The Miraculous Fever-Tree

by Fiammetta Rocco

  In 1823 a new company, Rosengarten & Sons in Philadelphia, began isolating quinine from cinchona bark on a commercial scale, following a method that had been perfected by two Parisian pharmacists, Joseph Pelletier and Joseph Caventou, three years earlier. What they called ‘essence’ of cinchona bark was in fact quinine sulphate, a soluble salt which had the advantage of being much easier to swallow than ground-up bark. Legend has it that when he heard of Rosengarten’s new product, Dr Sappington immediately saddled his horse and rode all the way to Philadelphia. When he arrived, he sought out the company and bought its entire supply. After a few days, during which he attended some medical lectures, he returned home to Missouri carrying this wondrous substance in his saddlebags.

  Whether this story is true or not is unknown. What is certain is that shortly after returning from Philadelphia, Sappington began using refined sulphate of quinine in his practice in addition to ground cinchona bark. He soon arrived at a curative dose of one or two grains of quinine sulphate every two hours for two or three days. For use as a prophylactic he prescribed the same dose, given four or five times daily.

  In the spring of 1824, the efficacy of quinine sulphate was put to a severe test. On 16 May a large trading party, led by Meredith Miles Marmaduke, departed from Franklin, Missouri, bound for Santa Fe. Their first stop on the day after leaving Franklin was at the Sappington farmstead, at the start of the route known as the Santa Fe Trail, to purchase a supply of the ‘essence of bark’ that had been obtained in Philadelphia a few weeks earlier. There is a receipt for this purchase in the Sappington papers. In addition, the young Mr Marmaduke bade farewell to his fiancée, Lavinia Sappington, the doctor’s daughter. Many years later, Marmaduke would become Governor of Missouri, but not before he had led the Marmaduke-Storrs trading party of eighty-three men safely across the malarious Missouri and Arkansas river valleys to Santa Fe, where they arrived without a single bout of illness to report, having carefully taken their daily dose of quinine as instructed by Dr Sappington.

  The sick children in The Little House on the Prairie were treated by Mrs Scott, who ‘poured a dreadful bitterness out of a small folded paper on to Laura’s tongue’. Had they been travelling through Missouri in the 1830s, Mrs Scott would probably have dosed them with Dr Sappington’s Fever Pills, the ingredients of which were a closely guarded secret, though the lid was clearly marked ‘Price: One Dollar a Box’.

  It is not clear exactly when Dr Sappington branched out from doctoring and farming and started his new business. By 1832, though, it was going strong. That year, according to the working formula sketched out on the back of a ledger book, he had perfected the secret recipe for his cure:

  Sulphate of quinine 2 pounds

  Pulv Extr. Liquerice 1 ½ lb

  Pulv Gum myrrh ½ lb

  Oil of Sasafras

  Acqua Pura

  Make 240 boxes

  24 pills to a box

  Unlike the ancient Roman remedies that advocated incantations sung by virgins, or even Father Domenico Anda’s brief mention of the Peruvian cortex in one of his concoctions at the Santo Spirito hospital, Dr Sappington’s recipe was utterly practical. There was quinine as the active agent, liquorice to mask the bitter taste, sassafras oil for moistening the powdered ingredients, and gum of myrrh to bind it all together. In a long shed close to his farmstead, Sappington and, later, his sons and their slaves, would pound the mixture, press it into iron pill moulds, and pack the pills, twelve or twenty-four to a box, before stacking the boxes by the door ready for shipping.

  Demand for the pills grew rapidly. By 1836, when Dr Sappington’s son-in-law William Price travelled to Philadelphia to make his annual quinine purchases, he was ordering over 375 pounds of quinine sulphate at a time, more than a third of which had to be obtained in New York after the Philadelphia supply had been exhausted.

  Sappington’s sales force, particularly in the early years, consisted largely of family, friends and neighbours, all drafted in during the season to ensure the widest possible distribution. During the busier years, up to thirty-five people would set off, travelling for as much as six months of the year, to all parts of the central United States, from Ohio to Texas and from Nebraska to Alabama, distributing batches of pills to agents, who would sell them on for a commission. On major routes the agent could travel by steamer or by train, but once he penetrated deep into the less visited territories there was often no choice but to proceed by wagon or on horseback.

