspection of the island. Given the conditions in which the men were forced to live that summer, it seems likely that they were afflicted by several different diseases at once. A few complained of suffering from fever for three or four days at a time, with gaps of up to twenty-four hours’ remission between them, and red spots appearing on their chests, stomachs and limbs, which suggests a scarlet fever; many more tell of severe stomach pains and loose bowels, which one would expect from an epidemic of dysentery or typhoid, both of which were common where water supplies were inadequate and drainage and sanitary arrangements poor. Several write about the smell of the sick, ‘such as was only ever encountered in gaols’; typhus, which is spread by fleas borne by rats, was a common disease in over-crowded eighteenth-century prisons.