Story of Cinchona

Where Andes hides his cloud-wreathed crest in snow,
And roots his base on burning sands below;
Cinchona, fairest of Peruvian maids,
To Health’s bright goddess, in the breezy glades
Of Quito’s temperate plains, an alter reared,
Trilled the loud hymn, the solemn prayer preferred

Inaugural Dissertation upon the Cinchonas, their History, Uses and Effects, Hooker (1839)

The story of the cinchona tree is mysterious and remarkable. The bark of the tree eventually managed to influence the geopolitical machinations of colonial powers, accelerate the transition away from the embedded Galenic system of medicine and revolutionise the treatment of malaria. However, as this post will explore, the path was controversial and convoluted.

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Learning objectives

1. Explore the confusion around the history of cinchona

2. Consider the societal factors that influence the perception of a medication

3. Reflect on how we can try to avoid the mistakes of the past

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The amount of contradictory and uncertain information about cinchona can feel a bit meandering and sometimes frustrating. Therefore, I have attempted to compartmentalise the story into smaller chunks by dividing the blog post into different sections/time periods. The years may overlap in some sections but I hope this minor thematic simplification will help readability.

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1630s: Fact or fiction

Cinchona is a genus of plants native to South America, originally part of the high forest of the eastern slopes of the Andes mountains from Venezuela to Bolivia. Stories of its medicinal properties became apparent to the Spanish in the early 1630s.

Some sources report that Jesuit missionaries noticed that the indigenous Quechua population made tea from the bark of certain trees to manage individuals who were shivering. The bark was considered febrifugal, a term that appears to have gone out of fashion as it is sometimes considered synonymous with antipyretic. 

However, the legendary but disputed event that really brought the cinchona to European attention supposedly happened as follows…

Around the year 1630, Don Juan López de Cañizares (Corregidor of Loja) became ill with an intermittent fever in what is now modern day Ecuador. A Jesuit missionary named Juan López recommended a remedy that had helped him 30 years earlier in a village called Malacatos, south of Loja. He learned of the bark from Pedro Leiva, cacique of the Malacatos tribe. Levia had told the Corregidor that the tribe had used it for many centuries to treat fever. López tried the bark and quickly recovered.

Some time later, perhaps between 1631-1638, Doña Francisca Henríquez de Ribera, the Countess of Chinchón (the wife of the Spanish viceroy in Lima) became ill with a similar fever. The Corregidor sent some of the bark to the Count (Viceroy Don Luis Gerónimo Fernádez de Cabrera Bobadilla y Mendoza, Fourth Countif Chinchón) explaining its curative properties. The Countess agreed to try the remedy and was miraculously cured.

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Question

Why are medical stories and myths so powerful?

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The supposed details of the story are elaborated further…

“When this [the happy cure] was learned in the City of Lima, the people approached the Vivereine by intermediaries, not so much joyfully and congratucalanlatory, but supplicatingly, begging her to deign to help them, and say, if they would, by what remedy she had at last so marvellously, so quickly, recovered, so that they, who often suffered from precisely this fever could also provide for themselves… The Countess at once agreed. She not only told them what the remedy was, but ordered a large quantity of it to be sent to her, to relieve the suffering of the citizens, who often suffered from the fever. Nor did she only order this great remedy the Bark to be brought, but she wished to dispense it to the many sick with her own hands. And the thing turned out so well that just as she herself had experienced the generous hands of God in that miraculous remedy, so all the needy who took it marvellously recovered their health. And this bark was afterwards called Countess’s Powder…”

The dubious report of Sebastiano Bado, an Italian physician who claims to have got the story from a 1649 letter written by Antonius Bollis, a Genoese merchant who spent time in Peru. No such letter has ever been found.

The story of the Countess has become even more embellished with time which is perhaps unsurprising as the importance of the bark became more apparent. Bado reportedly said that the bark “proved more precious to mankind than all the gold and silver that the Spaniards had obtained from South America”.

But what of the the disease that the Countess experienced? It is purported that her supposed febrile illness was none other than malaria, itself likely to have been imported to the Americas through European contact and the Columbian exchange.

However, there was actually no mention of any serious illness regarding the Countess nor remedy in the official and meticulous diary of the Count of Chinchon. Rather, the Count himself is reported to have had intermittent fevers and was ‘bled’ by his physicians. Returning to the Countess, she never returned to Spain to personally disseminate her miraculous powdered bark but is instead reported to have died in Columbia in the year 1641. It has been suggested that the Countess may have had the fever prior to the diary starting 1631, although most authors seem to agree that the Countess legend (or at least some of it) is a fabrication.

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 For the complete story click the link below!