  The letters the agents wrote back are full of annoyances and difficulties: extreme heat, flies and saddles that made the backs of the horses raw. At least two agents lost their horses altogether. A Mr Hall, having seen his horse killed by buffalo gnats, was forced to walk ninety-eight miles, at least part of it through a rising swamp. Augustus Stevenson was detained not only by rains and high water, but by the attempted theft of his bridle, martingale and saddle-blanket, which he retrieved by running after the thief and catching him. No agent provided such emphatic descriptions of his trials as George F. Bicknell, Sappington’s agent in Mississippi, Louisiana and Texas. ‘I have dragged like a snake my slow length along over hills and through mud to this place,’ he said in one letter; and in another: ‘I have been mightily persecuted with rain, roads impassible, bridges gone, creeks swimming …’. He was sure his horse would see ‘affliction and infliction’ before he was done with Texas, and ended his letter with the words: ‘The Horse is alive but a little leg weary as is Yr Humblesvt.’

  The profitability of the Sappington business relied on securing the main ingredient, quinine, at a reasonable price and on ensuring that the pills were properly paid for, which was not always easy in a new country where credit expanded and contracted, gold or silver were not always readily available, and paper money often fell in value. Despite their complaints, the agents pursued fresh sales with great success. In 1844, a good year, 500,000 boxes of fever pills were produced. Stories have been handed down that church bells were often tolled throughout the Mississippi valley at two-hourly intervals during the summer and autumn to remind all within hearing to take their anti-fever pills. Sappington, like Dona Phelicia Garzan with her shipment of bark from Peru to Spain more than a century earlier, had an effective product and a clientele that was willing to pay for it. As he himself would later recall in his book on treating fevers, he ‘realised considerable sums of money’ from the sales of Dr Sappington’s Fever Pills.

  For thirty years, the business thrived. But the coming of the Civil War would destroy Sappington’s operation; quinine supplies became so intermittent that production virtually collapsed, as did his network of agents. Yet the authorities on both sides of the conflict, who saw their soldiers fall sick with malaria on almost a daily basis, would have benefited mightily had they paid the slightest attention to protecting and encouraging Sappington in what he was trying to achieve. In passing up this opportunity, they sentenced many of their soldiers to a lifetime of recurrent illness and, all too often, an early death.

  Of all the grand civil engineering projects of the nineteenth century, none was more ambitious than the two canals dreamed up by the French at Suez and in Panama. More than 5500 Frenchmen, along with another seventeen thousand workers from other countries, died in Panama between 1881 and 1889, during Ferdinand de Lesseps’ ultimately ill-fated attempt to dig a canal across Central America. Because the Panamanians hold the French to blame for the fact that the canal belonged for nearly a hundred years to the United States of America, there is little to commemorate the work that de Lesseps and his compatriots were able to complete. Most of the bodies of the dead – other than those that were repatriated at great expense by their families – lie beneath the dark waters of the canal itself, along with more than seventy railway locomotives and thousands of tonnes of machinery and dredging equipment.

  The main municipal cemetery of Panama City is in Chorillo, once one of the poorest quarters of the capital, where cinder-block public housing has now replaced the old wooden shacks of the
canal workers. Within it rises one of the few remaining monuments to the period when the French were attempting to build the canal. The ‘Recordación Perpetua a los Gloriosos Franceses Zapadores del Canal de Panamá’ records the names of twenty-seven men who died working for Ferdinand de Lesseps. They were born variously in Paris, Marseilles, Haute Savoie, Bresse, Tarn, Fontainebleau and, memorably, given the connection with de Lesseps, ‘au barrage du Nil (Egypte)’. They stand for thousands of others listed in the French records as ‘décédé à Panama’. Of the twenty-seven names, there is not one who was not a graduate of one of France’s best engineering schools. Only two had reached the age of thirty. And they all died within weeks of arriving in Central America, in the winter of 1884–85, when the isthmus was swept by the worst epidemic it had ever known of yellow fever and malaria. Medicine was in short supply, and thousands of workers died. The Compagnie Universelle du Canal Interocéanique, for whom they worked, was so terrified of what was happening that it forbade its employees from disclosing the conditions under which they lived. One anxious French shareholder who wrote to the company to ask about the reports of excessive numbers of deaths, was soothed with the words: ‘We know you have confidence in us … If we say there is no illness on the isthmus, this is because there is none, and anyone who asserts the contrary is a gossipmonger who is merely trying to undermine your confidence so that he can take over himself.’ Telling outright lies, the company decided, was preferable to admitting the truth.

