The Miraculous Fever-Tree

by Fiammetta Rocco

  The technique is common in Europe and America, but has proved difficult to carry out in Africa, where electricity supplies are intermittent at best and trained laboratory technicians are hard to find. As a precaution, Pharmakina began its laboratory experiments in Switzerland. But transporting seedlings from Europe to the Congo proved too difficult – as with Sir Clements Markham’s efforts more than a century earlier, most of the plants died en route. If Pharmakina was to have any success at cloning its trees, Gebbers realised, it would have to do it in the Congo.

  In the white-walled cuisine, technicians separate a healthy cinchona leaf into pieces that are hardly a millimetre wide. Dropped into a cup of algal extract, with added sugar, vitamins, minerals and a plant growth hormone, the cinchona cells develop within three months into what is recognisably a tiny plant, with stem, leaves and pale translucent roots. Left for another three months in the rich algal extract, the cinchona seedlings are then ready to be planted out in the open, not in the forest yet, but in seedbeds that have been specially prepared to receive them. Regularly watered, the plants flourish in the warm African sun. After nine months they are ready for the open sea of the plantation.

  Mudwanga reaches for a pot. In it is a seedling that is hardly bigger than my thumb. Its leaves show a busy network of narrow veins. Around its fragile stem, the bark covering where the quinine will develop is as fine as a silk stocking, but visibly already there. In that tiny plant, the eternal journey of the miraculous fever-tree has begun once more. In time the sap will swell, just as it did for the Jesuit priests who discovered it in another forest across another ocean. Sweettasting now, it will mature into a bitter brew as poisonous to the parasite as it is precious to mankind.

  NOTES ON SOURCES

  Introduction: The Tree of Fevers

  Francesco Torti, who was such an enthusiast of the Peruvian bark that he turned his theory of treating illness into the engraving of the ‘Tree of Fevers’, published two treatises on fever, Therapeutice specialis ad febres quasdam perniciosas, in 1709, and a slightly enlarged version in 1712. Both manuscripts are in the Biblioteca Nazionale Centrale di Firenze. Torti’s clinical consultations have been translated into English by that doyen of early cinchona studies, Saul Jarcho, and published in Clinical Consultations and Letters by Ippolito Francesco Albertini, Francesco Torti and Other Physicians, Francis A. Countway Library of Medicine, Boston, 1989.

  Chapter 1: Sickness Prevails – Africa

  Much of the material in this chapter is drawn from family letters, Gaston Bennet’s inventory of my grandparents’ 1928 expedition to Africa, and the diaries that my grandfather, Mario Rocco, and my grandmother, Giselle Bunau-Varilla Rocco, kept for the years 1927–31 and 1939–45.

  Edward Lear’s letters were edited by Lady Strachey and published by T. Fischer Unwin in 1907. ‘Malaria’ appears in Giovanni Verga’s first collection of tales about Sicily, Novelle rusticane, published in 1883 and translated into English by D.H. Lawrence in 1925, three years after Verga’s death. George Gissing, By the Ionian Sea, was published by Chapman & Hall in 1901.

  Henry Morton Stanley’s medicine chest, containing a single phial of the anti-malarial, ‘Zambesi Rouser’, was sold at Christie’s, London, in November 2002.

  Chapter 2: The Tree Required – Rome

  Giacinto Gigli’s diaries, 1608–70, are in the Biblioteca Vaticana in Rome. Alessandro Ademollo translated part of the manuscript into Italian in 1877, while Giuseppe Ricciotti undertook a fuller work in 1958. Neither is complete. Another contemporary chronicler of Counter-Reformation Rome is the Dutch diplomat Teodoro Ameyden (1586–1656), whose diaries were translated into Italian by A. Bastiaanse and published in 1967 as part of Studien van het Nederlands Historisch Instituut te Rome by Staatsdrukkerij, ‘s-Gravenhage.

