Thread by @lexinary

Uppsala, Peru, Malaria, and Gin & Tonic

Once upon a time, a man had the position of professor of medicine at a prestigious university. But he wasn’t happy and swapped his professorship and became the head of the university's botanical garden. That happened in the 18th century.

The university was in Uppsala, Sweden. The man’s name was Carl.
He was not any Carl. He was one of the most renowned scientists in history. He led the way to create the modern-day biological nomenclature for classifying organisms.

i.e. how do you differentiate a cow from a donkey, a zebra, or a horse? It’s easy. Just look at them and you can see the differences. The difficult question is: how do you scientifically differentiate them? That is, a systematic approach to distinguish species, genus, family...

Not so easy, right? But that’s what Carl did. One day while traveling in Lapland, he saw a bone lying on the ground and he realized that if he had a system of classification for animals, he could have identified that bone. And that he did.

Then he continued with minerals, plants, and other organisms. Thousands of them. From algae to trees, From the fruit fly Drosophila melanogaster to horses, to Homo sapiens. Carl’s careful observations birthed scientific nomenclature.

Carl’s name was Carolus Linnaeus (1707-1778), the famous Swedish zoologist and botanist. The scientific names exist because of Linnaeus’ genius. He is considered to be the father of taxonomy.

Linnaeus traveled extensively and discovered hundreds of species that had no scientific designation. He published many works on numerous specimens.

In 1742, Carl Linnaeus named a South American tree Cinchona pubescens, commonly known as "Chinchona," in honor of the Spanish Countess of Chinchon.

The Countess of Chinchon, Francisca Enriquez de Rivera, was the 2nd wife of Luis Jeronimo Fernandez de Cabrera y Bobadilla, Count of Chinchon. He was chosen by King Phillip IV of Spain to be the Viceroy of Peru. The Chinchon couple lived in Peru from 1629 to 1639.

History records that the countess was kind to everyone, including her servants. In 1630 the Countess of Chinchon became sick with malaria. Like most infectious diseases, malaria was incurable in those times.

But the indigenous people had some “magical powder” to treat malaria, which they kept secret from their white conquerors. However, looking at the Countess so sick, one of her servant girls gave her the “magical powder” in a beverage.

Thinking that the servant girl intended to poison the Countess the servant was arrested and imprisoned. When the servant girl was about to receive her punishment the Countess came to her defense and the girl was freed.

Thankful for saving his daughter, her father revealed to the Countess the source the magical powder, derived from the bark from the quina-quina tree. The Countess of Chinchon was the first European treated with that bark.

The news traveled to Europe and a physician took samples of the quina quina tree bark to Spain. Some Jesuits took the powder to Rome. It was then known as "Jesuits' bark," "Cardinal's bark," “Countess’ powder,” "Sacred bark" and “Chinchona.” Unknown to them, it contained quinine.

It was one of the most serendipitous medical discoveries of the 17th century. Treatment of Malaria with quinine marked the first successful use of a chemical compound to treat an infectious disease. Quinine is one of the 4 anti-malarial components of the bark of the cinchona.

How did the South American natives know that? According to one legend, an Indian with a high fever was lost in a jungle. Thirsty, he drank from a pool of stagnant water and found that it tasted bitter.

Realizing that the water had been contaminated by the surrounding quina-quina trees (chinchona) he feared he was poisoned. Surprisingly, his fever soon abated. He shared his accidental discovery with fellow villagers, who thereafter used extracts from the tree to treat fevers.

While “Jesuits Powder” was used with success in 17th century Europe, it was not accepted in Protestant England. Even when King Charles II in 1679 was cured of the 'fever' by his doctor, Robert Talbor, the royal physician kept it a secret.

Europeans were busy in 18th and 19th centuries exploring and colonizing Latin America, Africa and Asia. White settlers acquired many infectious diseases and malaria was not an exception. The cause of malaria (from Latin bad air) is a parasite named Plasmodium.

There are several species of Plasmodium that infect humans such as P. vivax, P. malariae and the more fatal P. falciparum prevalent in Africa. Plasmodium parasites in humans penetrate and reproduce inside red blood cells.

In their synchronized cycle, huge numbers of the new generation of parasites ripped each parasitized red blood cell and freed into the bloodstream to parasitize more red blood cells. The tremendous numbers of free parasites overwhelm the immune system causing high fever.

While bark from the quina-quina or Cinchona tree was effective against malaria, it tasted very bitter. Before 1820, the bark of the cinchona tree was first dried, ground to a fine powder, and then mixed into a liquid (commonly wine) before being drunk.

In 1820, quinine was extracted and purified from the bark and named “quinine” by Pierre Joseph Pelletier and Joseph Caventou. Purified quinine then replaced the bark powder as the standard treatment for malaria.

Quinine and other cinchona alkaloids including quinidine, cinchonine and cinchonidine are all effective against malaria.

However, the fame of this remarkable tree became world renowned in the 1820's when officers of the British Army in India, in an attempt to ward off malaria, mixed quinine with sugar and water, creating the first Indian Tonic Water.

There was a huge demand for the bark and quinine. In the 1850s the East India Company alone spent £100,000 annually on the bark, but it was not enough to treat sick British colonists. The answer was to cultivate Cinchona trees elsewhere in the colonies.

This initiative inspired intrepid plant hunters to travel to South America to harvest the valuable of seeds. Many entrepreneurs failed, such as the Englishman Richard Spruce whose seeds from Ecuador were planted in India and Ceylon.

The exported Cinchona species were poor in quinine. The Dutch had better luck with seeds provided by Charles Ledger, a British explorer in Peru. Ledger found no interest in the seeds from the British government.

Ledger's seeds yielded up to eight times more quinine and subsequently gave Holland a near monopoly of the market. The efficaciousness of the four Cinchona tree alkaloids were evaluated in one of the earliest, controlled clinical trials.

The clinical trial (1866-1868) involved 3600 patients using prepared sulfates of the alkaloids. Using as a primary endpoint "cessation of febrile paroxysms", all four alkaloids were found to be comparable, with cure rates of >98%.

Tonic water made the bitter-tasting treatment more bearable. One British soldier tried an additional approach. He mixed Tonic Water with gin. It definitively made it more palatable. Thus, the mixture became the popular and original GIN & TONIC.

Soon, Gin & Tonic became the archetypal drink of the British Empire. All thanks to malaria parasites, the South American tree bark, the native who discovered its healing properties, the Countess of Chinchon & the British soldiers who came up with Tonic Water and gin.

An image of the quina quina tree is currently in Peru’s flag. And yes, Carl mistakenly named the tree “Cinchona” instead of “Chinchona,” after the name of the Countess, or maybe got the name from Latin or Italian Jesuits who pronounced it “Kinkona”.

End of thread

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