  Philippe Bunau-Varilla, my great-grandfather, knew nothing about the epidemic when he sailed on the steamship Washington from St Nazaire to the Panamanian port of Colón in October 1884, although he made the crossing of the Atlantic in the company of the Chief Engineer of the canal project, Jules Dingler, and his family. It is likely that even if Dingler, who had already served with distinction as the chief of bridges and roads in France, had made a clean breast of the problems they faced, the diminutive Bunau-Varilla would not have listened. He had lived through the Franco-Prussian war, and had seen people who were so hungry during the siege of Paris of 1871 that they ate the animals in the zoo. He was an outsider, a Protestant from the German borderlands who had learned to make his way within the Catholic establishment, and he was so determined to break out of metropolitan France to make his fortune that he would have risked any peril to achieve his aim. When asked by an indiscreet company librarian why he should wish to commit suicide by going to Panama, Bunau-Varilla had replied that he was determined to go ‘as an officer runs to [death] when he hastens to the battlefield, and not as the coward who flees from the sorrows of life’.

  Bunau-Varilla was born the son of a boarding-house owner from Alsace, and won a scholarship to the Ecole des Ponts et Chaussées, the engineering faculty of the Polytechnique de Paris, where he hid the fact that he was both a Protestant and illegitimate (‘de père inconnu’, his records say) behind a sharply pointed moustache and a swagger that made one forget that he stood barely over five feet three inches tall. At the age of twenty-five he had achieved a good part of his ambition simply by getting to Central America, and nothing was going to stand in his way.

  He had set his heart on the Panama Canal after hearing le grand français, Ferdinand de Lesseps, lecture at the Polytechnique. De Lesseps, who was still fêted throughout France for his triumph in completing the canal at Suez in 1869, appealed to the young engineers before him to pledge their lives to his grand new project for the sake of la patrie et la gloire de la France. Like many of those seated in the lecture hall, Bunau-Varilla needed no second call.

  Had he been more sceptical, Bunau-Varilla might have asked de Lesseps some pertinent questions. Such as why, given that Panama was as rocky and mountainous as Suez had been sandy and flat, did he feel it was appropriate that the new canal should be built without locks? Why had no survey been carried out? What were the sanitary conditions of the isthmus? How were the sick to be cared for? What would happen if the costs ran over and the money ran out before the project was complete?

  When the Dinglers disembarked at Colón in November 1884, with Bunau-Varilla close behind, it was raining so hard that they could not even see the hilltops that breasted the canopy of the jungle. To a first-time visitor, the mountains of the isthmus appear to be lined up in a continuous range, but as you approach them more closely you can see that they are really a succession of individual hills, arranged in bewildering complexity. Most mountain ranges were formed by the upward pressure of the earth’s surface rising and folding. But the mountains of Central America are individual volcanic cores, little islands of hard rock such as basalt, diorite and andesite that pushed up through the layers of lava and ash. A cross-section of the isthmus shows not an orderly arrangement of layered ranges, but a profusion of faults, valleys, cores and dykes. In less than thirty miles, between Colón and Panama City, there are six major faults, five significant volcanic cores and seventeen different kinds of rock. It is not the easiest place to construct a canal.

  In the course of the long windy days spent crossing the Atlantic, Dingler had told Bunau-Varilla a great deal more about the project, though he dwelt little on the difficulties that were growing worse by the day. One of these was the terrain they would have to work in; another was the climate. The rainy season came late in the winter of 1884, but it made up for the delay with a vicious intensity. I have never seen rain like the rain in Panama, not even as a child growing up in Africa, where we always believed we had real rain, rain that danced across the veld leaving a lemony light and a smell of new life. Even that was not the kind of rain that barrels down crumbling buildings, swelling the muddy torrents that swirl about so that you no longer can tell what is road and what is pavement. Panama rain is rain with cojones; what John le Carré calls ‘six-inch raindrops, pumping up and down like bobbins on the front steps, the thunder and lightning setting off every car alarm in the street, and the drain covers bursting their housings and slithering like discuses down the road in the current’. I have never seen rain like the rain in Panama, and I bet my great-grandfather hadn’t either.

