The Discovery of Peruvian Bark

Two hundred and fifty years ago the city of Lima was the splendid capital of the Spanish empire in South America. Full of convents and churches, — monuments of the age of faith, — it was the principal office of the Holy Inquisition, the seat of the Archbishop of Peru, and the home of the Spanish viceroy, whose authority was recognized from Patagonia to the Isthmus of Panama. Here were the costly buildings of the oldest university in America, founded in 1576. From the ranges of the Andes that towered above each other behind the city, a continual procession of slaves and beasts of burden brought to the royal treasury silver and gold from the mines of Potosi and of Pasco. Seven miles across the plain, upon the shore of the great Pacific Ocean, lay the seaport town of Callao, whence sailed the galleons, laden with silver and gold and precious stones, bound to Acapulco and Manilla and the Spice Islands beyond the western sea; bringing back in return the silks, teas, and costly wares of India, China, and Japan. Within♦ the narrow limits of the capital was concentrated an amount of wealth at that time unsurpassed by any of the royal cities of Europe. It is recorded that in the year 1681 the viceroy rode through the streets over a pavement of solid silver ingots, on a horse whose mane was strung with pearls and whose feet were shod with gold. To this centre of luxury came the Spanish grandees who had found favor with their sovereign, for the avowed purpose of enriching themselves as rapidly as possible. It was a ruthless system of legalized robbery and oppression, coining the life-blood of the enslaved people into glittering pieces of eight and shining doubloons, with which, so soon as his avaricious hunger was somewhat appeased, the adventurer hurried home to Europe, only to make room for another tyrant, more eager, more rapacious, and less merciful than the first.

In the year 1638, the Count of Chinchon held his court in the vice-regal palace beside the river Rimac. The countess was grievously sick, prostrated by one of the miserable calenturas of the country, — an ague, which would not yield either to the ministrations of the physicians, or to the prayers of the archbishop and of all his clergy. It was a serious matter, for the noble lady had lost all her bright color, and was visibly wasting to a mere shadow of her former self. The court doctors, the surgeongeneral of the army, and the chief surgeons from the ships of war at Callao had been summoned in frequent consultation, no doubt; but the countess was none the better. Some of the older residents may have thought that the case was not without hope, for it was whispered abroad that there were native remedies, sometimes in use among the Indian slaves, by which such distempers might be healed. But the situation was delicate. Spanish etiquette was exceedingly punctilious, and when the court doctors and the surgeons from the army and the navy had pronounced an opinion, who might gainsay their doctrine ?

In the midst of this dilemma the chief magistrate of the province of Loxa made his appearance at court. Eight years before he had himself wrestled with this same malignant ague, and had been healed by the administration of a bitter powder, procured from the Indians who dwelt among the mountains in his province. The pious monks of the convent at Loxa, moreover, had long possessed the secret of this remedy, having recorded its virtues as far back as the year 1600, when one of the brethren had been cured at the hands of an Indian disciple. Armed with this experience, the corregidor went straight to the viceroy, and urged a trial of the remedy which he had used with such advantage. Of course this raised a commotion at once. Out of the past we seem to hear voices, arguing and protesting. “ Poisonous! Why, have I not swallowed whole handfuls of the stuff, and do I look like a man who has made the acquaintance of poison ? Is there not a sufficient number of slaves, upon any one of whom the drug can be tried at a moment’s notice? Have not the holy fathers at Loxa pronounced in favor of the remedy ? Yea, verily, has not this very package been duly blessed by the father superior himself, before I came from home ? ” Such reasoning overcame all opposition, at last. The countess received the bitter draught, and was healed. It is not difficult to imagine the triumph of the man of laws ; let us draw a veil of decent sympathy over the features of the fashionable physicians of Lima, leaving them in shadow-land to justify their ignorance and their discomfiture. No doubt they were equal to the occasion.

