The problem with the story of the Countess’s miraculous discovery, however, is that it is completely untrue.
The Countess of Chinchón died suddenly in Cartagena on 14 January 1641, on her way back from Peru to Madrid, though her husband’s diaries show she was rarely ill before that, and never with anything resembling malaria. Malaria may well have struck the Count, the Viceroy of Peru, on more than one occasion; he even seems to have suffered from it after he returned to Spain. In time he recovered, but the detailed diaries left by his secretary, Antonio Suardo, make no mention of tree barks or miraculous remedies of any description.
That the fable of the Countess’s miraculous cure continued to be retold may have much to do with the fact that cinchona bark, in the early seventeenth century, really was a miracle cure. Here was an incomprehensible disease – malaria, marsh fever or the ague, as it was then called – that had been the scourge of Europe for centuries, while the cure for it was to be found high in the dense forests of a mountain range halfway across the world. The word ‘malaria’ did not then exist, and no one knew what really constituted agues – whether quotidian, tertian or quartan – or how people caught them, let alone how they might be cured of them. Nor, when they came eventually to learn about cinchona bark, did the doctors and apothecarists who prescribed the cure really understand how it worked either.
So how did anyone ever make the connection? How was it possible that a Jesuit priest, with little knowledge of doctoring, came to understand enough about the medicinal properties of the bitter bark to know that it might prove useful in treating malaria, a disease that would not be fully understood for another two centuries?
Some nationalistic South American historians have insisted, with little evidence, that the Spanish conquistadors must have learned about cinchona’s fever-curing qualities from the Incas. While it is certainly true that the local Indians were renowned for their knowledge of plants, poisons and cures, there is scant evidence to support the argument that they knew cinchona bark cured malaria. The conquistadors wrote home about many things in the century after they first arrived in Peru in 1532, but cinchona is not mentioned by any of them. Other historians insist that the Incas kept back the secret of the miraculous fever-tree to show their displeasure at the Spanish occupation. While theoretically possible, this is unlikely, given the extent and complex nature of the contacts between the conquistadors and the local populations they encountered in South America.
The reality is that many Peruvians may not have known that the bark existed at all, at least not as a cure for malaria. The cinchona tree grew in small isolated clumps in the foothills of the high Andes. And although malaria has existed in Peru since the days of Christopher Columbus, it is found in areas of low altitude, as it is in Africa, and not at the heights where the cinchona tree grows most happily.
According to contemporary written accounts, the Indians who lived in the Andes sometimes drank infusions of cinchona bark to stop them shivering. But the observation that it might also cure marsh fever, or tertian ague, came only a century after the first conquistadors arrived in the New World, and it was made not by the local Indians, but by the European visitors.
Two Spanish writers living in Peru were the first to make any detailed description of the effects of cinchona bark on patients suffering from the ague. In 1638 an Augustinian friar and herbalist, Antonio de la Calancha, wrote: ‘A tree grows in the country of Loxa which they call of fevers, whose bark, of cinnamon colour, made into powder given to the weight of two reals of silver in a drink, cures the ague and tertians; it has produced in Lima miraculous results.’
Calancha had been born in Chiquisaca (now Sucre), in the highlands of Bolivia, in 1584. He grew up among the Andean Indians, and was intimately aware of their customs and folk medicine. He entered the Augustinian Order in 1598, and was appointed the Rector of St Idelfonso College in Lima nearly twenty-five years later. Calancha spent much of his adult life writing his nine-hundred-page Corónica moralizada de la orden de N.S.P.S. Agustín en el Peru, and his account of the properties of the cinchona bark was probably written around 1630, the year that the Viceroy, the Count of Chinchón, first fell ill with the ague, as noted in the diary of his secretary, Antonio Suardo.
Another priest, Bernabé Cobó, a Jesuit who arrived in Lima from Spain in 1599, wrote an account of cinchona as a short chapter entitled ‘A Tree for the Ague’ in his magnificent multi-volume Historia del Nuevo Mundo, which was written in 1639 but not widely disseminated for another two centuries. In it he says: ‘In the district of the city of Loxa, diocese of Quito, grow certain kind of large trees, which have bark like cinnamon, a bit coarse and very bitter; which, ground to powder, is given to those who have the ague and with only this remedy it is gone. These powders must be taken to the weight of two reals of silver in wine or any other liquor just before the chill starts. These powders are by now so well known and esteemed, not only in all the Indies, but in Europe, that with insistence they are sent for from Rome.’
The writings of Calancha and Cobó were well known to virtually everyone who has written about cinchona or quinine over the past hundred years. Four other Spanish writers, all of them far more obscure, bear out Calancha and Cobó’s observations that cinchona came to the attention of the Jesuits in Peru in or around 1630.
Gaspar Caldera de la Heredia was born in Seville of Portuguese extraction in 1591 or thereabouts. He studied medicine at the University of Salamanca, practising first in Carmona before settling in Seville, then already the centre of Spanish imports from the Indies. Caldera’s interest in remedies from the New World is easily understood; his father had lived in Mexico, and three of his children went to Lima in 1641, precisely at the time when the use of cinchona in Spain and other parts of Europe was gaining momentum. His writings on cinchona are preceded by a series of letters that he exchanged in 1661 with Girolamo Bardo, the pharmacist at the Jesuit College in Rome and a close collaborator of the doctors from the Santo Spirito hospital who cured Pope Urban VIII of the malaria he caught during the papal conclave that elected him.
Caldera’s Tribunalis Illustrationes et Observationes Practicae, in which he writes about cinchona, was published in 1663, the same year that the Genovese doctor, Sebastiano Bado, published his celebrated book on cinchona, Anastasis Corticis Peruviae Sen Chinae Chinae Defensio. Caldera’s writing shows him to be a learned man, a cautious scientist, a sound clinical practitioner and a faithful witness. Cinchona, he wrote, came from a tree like a large pear tree called quarango by the Indians, who used it as timber. Jesuits at missions in the foothills of the Andes noticed that the Indians drank its powdered bark in hot water when shivering after being exposed to dampness and cold. Quinine has many side effects, some of them quite unpleasant, such as tinnitus, but one of its more beneficial properties is that it can act as a muscle relaxant, which is why it calms the nervous impulse that causes shivering, and why today it is sometimes prescribed for people with pacemakers, or more commonly for those who suffer from leg cramps.
The Jesuits, Caldera noted, believed that cinchona might be effective in checking the shivering that is associated with ague, and they tested the powdered bark on a few patients suffering from quartan and tertian fever. Shortly afterwards, some Jesuits of the missions in Quito took the bark to Gabriel de España, an energetic pharmacist who had his botíca in Lima near the bridge over the Río Rimac, and who was renowned throughout the young city for his knowledge of local medicinal plants. De España began to pass samples of cinchona to a number of physicians as well as other apothecaries in the city, who used