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The Miraculous Fever Tree, Malaria and the Quest for a Cure That Changed the World

Fiammetta Rocco

(HarperCollins)

A Most Unusual Tree

Epidemics have often been more influential than statesmen and soldiers in shaping the course of political history, and disease may also color the moods of civilizations.
— René Dubos and Jean Dubos, The White Plague


If there is a creature we’d like to see extinct it’s the mosquito. While the mosquito causes a lot of mischief from irritating welts to West Nile Fever, our gravest complaint is malaria, undoubtedly the most destructive disease in human history.


Consequently, there has been a lot written about malaria and the mosquito, so I approached The Miraculous Fever Tree skeptically. What new could anyone possibly have to say on the subject? I was relieved, then, when the author made the same observation in her second paragraph. She rises immediately to the challenge. Her interest is in the cinchona tree and its bark, the stuff that gives us quinine and some degree of control over malaria. Furthermore, as an historian, she is intent on plunging deeply into unexplored archives to examine what this strange bark, cinchona, had to do with human history. She proceeds to do exactly that and comes up with a fascinating story.


An introductory chapter explains her interest in malaria gained as a child in Kenya where the disease affected her personally. She then turns to 17th century Rome where malaria was a scourge, but just about the time that Urban VIII was becoming Pope, cinchona bark started drifting in and providing some miraculous relief for those who could afford it. She then turns to 17th century Peru where the stuff was coming from and we learn a lot about how the Jesuits ran their affairs not to mention the finest and most important apothecary of the day.


By the end of the 18th century, cinchona was likely the most valuable and important import from the New World but it was controversial. Cinchona ran contrary to classical medical theory and was therefore rejected by the medical profession while Protestant Europe was skeptical of a Popish plot. Feeling ran particularly strong in England, which could little afford to be skeptical, until one of their quack-hucksters proved the sages and bigots wrong.


In the meantime, the French and then the Spanish tried to find out something about the plant or plants involved. If you are expecting Bertram and Audubon, forget it. This is a fascinatingly sad story of ineptitude, failure, lost opportunities, sunken ships and revolutionary zeal. How could ‘science’ do so much wrong? And even when it did things right everything else went wrong. Even the great Linnaeus managed to misspell the name, thus giving us cinchona instead of chinchona.


But in 1809, cinchona’s story took a commercial and imperial twist. England sent an expeditionary force to Holland that Napoleon fought with malaria as a WMD. It worked marvelously but triggered the worst epidemic of malaria in European history. The British military learned its lesson and the problem of what malaria was, and what cinchona did, became a military problem, never again to be taken lightly.


An American snake-oil salesman then entered the picture. He found a way to put concentrated cinchona, quinine, into a pill. Beats eating a mouthful of bitter tree bark! If the Union Army had had enough of these pills they might have put a stop to the Civil War in a year but alas, supplies were short. But it is the Americans in Panama who made the first application of quinine on an industrial scale, and they applied it as preventative rather than a curative agent. You don’t need a cure for malaria if you never get it in the first place.


But the world supply of cinchona was falling short. Solution: domesticate the plant. That required finding the plant and raising it in plantations, in say, Java. There followed intense competition between several nations and many explorers. Heroics, foolishness and tragedy punctuated the search, but the Dutch that won the day, and Java became the world center of cinchona production.


That’s good. Well, not really. Recall that Java fell quickly to the Japanese in WWII. Americans found themselves searching every drugstore in Kansas for long forgotten supplies of cinchona or quinine.


It would be nice if we could synthesize the active ingredient in cinchona, but that requires knowing something about what causes malaria. This problem wasn’t solved until the late 19th century, again in a dramatic and often-told tale of scientific competition enwrapped, predictably, in heroics, envy, and jealousy. Still, even knowing the cause of malaria, successful synthesis of a cinchona like pharmaceuticals was not accomplished until 1944, too late to do the troops much good.


But, hey, how ‘bout it? Is the synthetic cinchona as good as God’s natural juices? The answer is debatable. Whatever the answer, it would be nice to have these trees around just in case. Indeed they are around here and there, but only in the Congo is a plantation still producing cinchona in quantity. It’s had a hell of a time what with the war, rebellion, more war and general corruption that characterizes the Congo. Despite all, the plantation is doing remarkably well, even now experimenting with cloning the trees.


As a good popular history, Rocco’s book is full of monks and monsters, sinners and saints, grand drama, pathetic failure and remarkable good fortune. But, when all is said and done, has she produced anything new? Well, yes. She may wander far, but she always returns to that singular thing—the miraculous tree. By putting her emphasis on this genus she tells an entirely new story, one that will appeal to anyone whose interests lean toward history, natural or otherwise, and high adventure.


Rocco reviews her sources but of more interest to the average reader is her recommended reading list, a list of classic good history and science available in any large university or public library. Besides all this, Rocco writes with a mature beauty and elegance that could be the polestar of any young writer of serious non-fiction. This is how it is done. The story of cinchona is an exciting one that Rocco tells it damned well.

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