  Horace Walpole’s letters are in the Yale Edition of Horace Walpole’s Correspondence, 48 vols, 1937–82

  For information about malaria in Italy, the fullest sources are F. Bonelli, ‘La Malaria nella storia demografica ed economica d’Italia’, Studi Storici, 1966, 659–721; Angelo Celli, ‘The Campaign Against Malaria in Italy’, Journal of Tropical Medicine and Hygiene 1908, 11,7: 101—8; and The History of Malaria in the Roman Campagna from Ancient Times, John Bale, Sons & Danielsson, 1933; Corrado Tommasi-Crudeli, ‘On the Generation of Malaria in Flowerpots’, The Practitioner 1881, 27: 3878 and The Climate of Rome and the Roman Malaria (translated by C.C. Dick), J. & A. Churchill, London, 1892; Ronald Ross, ‘Dea Febris: A Study of Malaria in Ancient Italy’, Annals of Archaeology and Anthropology 1909, 97–124. A more recent work is Robert Sallares, Malaria and Rome: A History of Malaria in Ancient Italy, Oxford University Press, Oxford, 2002.

  For detailed information on early medicine in Rome and the history of the Santo Spirito Hospital, see Louise S. Bross, The Church of Santo Spirito in Sassia: A Study in the Development of Art, Architecture and Patronage in Counter-Reformation Rome, Ph.D. dissertation, University of Chicago, 1994; Francesco Cancellieri, Storia dei solenni possessi di sommi pontefici detti anticamente processi o processioni dopo la loro coronazione dalla Basilica Vaticana alla Lateranensa, Rome, 1802; Alessandro Canezza and Mario Casalini, Il Pio istituto di Santo Spirito e ospedali riuniti di Roma, Rome, 1933; Pietro De Angelis, ‘La Spezeria dell’arcispedale di Santo Spirito in Saxia e la lotta contro la malaria’ in Collana di studi storici sull’ospedale di Santo Spirito in Saxia, e sugli ospedali Romani, # 13, Rome, 1954; Silvia De Renzi, ‘A Fountain for the Thirsty and a Bank for the Pope: Charity, Conflicts and Medical Careers at the Hospital of Santo Spirito in Seventeenth-Century Rome’, Health Care and Poor Relief in Protestant Europe, 1500–1700, edited by Ole Peter Grell, Andrew Cunningham and Jon Arrizabalaga, Routledge, London and New York, 1997; Camillo Fanucci, Trattato di tutte le opere pie dell’alma città di Roma, Rome, 1601; Eunice Dunster Howe, The Hospital of Santo Spirito in Sassia and Pope Sixtus IV, Ph.D. dissertation, Johns Hopkins University, 1978; Richard Krautheimer, Rome: Profile of a City, 312–1308, Princeton University Press, 2000; Laurie Nussdorfer Civic Politics in the Rome of Urban VIII, Princeton University Press, 1992; Angela Palma, L’Ospedale di Santo Spirito in Saxia, Biblioteca di Galileo, Padova, 1994.

  The manuscript, now stolen, that Pietro De Angelis cites as containing the first mention of Peruvian bark is Fra Domenico Anda, Capo Speziale di Santo Spirito, Ricettario manoscritto 334, Biblioteca Lancisiana, Rome.

  Chapter 3: The Tree Discovered—Peru

  The most important sources of information that survive in Lima about Brother Agustino Salumbrino and the Jesuit College of San Pablo were gathered together by the Jesuit historian and collector, Father Rubén Vargas Ugarte. The two earliest volumes, Libros de Viáticos y Almacén, 1626–28 and 1628–31, are now in the Archivo General de la Nación (Companía de Jesús, Cuentas de Colegios, 1583–1669, Legajo 41, Cuaderno 2 & 3), as are the two later volumes, Cuenta de la Botíca 1757–67 and 1768 (Temporalidades Inventarios, Legajo 2, Cuaderno 28).

  The correspondence between Brother Salumbrino and the Vicarate-General of the Order of the Society of Jesus can be found in the Archivio della Compagnia di Gesú in Rome, and details of some of the medicines he sent to Rome are available in the apothecary’s archive which is to be found in the Archivio di Stato di Roma, La Sapienza.

