The Miraculous Fever-Tree: Malaria and the Quest for a Cure That Changed the World ハードカバー – 2003/8/1
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"Cinchona revolutionized the art of medicine as profoundly as gunpowder had the art of war."
-- Bernardino Ramazzini, Physician to the Duke of Modena, Opera omnia, medica, et physica, 1716
In the summer of 1623, ten cardinals and hundreds of their attendants died in Rome while electing a new pope. The Roman marsh fever that felled them was the scourge of the Mediterranean, northern Europe and even America.
Malaria, now known as a disease of the tropics, badly weakened the Roman Empire. It killed thousands of British troops fighting Napoleon in 1809 and many soldiers on both sides of the American Civil War. It turned back travelers exploring West Africa in the nineteenth century and brought the building of the Panama Canal to a standstill. Even today, malaria kills someone every thirty seconds. For more than one thousand years, there was no cure for it.
Pope Urban VIII, elected during the malarial summer of 1623, was determined that a cure should be found. He encouraged Jesuit priests establishing new missions in Asia and in South America to learn everything they could from the peoples they encountered. In Peru a young apothecarist named Agostino Salumbrino established an extensive network of pharmacies that kept the Jesuit missions in South America and Europe supplied with medicines. In 1631 Salumbrino dispatched a new miracle to Rome.
The cure was quinine, an alkaloid made of the bitter red bark of the cinchona tree. Europe's Protestants, among them Oliver Cromwell, who suffered badly from malaria, feared that the new cure was nothing but a Popish poison. More than any previous medicine, though, quinine forced physicians to change their ideas about illness. Before long, it would change the face of Western medicine.
Yet how was it that priests in the early seventeenth century–who did not know what malaria was or how it was transmitted–discovered that the bark of a tree that grew in the foothills of the Andes could cure a disease that occurred only on the other side of the ocean?
Using fresh research from the Vatican and the Indian archives in Seville, as well as documents she discovered in Peru, award-winning author Fiammetta Rocco chronicles the ravages of the disease; the quest of the three Englishmen who smuggled cinchona seeds out of South America; the way in which quinine opened the door to Western imperial adventure in Asia, Africa and beyond; and how, even today, quinine grown in the eastern Congo still saves the lives of so many suffering from malaria.
“An absorbing and superbly researched history of malaria and its cure.” (Sunday Times (London))
“Ms. Rocco tells her four-century saga briskly, with a confident blend of scholarship and memoir.” (Wall Street Journal)
“Lively, elegantly written and often fascinating” (Evening Standard (London))
“Snappy and sharp...it’s almost a crime that so heinous a disease should be treated to so grand a biography.” (Kirkus Reviews)
“An engrossing story...written with immense verve and confidence...crisp and fluent...a gripping and highly readable tale.” (New York Times Book Review)
This may not be the definitive book on malaria and quinine, but in my opinion the story was covered in sufficient detail for me and in a manner that I greatly appreciated. I recommend this book to those interested in the history of medicine, history in general and to all those who appreciate a well-written non-fiction book.
Jesuit missionaries in the New World discovered Native Americans using a powdered tree bark to treat fevers and "agues". Sending the powder back to Catholic Europe introduced the first therapy for malaria, probably just as these same interlopers were infesting the Western Hemisphere with the parasite. Cinchona powder, diluted in wine to cover its bitterness, verged on the miraculous. As Rocco describes its effect, she also recounts the resistance to the "Jesuit powder" in Protestant Europe, particularly Britain. Lack of enthusiasm, plus military ineptness, led to a malarial onslaught in 1808, when an English attempt to invade Napoleon's empire ended in disaster.
Empire, war and malaria remained in close company throughout the 19th Century. British incursions into west Africa were stalled by the infection. At one point the medical records indicated more cases of malaria than there were settlers - due to repeat hospital patients. Even against this severity, progress was being made. It's said "there's always one" and Rocco shows how one dedicated man made an immense difference. On a voyage up the Niger, Baikie imposed a strict daily regimen of quinine dosage. One of his crew was murdered and one drowned - but none were lost to malaria.
Returning to the Western Hemisphere, Rocco describes the inept handling of fevers by the in the American Civil War. Vicksburg, she asserts, failed to be taken due to the Union's lack of quinine for its troops investing the city. Even greater disaster awaited the French in their attempt to link the Atlantic and Pacific with a Panama Canal. Instead of treating the workers, the French merely hid the casualty list and hired replacements. Even as late as World War II, battlegrounds in the Pacific highlighted the need for plentiful supplies of quinine. By that time, however, some synthetics had been developed. Malaria, however, is neither easily diagnosed nor treated. Rocco notes that there are several versions of the illness, and many varieties of cinchona. Matching them takes skill.
At the end of the 19th Century, malaria had been identified as a parasite, not the effusion of swampy fumes. Rocco describes the labours of British Army doctor Ronald Ross, who laboured under appalling conditions in India. He traced the course of the parasite, in part by dissecting mosquitoes with a razor blade! This new understanding led to more directed treatment, and, ultimately, a Nobel Prize for Ross. Rocco's diagram of the life cycle of the parasite suggests the complexity of the problem of diagnosis and therapy.
Rocco concludes with a reminder that malaria identified is not malaria eliminated. It kills millions of children every year and prostrates whole communities. South American forests were denuded by exploiters seeking the bark. The synthetics developed proved a temporary solution since the parasite appears to have evolved resistance to them. Today's chief source of natural quinine is a threatened forest in war-torn central Africa. She describes the travails of a firm struggling to maintain supply. The picture would be encouraging if the firm obtained support from industrial nations. That hasn't been forthcoming.
Rocco's opening sentence, "My grandparents had been married for many years when they left Europe for Africa - although not to each other" sets the tone of this book. Her personalised narrative form skips the use of footnotes, but there are Notes on Sources and a Further Reading list. A collection of photos and maps adds reference. [stephen a. haines - Ottawa, Canada]