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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.
- Sales Rank: #943523 in Books
- Published on: 2003-08-05
- Released on: 2003-08-05
- Original language: English
- Number of items: 1
- Dimensions: 9.00" h x 1.17" w x 6.00" l,
- Binding: Hardcover
- 368 pages
From Publishers Weekly
Before the discovery of malaria's causes and treatments, the mosquito-borne illness was a killer that held sway over tropical countries and extended deadly tendrils into more northern climes. Born in Kenya, Rocco (literary editor at The Economist) was exposed to the disease at an early age. Four of the girls from her primary school class died of cerebral malaria before they turned 40, and she herself contracted the illness in her teens, a fact which may have spurred her desire to write this engaging history of malaria's most popular cure: quinine. Using anecdotes from her far-ranging research as a narrative hook, Rocco traces the history of quinine from its discovery in the 17th century by Jesuit missionaries in Peru to its use by expanding European colonial powers and its role in the development of modern anti-malaria pills. The priests learned of the bark of the cinchona tree, which was used by Andean natives to cure shivering, at a time when malaria, then known as Roman ague or marsh fever, was devastating southern Europe. The Jesuits eagerly began the distribution of the curative bark. It also helped European explorers and missionaries survive the disease as they entered new territories. Rocco's many descriptions of her travels and of her personal experiences with malaria keep her story interesting and immediate, and she stirs in enough science to explain the how malaria and its cure actually work, making this a good choice for fans of memoir and science history. 16-page b&w photo insert.
Copyright 2003 Reed Business Information, Inc.
From Booklist
*Starred Review* Like Mark Kurlansky's superb Cod (1997) and Salt (2001), Rocco's book is the history of a commodity--quinine--and commerce is the mainspring of its development. Europeans had suffered from malaria immemorially but found reliable relief only as a result of colonizing South America, where Spanish Jesuits heard of and were led to the cinchona tree; they prepared its bark as directed by the indigenes, took it to Rome, and persuaded at least some of the medical establishment of the time that the "Jesuit powder" was effective. Spain then cornered the quinine trade, and rival European powers strove by means mostly foul--smuggling cinchona seeds and seedlings--to subvert it, ultimately successfully. The science of malaria and quinine were worked out in the late nineteenth and early twentieth centuries, and the latest major part of quinine's story is about maintaining supplies under trying conditions in the places that now need it most: the often strife-torn tropical nations. Rocco unfolds this saga in terms of major figures and events, from malaria-threatened seventeenth-century papal elections to a contemporary quinine producer's decision to remain in the Congo and help its people. Her clear prose and personal investment--having grown up in Africa, she knows malaria and quinine all too personally--ensure that every episode of her narrative enthralls. Ray Olson
Copyright © American Library Association. All rights reserved
Review
“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)
Most helpful customer reviews
11 of 11 people found the following review helpful.
The Unwon Battle of Cinchona Against Malaria
By Rob Hardy
The most devastating disease to humans has undoubtedly been malaria. Fiammetta Rocco is qualified to write about the disease. She has had it herself, and her father had it many times. Her grandparents kept a farm in Africa, and while it can be expected that there were plenty of diseases to bother or kill, malaria was the most prevalent. The story of the battle against malaria has been told many times, but since it combines science, the conquest of nations, and religion, it will always prove inexhaustible. In _The Miraculous Fever-Tree: Malaria and the Quest for a Cure that Changed the World_ (HarperCollins), Rocco has focused on the discovery, utilization, and culture of quinine, the drug that for centuries has brought some hope against the disease. That it has had to work for centuries, of course, means that the battle is far from won.
Perhaps the most malarious city in the world was Rome. It was said that the many marshes around the city provided "bad air" (how the disease gets its name), but of course they actually provided breeding grounds for the mosquitoes that spread it. When there was a convocation of cardinals, for the eventual election of Pope Urban VIII in 1623, there was a clash of politics, philosophies, and personalities, but the most worrisome aspect of the meeting was that one cardinal after another sickened and died. At just about that time cinchona bark started coming in. That it was a miracle cure is clear, and part of the wonder was that a constant scourge of Europe had a cure growing in dense forests in the mountains halfway around the world. Jesuit priests in missions in the Andes saw that natives used it to stop the shivers when exposed to dampness and cold, and when it was tried on malaria, not only did it work to ease the shivering, it took away the other symptoms of the disease. It became know as "Jesuit Powder," and Protestants protested against its use; it also seemed to contradict the humoral theory by which medicine was done at the time. Its efficacy meant that it would conquer such prejudices, but Rocco shows how in one world war after another, the medicine was not available to troops who needed it.
Malaria is still a killer, one person succumbing about every fifteen seconds. The pharmaceutical industry is generally uninterested in researching and producing medicines for tropical diseases, and the artificial substitutes for quinine have resulted in resistant strains. But surprisingly, the Jesuit Powder has barely sparked any resistance, and it still works. This detailed and fascinating book ends with the optimistic outlook for the company Pharmakina, based in the Congo, which is simply growing cinchona trees, harvesting the quinine, and selling it at affordable prices. Such an operation won't do for the big drug companies, but sensible profits from a reliable product represent good business. This is a reminder that for all the colorful and dramatic history of malaria and our efforts to treat it, the past is not as important as the future.
9 of 9 people found the following review helpful.
Bark, bugs and battles
By Stephen A. Haines
This engaging account sketches the investigation and quest for a cure for the "mal 'aria" of Rome. "Mal 'aria" was once thought to emanate from the "bad air" of swamps and marshes. Rocco, herself a victim of this dread illness, narrates its impact from ancient times into the modern world. When the death of a pope brought 55 cardinals to Rome to replace Gregory XV, 10 of them had contracted malaria within two weeks. Those who survived returning to Sees in European nations spread further a malady already prevalent in many nations as distant as the British Isles and Scandinavia. Even as the papal successor, who was also prostrated with chills and fever, struggled to survive the infection, some of his minions were advocating a likely cure against great skepticism.
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]
9 of 9 people found the following review helpful.
Splendid Overview Of The Search For Malaria's Cure
By John Kwok
Fiammetta Rocco's "The Miraculous Fever-Tree" is yet another contemporary example of the popular science treatise exemplified by Dava Sobel's "Longitude" and Simon Winchester's "Krakatoa" and "The Map That Changed The World". Ms. Rocco, the literary editor of the Economist, takes us on a globe-spanning, centuries-long odyssey in search of Malaria's cure, quinine, distilled from the bark of the South American cinchona tree. It is a moving, elegant look at the age of discovery and exploration, vividly recounting how the discovery and use of cinchona bark, and then later, its chemical derivative, quinine, allowed Western imperial states such as Spain and Great Britain to colonize vast tracts of South America, Africa and Asia. She also offers a fascinating glimpse into malaria's deadly impact on Allied and Axis military forces during World War Two. And she elegantly weaves in her own personal struggle with malaria, which she contracted during her late adolescence/early adulthood in Kenya. Rocco's crisp prose is as eloquent as those from Sobel and Winchester. Without question, this is among the finest books on popular science and medicine published in the past year.
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