  On the early Jesuit presence in South America, Nicholas P. Custner, Lords of the Land: Sugar, Wine and Jesuit Estates of Coastal Peru, 1600–1767, State University of New York, Albany, 1980; S.J. Harris, Jesuit Ideology and Jesuit Science: Religious Values and Scientific Activity in the Society of Jesus 1540–1773, Ph.D. dissertation, University of Wisconsin, Madison, 1988; E. Saldamando Torres, Los antiguos Jesuitas del Perú, Imprenta Liberal, Lima, 1882; José Luis Valverde, Presencia de la Companía de Jesús en el desarollo de la farmacia, Universidad de Granada, 1978; Rubén Vargas Ugarte, Historia de la Compania de Jesus en el Perú (4 volumes), Burgos, 1963–65.

  The biographical details about the Count of Chinchón come from his own memoir, Memorias de l
os Virreyes del Peru, edited and published in Lima in 1899, and from those of his secretary J.A. Suardo, edited by Rubén Vargas Ugárte, Diario de Lima (1629–34), Vasquez, Lima, 1935.

  Early recountings of the legend of the Countess of Chinchón are to be found in Sebastiano Bado, Anastasis cortices Peruviae, seu chinae chinae defensio, Genoa, 1663; Gaspar Bravo de Sobremonte, Disputatio apologetico pro dogmatica medicine praestantia, 1639; Bernabé Cobó, Historia del Nuevo Mundo, Seville, 1890–95; Antonio de la Calancha, Corónica moralizada del orden de San Augustín en el Perú, Barcelona, 1638; Gaspar Caldera de la Heredia, Tribunalis medici illustrations et observations practicae, Antwerp, 1663; Pedro Miguel de la Heredia, Operum medicinalium, Lyons, 1665, Migual Salado Garcés, Estaciones medicas, Utrera, 1655.

  For how the legend of the Countess should not be taken as fact, see A.W. Haggis, ‘Fundamental Errors in the Early History of Cinchona’, Bulletin of the History of Medicine 1941, 10,3: 417–59 and 568–92; Jaime Jaramillo-Arango, ‘A Critical Review of the Basic Facts in the History of Cinchona’, Journal of the Linnaean Society of London (Botany) 1949, 53: 272–311; C.H. La Wall, ‘The History of Cinchona’, American Journal of Pharmacy 1932, 104: 23–43.

  For an analysis of the early writings on cinchona, see Francisco Guerra, ‘The Introduction of Cinchona in the Treatment of Malaria’, Journal of Tropical Medicine and Hygiene 1977, 80: 112–18 and 135–40; Fernando Crespo Ortiz, ‘Fragoso, Monardes and pre-Cinchona Knowledge of Cinchona’, Archives of Natural History 1995, 22,2:169–81.

  On early medicine in Peru, Juan B. Lastres, Historia de la medicina peruana (3 volumes), Universitad Nacional de San Marcos, Lima, 1951.

  The most important work on the early trade across the Atlantic, Pierre and Huguette Chaunu, Seville et l’Atlantique 1504–1650, Paris, 1955, shows that trade in cinchona did not exist in the early Conquistador period. For details of how the cinchona trade blossomed in the seventeenth and eighteenth centuries, see F. Arriba Arraz, Papeles sobre la introducción y distribución de la quina en España, Valladolid, 1937, which gathers together all the holdings regarding cinchona in the Spanish Archivo General de Simancas; also Edoardo Estrella, Compendio histórico-medico-commercial de las quinas, Burgos, 1992; John Fisher, Commercial Relations Between Spain and Spanish America in the Era of Free Trade 1778–1796, Liverpool, 1985, and Antonio Gonzalez Garcia-Baquero, Cadiz y el Atlantico 1717–1778 (2 volumes), Escuela de Estudios Hispano-Americanos, Seville, 1976.

  Chapter 4: The Quarrel – England

  The account of the chartering of the Conde by, among others, Dona Maria Josepha de Albinar, Dona Pheliziana Barbara Garzan and Dona Elena Woodlock y Grant, and the cargo it transported from Guayaquil to Cadiz on its transatlantic voyage of 1748, is to be found in the Archivo General de Indias, Seville, Legajo 2770.