  ‘The points where my locomotive passed on the previous day were now covered by fourteen feet of water,’ Bunau-Varilla wrote in his diary of a journey he made early on from the coast to Balboa in the centre of the isthmus, on the Chagres River. ‘So I requisitioned three Indian canoes. We took these by train as far as we could, then embarked in them. As we paddled along through a channel apparently cut out of virgin forest all the workings were submerged and the tops of the telegraph poles were scarcely visible above the water.

  ‘In places we had to drag the canoes over small hillocks, and in this way one canoe was damaged. We had then to crowd into the remaining boats, although the load was almost too much, and the freeboard was not more than an inch above water. One of the engineers, a M. Philippe, said that he couldn’t swim. I told him jokingly, “There is no danger. I could easily tow you to the nearest trees.” It was only then that I noticed the strangest phenomenon: the tops of the trees were not their usual green, but a distinct and ever-shifting black; as we drew nearer, I saw they were covered with the most enormous and deadly spiders: tarantulas.’

  The flooding Chagres, whose level could rise fifty feet or more overnight, contributed not just to the workers’ physical discomfort, but directly to the dangers in which they worked. De Lesseps’ insistence that the canal would be built without locks had led the engineers to attempt to cut directly through the rock. At the highest point of the isthmus is the Gaillard Cut, then known as Culebra, a mile-long saddle of rocky land that soars three hundred feet above sea level. Its rocks consist of volcanic brescia, overlaid with a soft red clay that at first proved delightfully easy to dig away. ‘He who did not see the Culebra Cut during the mighty work of excavation,’ declared one witness, ‘missed one of the great spectacles of the age – a sight that no other time or place was, or will be, given to man to see.’

  In his arrogance, and because he had seen such an idea work on the terrain of the
Corinth Canal in southern Greece, de Lesseps had decided that the walls of the Panama Canal would be cut through almost at the vertical. He had not reckoned on the rain that turned the clay to mud. Just one downpour was enough to send a slice of a newly exposed hillside slithering into the ditch that the French were trying to excavate. In mid-1883 the company was extracting the apparently impressive figure of more than 150,000 cubic metres a month – but de Lesseps had promised his investors that by that time the Compagnie would be carting away nearly ten times that volume.

  By the end of 1884, when Bunau-Varilla got to work reorganising the dredging system on the deepest sections of the canal, matters had improved. But over the following year, more mud and rock fell into the ditch than it was possible to haul out of it. A total of 9.8 million cubic feet had been excavated by the end of 1884; after a further year of digging, dredging and carrying away of mud and rock, the total cumulative figure had been reduced by the end of 1885 to 9.4 million cubic feet. The French engineers were being assailed on every side. Machinery was constantly breaking down, and the sides of the canal would not stay in place. In the rainy season the rain never let up, not even for an hour. It forced up the level of the Chagres River, sent it flowing over its banks and cascading into the works that Bunau-Varilla and his companions thought they had completed.

  With the rain came sickness. Never having been exposed before to the mosquitoes that carried yellow fever or malaria, the workers on the Panama Canal were easy prey to disease. The workers refused to drink the rank water of the Chagres River, so the Compagnie carefully collected rainwater in empty tubs and bins at every street corner in the city. In the managers’ gardens, precious shrubs and trees were protected from the tropic’s voracious ants by tubs of water. And in the hospitals, black spiders were stopped from climbing into bed with the patients only when the bedlegs were placed in bowls of water. The rain filled ditches, holes and puddles. And wherever water lay undisturbed, the larvae of two kinds of mosquito were able to hatch: Anopheles, which carries Plasmodium falciparum, deadliest of the malaria parasites, and Aedes aegypti, or Stegomyia fasciata as it was then called, which transmits yellow fever.