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

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A rich and wonderful history of quinine – the cure for malaria.In the summer of 1623, ten cardinals and hundreds of their attendants, engaged in electing a new Pope, died from the 'mal'aria' or 'bad air' of the Roman marshes. Their choice, Pope Urban VIII, determined that a cure should be found for the fever that was the scourge of the Mediterranean, northern Europe and America, and in 1631 a young Jesuit apothecarist in Peru sent to the Old World a cure that had been found in the New – where the disease was unknown.The cure was quinine, an alkaloid made of the bitter red bark of the cinchona tree, which grows in the Andes. Both disease and cure have an extraordinary history. Malaria badly weakened the Roman Empire. It killed thousands of British troops fighting Napoleon during the Walcheren raid on Holland in 1809 and many soldiers on both sides of the American Civil War. It turned back many of the travellers who explored west Africa and brought the building of the Panama Canal to a standstill. When, after a thousand years, a cure was finally found, Europe's Protestants, among them Oliver Cromwell, who suffered badly from malaria, feared it was nothing more than a Popish poison. More than any previous medicine, though, quinine forced physicians to change their ideas about treating illness. Before long, it would change the face of Western medicine.Using fresh research from the Vatican and the Indian Archives in Seville, as well as hitherto undiscovered documents in Peru, Fiammetta Rocco describes the ravages of the disease, the quest of the three Englishmen who smuggled cinchona seeds out of South America, the way quinine opened the door to Western imperial adventure in Asia, Africa and beyond, and why, even today, quinine grown in the eastern Congo still saves so many people suffering from malaria.Note that it has not been possible to include the same picture content that appeared in the original print version.

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By the second half of the seventeenth century, according to an early map of Lima in the state archive, the citizens of the capital had begun calling the street in front of the Jesuit infirmaries Calle de la cascarilla , Bark Street. Now part of the long, fume-laden Jirón Azangaro, which runs through downtown Lima from the Palacio de la Justicia as far as the Franciscan convent near the river, Calle de la cascarilla would remain up to the start of the republican period in 1825 as a public testimony to San Pablo’s role in distributing cinchona first in Peru and then around the world, and it appears in many of the maps of that time.

The final decade of the botíca at San Pablo saw Brother Salumbrino’s ambitions come to fruition. The pharmacy itself, where the cinchona bark was weighed out and packed, was beautifully furnished. On its wall hung a large portrait of Salumbrino which his fellow Jesuits had commissioned in 1764 at a cost of 140 pesos , and which bore the legend: ‘Agustino Salumbrino, first founder of this pharmacy of San Pablo’.

The walls were covered from floor to ceiling with solid oak shelves laden with bottles and flasks. Several tables and chairs were spread around the room, made of wood imported from Chile, and in the centre of the room was a long, wide mahogany counter of a beautiful reddish-brown colour. On top of the counter, in sharp contrast to the dark heavy wood, rested four delicate scales.

The three black employees who worked in the pharmacy spent their day in the laboratory, a forest of glazed earthenware and shiny instruments, some of lead or bronze, some of pure silver. The laboratory was filled with large jugs, scales, all kinds of stills used for distilling liquids, glass and metal funnels of all shapes and sizes, crystal flasks, retorts and matrasses, gridirons and hand mills, pumping engines and ovens, condensers and cauldrons, handsaws and sieves.

Brother Salumbrino’s Jesuit masters might have been uncomfortable in that room, with its heavy fumes and thick, unpleasant odours of medicines and chemicals, but they would have been happy to know that in San Pablo’s pharmacy he and his brother pharmacists had the means to preserve and restore the health of the hundreds of priests working in the field. The final inventory of the pharmacy includes more than five hundred medicines, in addition to the books in the library and the vast quantity of stills, bottles and other material that filled the laboratory’s shelves. Of the medicines in the pharmacy, by far the most valuable was una grande tinafa – a great jar – of cinchona bark, which is valued at one hundred pesos.

Despite the excellence of its pharmacy, the small world of San Pablo was about to be engulfed in political events that were fuelled, as so often happens, by fear and greed. Secret orders had arrived from Madrid: the Society of Jesus was to be expelled from the whole of the Spanish Empire on the orders of King Charles III, who feared its swelling power and longed to own its properties and who finally, after many decades, had chosen to believe the Jesuits’ enemies who had long tried to discredit them in the eyes of Charles and his court.

At four o’clock in the morning of 9 September 1767 the Viceroy, Don Manuel de Amat, had everything ready to carry out the King’s instructions in Peru. Four hundred soldiers were stationed within the viceregal palace. In the dead of night a number of the most important men in Lima also arrived at the back door of the palace, summoned by a handwritten note from Amat that read, ‘I need you for matters of great service to the King, and I warn you to come so secretly that not even those of your household would realise that you had gone out.’

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