  On Cardinal Juan de Lugo, see Camilo P. Abad, ‘El Magisterio del Cardenal de Lugo en España con algunos datos mas salientes de su vida y siete cartas autografas ineditas’, Miscelenea Comillas 1943, 1: 331–70; Gabriel Brinkman, The Social Thought of John de Lugo, Ph.D. dissertation, Catholic University of America, Washington D.C., 1957; J.S.I. Rompel, ‘Kardinal de Lugo als Mazen der Chinarinde, Aus dem Leben das Kardinal’, 75 Jahre Stella Matutina Festschrift (volume I), Selbstverlag Stella Matutina, Feldkirch, 1931.

  For details of the quarrel over the advisability of prescribing the Peruvian bark, see Joannes Jacobus Chifletius, Pulvis febrifugus orbis americani ventilatus, Louvain, 1653; Antimus Conygius (pseudonym of Honoratus Fabri), Pulvis peruvianus vindicatus de ventilatore eiusdemque suscepta defensio, Rome, 1655; Vopiscus Fortunatus Plempius, Antimus Conygius, Peruviani pulveris febrifugi defensor, repulses a melippo protimo belga, 1665; Pietro Paolo Puccerini, Schedula Romana, Rome, 1651.

  On how quinine influenced the shift in medical thought away from Galenic theory, see W.F. Bynum and V. Nutton (eds), Theories of Fever from Antiquity to the Enlightenment, Medical History, Wellcome Institute, London, 1981; Andreas-Holder Maehle, Drugs on Trial: Experimental Pharmacology and Therapeutic Innovation in the Eighteenth Century, Editions Rodopi, Amsterdam, 1999.

  On malaria in England and the introduction of cinchona, A.W. Alcock, ‘The Anopheles Mosquito in England’, Lancet 4 July 1925, 208: 34–5; Leonard Bruce-Chwatt (with B.A. Southgate and C.C. Draper), ‘Malaria in the United Kingdom’, British Medical Journal 29 June 1974, 707–11; M.J. Dobson, ‘Marsh Fever – The Geography of Malaria in England’, Journal of Historical Geography 1980, 357–89, and ‘Malaria in England: A Geographical and Historical Perspective’, Parasitologia 1994, 36: 35–60; S.P. James, ‘The Disappearance of Malaria from England’, Proceedings of the Royal Society of Medicine 25 October 1929, 1–87; H. Kamen, ‘The Destruction of the Silver Fleet at Vigo in 1702’, Bulletin of the Institute of Historical Research 1966, 34: 165–73; Alice Nicholls, ‘Fenland Ague in the Nineteenth Century’, Medical History 2000, 44: 513–30; Paul Reiter, ‘From Shakespeare to Defoe: Malaria in England in the Little Ice Age’, Emerging Infectious Diseases 2000, 6.

  The most important sources on Robert Talbor are his own writings, principally Pyretologia: A Rational Account of the Cause and Cure of Agues, London, 1672, and The English Remedy: or Talbor’s Wonderful Secret for Cureing of Agues and Feavers, Paris and London, 1680 and 1682. See also George Dock, ‘Robert Talbor, Madame de Sévigné, and the Introduction of Cinchona: An Episode Illustrating the Influence of Women in Medicine’, Annals of British Medical History 1922, 4: 241–7; S. Mason, ‘Robert Talbor alias Tabor and the Ague’, Essex Journal 1997, 32: 18–21; Rudolph E. Siegel and F.N.L. Poynter, ‘Robert Talbor, Charles II and Cinchona: A Contemporary Document’, Medical History 1962, 6: 82–5; Thomas Sydenham, Observationes medicae, London, 1676.

  On Charles II’s health, Raymond Crawfurd, The Last Days of Charles II, Clarendon Press, Oxford, 1909; Audrey B. Davies, ‘The Virtues of the Cortex in 1680: A Letter from Charles Goodall to Mr H’, Medical History 1971, 15: 293–304.

  On Oliver Cromwell’s health, Leonard Bruce-Chwatt, ‘Oliver Cromwell’s Medical History’, Transactions and Studies of the College of Physicians of Philadelphia 1982, 4,2: 98–121; Saul Jarcho, ‘A Note on the Autopsy of Oliver Cromwell’, Transactions and Studies of the College of Physicians of Philadelphia 1982, 4,3: 228–31.

