26
been “Chinchona,” stemmed from translation of the Countess’s Spanish name to Italian by the botanist (8). In 1930, a diary of the Viceroy’s secretary was discovered, providing a detailed contemporaneous account of the Viceroy and his family’s activities in Peru. It contradicted the fabled and much quoted story about the Countess. The diary offers no evidence that she ever suffered from malaria, or that she had ever been treated with the Peruvian bark. But after two centuries of use, the genus Cinchona was firmly established and has remained unchanged (3, 8).
Wellcome Collection
Wellcome Collection
organized Indian laborers to harvest and process the bark. By the end of the 18th century, about 80 ships arrived annually in Spanish ports from Peru, each carrying a consignment of cinchona bark. Because of its discovery and strong advocacy by representatives of the Vatican, the red bark remedy was commonly called “Jesuit powder” or “Cardinal’s powder” (3). Malaria was also prevalent in southern Britain in the 17th century, but the predominantly Protestant country was skeptical and critical of any medicine advocated by continental Roman Catholics (3). Also, at that time, prescriptions varied widely, and many Western Treatment of Malaria patients suffered from the bitter powder’s side effects, Father Alonso Messia Venegás, an elderly Jesuit including tinnitus, nausea, vomiting, and headaches. priest, carried the first small supply of cinchona bark from In Cambridge, Robert Talbor, an enterprising South America to Rome in 1631 (3). Malaria was rampant apothecary apprentice, began studying ways to in Rome, and physicians soon found that cinchona bark optimize dosing of the Peruvian bark and minimize was indeed an effective treatment. Juan de Lugo, a its side effects. By 1670, Talbor had perfected his Jesuit pharmacist at the Santo Spirito Hospital in Rome prescription and set up shop in London as a fever and later Cardinal, became the most influential advocate specialist (3, 8). Fully aware of the religious stigma for cinchona bark in continental Europe (3). associated with cinchona bark, he refused to divulge To meet European demand, the Jesuits in Peru his recipe, saying only that it consisted of two ingredients from England and two from abroad. Talbor charged huge fees and was dismissed as a quack by the Royal College of Physicians, but his remedy worked. His fame— and the disdain of the medical establishment—only grew after he cured Britain’s King Charles II, as well as the Queen of Spain and Louis XIV’s son in Paris (3). After Talbor’s death, his formulation was published in France. It consisted of rose leaves, lemon juice, and a strong infusion of cinchona bark in wine (3, 8). More important than the formulation was Talbor’s success in optimizing treatment. He lowered the conventionally used dose and administered his Page 51 of The English Remedy: remedy at frequent intervals. Or, Talbor’s Wonderful Secret for Cureing of Agues and Feavers (English translation). The English Remedy: Or, Talbor’s Wonderful Secret for Cureing of Agues and Feavers (1682). In 1682, Talbor’s remedy was published in French; the English translation appeared in the same year. Front page of English translation. The Pharmacologist • March 2018
Dr. Sappington’s Pills American physicians were also wary of Peruvian bark, not on religious grounds but rather because