Just the Tonic - beginning the remarkable cinchona story

Article One of the Cinchona Story Series

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"Among the vast majority of medicinal drugs produced in various parts of the world there is not one, with probably the single exception of opium, which is more valuable to man than the quinine-yielding cinchonas" John Grey, 1738

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In June 1863 a London pharmaceutical chemist, John Eliot Howard, received a package from India. Within it were several samples of cinchona bark. “It was with no small satisfaction”, he wrote later, that from these samples “I first succeeded in obtaining from bark of the second year’s growth in India the same alkaloids, and in equal quantity, as from bark grown in South America.” On reading this short quote, the historian of science will be immediately alerted to several questions. Why was Howard, in particular, sent these samples of bark, and who sent them? What was he looking for? What was his analytical process? And, most broadly, how and why did a tree native to the Andes mountains of South America find itself being cultivated in India and distributed to Britain?

This is the first article in a series concerning the cinchona tree and its cultivation in India by the British imperial state. In my view, this brief moment in history – between about 1850 and 1900 – represents an excellent case study in the relationships BotanicalHistory.co.uk is all about: how plants, their products, and people have interacted through time. Over the next few articles I hope to reveal to you the fascinating complexities of the cinchona story. To begin with, we’ll start by considering the big picture: why was cinchona being grown in India? To answer this, we must understand malaria in the mid-nineteenth century, and how the imperial state related to it.

As mentioned, cinchona is native to the South American Andes where it grows between 1200m and 3000m above sea level in the dense jungles of the mountainsides there. The bark contains many alkaloids of medicinal value. Four of these are therapeutics for, and prophylactics against, malaria: cinchonidine, cinchonine, quinidine and – most well-known – quinine. Malaria is now known to be caused by a bloodborne parasite of the Plasmodium group spread between hosts by the female Anopheles mosquito, and there are five Plasmodium species that can infect humans: P. vivax, P. malariae, P. ovale, P. knowlesi and P. falciparum. The last is deadliest.

However, understandings of malaria by the nineteenth-century were more limited than today. For most of its history, malaria has been a global disease, with the possible exception of the Americas where there is a suggestion its introduction came as a consequence of European colonial contact. Malarial fever was not diagnostically distinguished as a unique ailment, rather it was lumped together with various other fevers and referred to often as ‘intermittent fever’. The malarial parasite’s lifecycle is now well understood: following an infected bite the Plasmodium sporozoites move to the liver where they grow and divide for several days before being released into the bloodstream where red blood cells are invaded and ultimately destroyed. Symptoms are therefore the result of bloodstream infection only. Someone can recover only for the disease to recur 8-24 weeks later, the result of dormant hypnozoites in the liver, where they can persist for a year. In 1850 this was not known. Yet it was apparent that these “intermittent fevers” had a higher incidence in areas where there was significant standing water: swamps in particular. Indeed, the Italian mala aria means bad air, and is indicative of the association between the putrid air common in swamp land and the disease which was common there.

Since the 1960s, historians have argued malaria was “an imperial disease”. Daniel Headrick’s classic text, Tools of Empire, argued that disease was the most significant barrier to European penetration of the African interior. Framing medical prophylaxis and treatment as a technological advance, Headrick drew a connection between the availability of anti-malarials like quinine and European movement beyond the African coastline to which they had been previously confined. But, as well as imperial expansion, anti-malarials played a role in the consolidation of empire. Lucile Brockway went as far as to say “quinine was an essential arm of mature British imperialism” in India in two respects. Firstly, it kept the army – composed of British officers and Indian soldiers – fighting fit, able to keep the peace, prevent revolt and permit the second arm of state, the bureaucracy, to expand. Quinine allowed the families of civil servants to settle in India, an important comfort, and allowed the exercise of that bureaucracy without prohibitive fear of disease. Examining a slightly later period, Patricia Barton suggested malaria continued to be the greatest cause of morbidity into the new century and the disease burden carried a cost of eighty million pounds per annum. Adjusted for today, that might be as much as thirty-seven billion.

A clear demand therefore existed for a widely available, effective product that would treat and even prevent intermittent fever. At the time, the apparent efficacy of cinchona bark as a treatment for intermittent fever was known, and had been since the early days of European presence in South America in the seventeenth century. Also called ‘Peruvian bark’ for its location, or ‘Jesuit’s bark’ in recognition of those that first brought the product to Europe to treat a sick Pope, the plant was jealously guarded. For South American countries, particularly Peru and Ecuador, the bark represented a valuable export and the removal of either seedlings or seeds was prohibited. Notwithstanding the political challenge, actually finding trees that grow in isolation on Andean mountainsides made accessing these most valuable trees perhaps seem impossible.

Yet evidently the trees did find their way to India. The story of how they did so will form the next article in this series, and mean encountering the first of many complex, controversial figures in our cinchona story: Sir Clements Markham.