  Chapter 5: The Quest – South America

  The original manuscript of John Evelyn’s diaries, 1620–1706, with the account of his visit to the Chelsea Physic Garden, is in the British Library. E.S. de Beer edited them and a six-volume edition was published by Clarendon Press, Oxford, in 1951.

  Charles Marie de la Condamine’s papers are in the Bibliothèque Nationale in Paris. His Journal du voyage fait par ordre du roi was published in Paris in 1751, and his account of the discovery of the cinchona tree was published under the title ‘Sur l’arbre du quinquina’, Mémoires de l’Académie Royale des Sciences, Paris, 1738. See also A. Le Sueur, La Condamine d’après ses papiers inédits, Paris 1911.

  For an analysis of the growing importance of science to Spain, see Raquel Alvarez Peláez, ‘La Historia natural en los siglos XVI y XVII’, La Ciença Española en Ultramar, Madrid, n.d.; Barbara G. Beddall, ‘Spanish Science and the New World’, Journal of the History of Biology 1983, 16, 3, 433–40; Mauricio Nieto Olarte, Remedies for the Empire: The Eighteenth Century Botanical Expeditions to the New World, Ph.D. dissertation, University of London, 1994; M.L. de A. Turrion, ‘Quina del nuevo mundo para la corona espanola’, Asclepio 1989, 41: 305–24.

  On Charles-Marie de la Condamine, Joseph de Jussieu and the first royal expedition to South America, see Antonio de Ulloa and Jorge Juan y Santacilla, Relación histórica del viaje a le America meridional, Madrid, 1748, and Joseph de Jussieu, Description de l’arbre a quinquina, mémoire inédit, Paris, 1936.

  The principal sources of information on the second royal expedition to the New World are the Journals of Don Hipólito Ruiz, the manuscript of which was discovered by Jaime Jaramillo-Arango, then Colombian Ambassador to Great Britain, in the bom
bed-out basement of the British Museum during the Second World War. An English edition of the journals was published by Timber Press, Portland, Oregon, in 1998. See also Ruiz’s Quinologia o tratado del árbol de la quina ó cascarilla, con su descripción y las otras especies de quinos nuevamente descubiertas en el Perú, Madrid, 1792, and its supplement.

  On José Celestino Mutis and the Botanical Institute of New Granada, A.F. Gredilla y Gauna, Biografía de José Celestino Mutis, Madrid, 1911; E. Restrepo y Tirado, ‘Apuntes sobre la quina’, Boletín de Historia y Antigüedades, Bogota, 1943, 30; José Florentino Vezga, La Expedición botánica, Bogota, 1936; Alba Moya Torres, Auge y Crisis de la Cascarilla en la Audencia de Quito, Siglo XVIII, Facultad Latinoamericana de Ciencas Sociales, Quito, 1994.

  Chapter 6: To War and to Explore – from Holland to West Africa

  Sources on the Walcheren expedition are surprisingly fragmented. The most informative are Brett James, ‘The Walcheren Failure’, History Today 1963/4, 13: 811–20 and 14: 60–8; Henry Coulburn, Vicissitudes in the Life of a Scottish Soldier, London, 1827; G.P. Dawson, Observations on the Walcheren Diseases which Affected the British Soldiers, Battely, Ipswich, 1810; William Dyott, Dyott’s Diaries, 1781–1845: A Selection from the Journal of William Dyott, sometime General in the British Army and aide-de-camp to His Majesty King George III (edited by Reginald W. Jeffrey), Constable, London, 1907; Robert M. Feibel, ‘What Happened at Walcheren: The Primary Medical Sources’, Bulletin of the History of Medicine 1968, 42: 62–72; John Harris, Recollections of Rifleman Harris as told to Henry Curling, London, 1928; Hamilton, ‘A Statistical Report of the Walcheren Fever, as it Appeared Among the Troops at Ipswich, on their Return from Holland’, Medical and Physical Journal 1811, 25: 1–13; T.H. McGuffie, ‘The Walcheren Expedition and the Walcheren Fever’, English Historical Review 1947, 62: 191–202; Thomas Wright, President of the Medical Society and Temporary Physician to the Forces, History of the Walcheren Remittant, London, 1811.