Drugs and Discovery: An Early Modern Perspective, Part II

Editor’s Note: Last week historian Matthew Crawford argued against the overdetermined notions of “discovery” and “invention,” and called instead for a palimpsestic understanding of the plant-derived drugs that appeared courtesy of transatlantic encounters.  Today, he takes his thinking further, looking for the earliest–and persistent– traces of the presence of cinchona bark in the pharmacopoeias of the Amazon.

Peru Offers Chinchona Bark to "Science" (Guess Who's Who?)

Before 1820, when the alkaloid was isolated, quinine effectively did not exist. Instead, people had a drug known in Spanish as quina or “the Peruvian bark” in English. Quina was a term for the pulverized bark of the cinchona tree, native to the Andean forests of South America, that would be dissolved in water or wine and administered to patients suffering from intermittent fevers. It was from this bark that Pelletier and Caventou isolated quinine and other alkaloids. Quina was a product of the early modern Atlantic World. Europeans, probably Jesuit missionaries, first encountered the bark in the 1630s and 1640s and it became quite popular by the end of the seventeenth century.

One point of contention in the early history of qiuna is whether the indigenous people of the Americas knew about and used the bark before the arrival of Europeans. In our current context of the destruction of indigenous cultures, debates over intellectual property rights with regard to pharmaceuticals derived from ethnobotanical knowledge, and the long shadow cast by colonialism, the question of indigenous use of quina is highly politicized.  Evidence of indigenous use of quina would provide useful evidence in the efforts to establish the utility of indigenous knowledge and the crucial need to protect and preserve indigenous cultures.  At the very least, such evidence would provide the means to respond to older, Eurocentric historical scholarship which simply assumed that indigenous healers could not possibly have been the discoverers of a drug so important to modern medicine.

Unfortunately, uncertainty abounds in the historical record. On the one hand, it seems unlikely that Europeans would have stumbled upon quina all on their own, especially in light of the incredible botanical diversity in the Andean forests of South America. How could Europeans, by chance, have fixed on this one tree out of the hundreds of new species they encountered as the conquered and colonized this region? On the other hand, historians, anthropologists and archaeologists have yet to discover direct evidence of usage of cinchona bark by indigenous peoples before the Spanish conquest of South America. At the same time, we know little about how indigenous groups used or thought of quina before Spanish conquest. After all, the first written records come from Spanish observers in the late sixteenth and early seventeenth centuries. In my view, rather than trying to award credit to one group or the other (Indians or Europeans), I prefer to think of quina as a product of the interactions of indigenous peoples and European colonizers.

The authors of the earliest accounts of quina discussed in my last post give almost no information on who discovered the bark originally or even how they learned about the bark.  In one of the earliest accounts of New World drugs, Nicolas Monardes provides the description of a medicinal tree bark from the region of Guayaquil that sounds a lot like quina, even though Monardes does not use this term because a specific European name for the bark did not yet exist. Monardes, a sixteenth-century  physician based in Spain’s Atlantic port of Seville, just asserts in his de Nuestras Indias Occidentales (1571) that “the Indians” had used the bark and that Spaniards started using the bark “on the advice of the Indies.” (Thanks to Rainer Bussman for pointing me to Monardes’ description of this tree bark.)

1891 Reprint, edited by M. Jiménez de la Espada (Seville: E. Rasco)

Bernabe Cobo, a Jesuit missionary in Peru, does not confirm or deny indigenous use of the bark and observes that the “powders” made from cinchona bark were already, in 1639 when he wrote, “well known and respected not only in the Indies but also in Europe”- a comment that suggests the circulation of the bark as a medicament preceded the circulation of information about the bark in print.  Finally, in 1639, Antonio de la Calancha, an Augustian monk born in South America,includes the bark in a discussion of “the pharmacy of the Indians,” which he hopes European physicians will adopt.

In addition to these early printed accounts, recent ethnobotanical work sheds some light on indigenous usage of quina or cascarilla, although with somewhat ambivalent results. Surveys of healers in Northern Peru and Southern Ecuador, the region in which Europeans first encountered cinchona bark, show that curanderos and other healers do make use of the bark and other parts of the cinchona tree. They use the bark for a variety of ailments, not just fever or malaria, the underlying cause of intermittent fever, and a 2009 study by Rainer Bussman and Douglas Sharon found that local healers and midwives in Loja used cinchona (Cinchona officinalis Linn.) primarily for cough, fertility, cancer, colds and rheumatism. Moreover, another study found that tree bark accounted for only about 3% of the medicaments used by curanderos in the region.

While these studies of contemporary curanderos and midwives in Northern Peru and Southern Ecuador offer no direct insight into the materia medica used by indigenous peoples at the moment of contact, they are suggestive that indigenous people may have been using quina, especially in combination with the earliest European accounts of the bark. Moreover, it is possible that new uses and applications of the bark were developed by indigenous healers or Spanish healers or both in the century or so after the Spanish conquest. In a recent study comparing the materia medica used by more isolated healers of indigenous communities in the Amazon to that used by healers in Quechua communities in the Bolivian Andes, Ina Vandebroek and her co-authors found that Andean healers, who had more contact with “Western healthcare,” were more knowledgeable of medicinal plants than their counterparts in the Amazon.Although this study offers no conclusive explanation for this unexpected finding, the author argue that areas of “high anthropogenic activity” and disturbance of the natural environment results in greater knowledge and use of local plants for medicinal purposes.

"High Anthropogenic Activity," Diego Rivera Style (Palacio Nacional, Mexico, 1951)

Spanish colonization of the Americas seems a good candidate for being a period of “high anthropogenic activity” and the kind of disturbance which provided a context for creative new applications of existing indigenous materia medica such as the application of quina bark to the treatment of fevers as well as other illnesses. Adapting a term from geographer Robert Voeks, we might argue that the pharmacopoeias adopted by healers throughout the Atlantic World – indigenous, mestizo, slave and Europe – were all “disturbance pharmacopoeias,” in which the pre-contact materia medica of these communities remained irrevocably augmented with new medicaments as well as new applications of existing medicaments. Moreover, at the same time that healers of all kinds were expanding their range of materia medica, the materials that constituted the news pharmacopoeias acquired new meanings and new uses as that expanded to new populations and circulated in new contexts.

Pelletier and Caventou: Descendez de votre Piédestal, Messieurs

Although the isolation of quinine was a long way off, physicians, pharmacists and healers of the seventeenth and eighteenth century made use of the same bark – cinchona bark – with which Pelletier and Caventou would work in the early nineteenth century.  It was these existing Atlantic World networks of exchange and experimentation with New World medicaments that made quinine possible. And, if we consider quinine as a palimpsest rather than a discovery, the deeper historical, geographical and cultural connections come into view and we can appreciate quinine as a product of a vast community of knowers and users rather than of a solitary pair of Parisian pharmacists in the early nineteenth century.

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