Fiammetta Rocco - The Miraculous Fever-Tree - Malaria, Medicine and the Cure that Changed the World

San Pablo’s infirmary was in a clean and quiet courtyard in the south-eastern corner of the college. By the time it was properly established it had about fifteen private rooms, all facing the fountain in the centre of the courtyard. Brother Salumbrino built his pharmacy close by the infirmary. Knowing that he needed to be as self-sufficient as possible, he began by planting a small herbarium in a corner of the garden at San Pablo. He chose plants that were well known for their medicinal properties: camphor, rue, nicotiana , saffron and caña fistula , a Peruvian wild cane that was often used for stomach disorders in place of rhubarb. These Brother Salumbrino and his two assistants made up into medicinal compounds, which were dried, powdered and mixed in the laboratory according to strict pharmaceutical rules. To help him, Salumbrino ordered two of the most important pharmacopoeias then available in Europe: Luis de Olviedo’s Methodo de la Colección y Reposición de las Medicinas Simples y de su Corrección y Preparación (printed in Madrid in 1581), which he had used in Rome; eventually, he also ordered Juan del Castillo’s Pharmacopoea Universa Medicamenta in Officinis Pharmaceuticis Usitata Complectens et Explicans (printed in Cadiz in 1622).

Pharmacopoeias were works that described chemicals, drugs and medicinal preparations. They were issued regularly with the approval of different medical authorities, and were considered standard manuals in every pharmacy in Europe. Besides these two classics, Brother Salumbrino could also consult and follow the prescriptions of Girolamo Mercuriale, physician to the Medicis and Professor at the universities of Padua, Bologna and Pisa, who exercised a profound influence on medical circles all over Europe.

Over the next century and a half the botíca at San Pablo would order at least ten other pharmacopoeias that specialised in local drugs and chemicals, including its vade mecum , Felix Palacios’ Palestra Farmaceutica , which was printed in Madrid in 1713, the year after Francesco Torti had his ‘Tree of Fevers’ published. The botíca put in regular orders for extra copies of Palacios’ work to be sent out to the other Jesuit colleges in the viceroyalty. The book was so highly regarded, and was so frequently referred to, that the pharmacists at San Pablo would eventually write inside the cover of their own copy: para el uso diario de esta botíca (‘for the daily use of this pharmacy’).

By 1767, when the Jesuits were forced to leave Peru and the final inventory of the pharmacy was compiled, the San Pablo medical library contained about a hundred books. The full list, given in another set of books that I found among Father Rubén’s boxes, Cuenta de la Botíca 1757–1767 , included the ancient classics by Galen and Hippocrates as well as voluminous Latin commentaries on the two masters by several medieval doctors. The library also had books on several other branches of medicine, including anatomy and osteology, treatises on different kinds of fevers and their remedies, descriptions of contagious diseases and their infections, and the methods of combating them.

Surgery was also a favourite subject at San Pablo, and one could find on the shelves of the college’s library Bartolomé Hidalgo de Agüero’s Thesoro de la Verdadera Cirugía y Via Particular contra la Común (printed in Seville in 1624), and Juan Calvo’s Primera y Segunda Parte de la Cirugía Universal y Particular del Cuerpo Humano , which was published in Madrid in 1626 and reprinted many times in the seventeenth century, and was still in use more than a hundred years later – though one shudders to think of operations being carried out without the benefit of any anaesthetic or antibiotics in the humid atmosphere of seventeenth-century South America.

The Jesuits who came to Peru just after Pizarro’s conquest of the Incas were the first order with a clear mission to educate and then, by doing so, to convert the Indians to Catholicism.

There was a clear division, though, over exactly how this should be done. The ascetic, intellectual Jesuits who ran the order from Rome were of one view, while the energetic activists who left their homes to promote its interests overseas were of quite another. The young Jesuits in Lima were pioneers of the soul. They believed strongly in catechism. Each day, a group of priests would leave San Pablo, walking in procession through the streets of Lima, holding a crucifix and ringing a bell to attract groups of Indians and blacks to whom they would preach. Not everyone liked this. One early Provincial Superior of the Jesuits in Peru, José de Acosta, was dismayed by this helter-skelter missionary activity, and was bitterly critical of having so many men tramp around as ‘holy vagabonds’. His own bias tended towards the old Jesuit ideal of learned men influencing councils and kings.

What he failed to realise was that most of the Jesuits, such as Brother Agustino Salumbrino, who went to Peru early on were not driven to write books or meditate. They were zealous, educated men, full of drive and courage, who wanted to make a difference, whether it was by saving souls or promoting good health.

The early Jesuits soon expanded their missionary activity to Cuzco, the old Inca capital that Pizarro seized in 1534. They bought a fine palace that had been taken over by one of Pizarro’s lieutenants on the main square, only to tear it down and build the towering pink Baroque church that still stands today. From there the Society sent its priests out into the countryside to make contact with the local Indian communities and urge them to renounce the animist gods they had worshipped for centuries in favour of a Christian Almighty.

The Inca world was ruled by spirits and superstition. Every village was surrounded by secret places – trees, rocks, springs and caves – that had a magical significance. The Incas collected unusual objects, and in every house there were canopas , or household deities, displayed in a niche in a corner or stowed in a special place, wrapped in cloths. They observed rituals throughout their daily lives, sprinkling chicha or coca when ploughing, saying prayers and incantations when crossing rivers, making sacrifices on particular occasions and always leaving an object on the pile of stones that is still often to be found at the top of every pass.

The Incas lived in fear of the sorcerers, the old men who foretold the future by studying the shape of ears of corn, the entrails of animals or the movement of the clouds, and were terrified of the magic spells they cast to cause love or grief in their victims. But they also revered them, for many of the sorcerers were medicine men as well as magicians. In some parts of Peru they would undertake trepanning, cutting open the skull to let out evil spirits and to offer the patient some relief from pain or swelling. The rich Quechua language shows that the Incas had a fine knowledge of anatomy and medicine, with words such as hicsa for abdomen, cunca oncoy for angina, susuncay for putting to sleep, siqui tullu for coccyx, husputay for haemorrhage, hanqqu for nerve and rupphapacuy for fever.

They amassed a great store of knowledge about local plants and how to use them to treat different ailments, and were particularly expert on poisons and plants with hallucinogenic qualities – every man would carry upon him a little packet of coca leaves for chewing on. They also used the trumpet-shaped Solanaceae , or datura as it is better known, in magic spells to cast their enemies into a trance, sarsaparilla as a diuretic, tembladera (Equisetum bogotense) against pyorrhoea, a plant they called llaquellaque (Rumex cuneifolius) as a purgative of the blood, ortiga (Urtica magellanica) to cure sciatica, and payco (Chenopodium ambrosoides) against worms.