In due course of time, the Count of Chinchon had filled his coffers, and another grandee reigned in his stead, Returning to his estates in Spain, the countess carried with her the strangely bitter powder that had made her whole. Whenever any one of her friends was prostrated with the calentura, she would bring forth her store, and would recite the narrative of her wonderful cure. The pious Jesuit fathers, also, sent specimens of the medicine to the general of their order, by whom it was properly investigated and accredited ; so that during the lifetime of the next generation the substance became tolerably well known as the “ Jesuits’ powder.” In aristocratic circles it was commonly called the “countess’ powder;” and after the year 1670, when Cardinal Lugo sanctioned its use in the treatment of malarial fevers at Rome, it was considered the proper thing among all true believers to speak of it as the “ cardinal’s powder.” Among the learned, however, it was known as the Pulvis febrifugus orbis Americani, or the Pulvis ‘peruvianus, or the Cortex peruvianus, as it is called in a controversial pamphlet of the year 1663, of which the Latin titlepage ¹ may be translated : The rehabilitation of Peruvian bark, or the defense of China, against the belchings of John Jacob Chifflet and the groans of VopisCus Fortunatus Plemp, eminent physicians. For the drug was not universally received as the heaven-sent blessing which its enthusiastic friends would have it appear. Some of the most learned professors in the medical schools of Italy decried its use, probably because of the variable quality of the barks that were sent from Peru, and the crude methods of preparation then in vogue. At any rate, it is certain that the reputation of the drug did not make great headway, and the remedy seemed likely to fall into disrepute. In London it had encountered great opposition, for the reason that it had been introduced to notice, not by the leaders of medical opinion, but by a practitioner of inferior rank, named Tudor or Talbot. Originally an apothecary in Cambridge, this man had learned the value of the newly discovered “ Jesuits’ bark,” and had devised an improved method for the exhibition of its remedial virtues. He removed to London about the year 1670, and was soon embroiled with the leading physicians of that city. In those days the privileges of the College of Physicians were so jealously guarded that an apothecary who treated fevers with more success than the regularly anointed doctors was looked upon as a wild beast, to be slaughtered without mercy. Evelyn records in his diary a conversation with the Marquis of Normanby “ concerning the Quinquina which the physicians would not give to the King (Charles II.), at a time when in a dangerous ague it was the only thing that could cure him (out of envy because it had been brought into vogue by Mr. Tudor, an apothecary) till Dr. Short, to whom the King sent to know his opinion of it privately, he being reputed a Papist (but who was In truth a very honest good Christian) sent word to the King that it was the only thing which could save his life, and then the King injoin’d his physicians to give it to him, which they did, and he recover’d. Being asked by this Lord why they would not prescribe it, Dr. Lower said it would spoil their practice, or some such expression, and at last confessed it was a remedy fit only for Kings.” According to Stillé, the jealousy excited by the success of the despised apothecary was so great that he was obliged " to seek the protection of the court, and the king actually issued ix mandate to the College, forbidding them to molest or disturb him in his practice.” But the diarist commemorates another occasion when the remedy was administered without avail. On Monday, February 2, 1685, King Charles had been “ surprised in his bed-chamber with an apoplectic fit.” He was immediately bled by his attending physician. “ This rescu’d his Majesty for the instant, but it was only a short reprieve. . . . On Thursday hopes of recovery were signified in the publiq Gazette, but that day, about noone, the physitians thought him feaverish. This they seem’d glad of, as being more easily allay’d and methodically dealt with than his former fits; so as they prescrib’d the famous Jesuits powder : but it made him worse, and some very able Doctors who were present did not think it a fever, but the effect of his frequent bleeding and other sharp operations us’d by them about his head, so that probably the powder might stop the circulation, and renew his former fits, which now made him very weake. Thus he passed Thursday night with greate difficulty, when complaining of a paine in his side, they drew 12 ounces more of blood from him ; this was by 6 in the morning on Friday, and it gave him reliefe, but it did not continue, for being now in much paine, and struggling for breath, he lay dozing, and after some conflicts, the physitians despairing of him, he gave up the ghost at half an houre after eleven in the morning, being 6 Feb. 1685.

But before this sad conclusion, Dr. Talbot had achieved another splendid triumph, — this time, in France. Louis the Fourteenth had been stricken down, in the year 1679, by an incorrigible ague. In vain the doctors of the court had essayed to break the fever; it would not down at their bidding. When every one was in despair, there came an Englishman, from London, who said that he had that in a little bottle which would cure his most Christian majesty. It was the apothecary Talbot, whose fame secured for him admission to the chamber of the king, where he obtained permission to administer the secret remedy which he carried. His majesty drank, and was cured.

What was the medicine which had accomplished such a marvel ? It was liquid, fiery, dark, and very bitter. More than this no one could tell. The curiosity of the king was thoroughly roused. Dr. Talbot shrugged his shoulders, and hinted that the knowledge might be had for a sufficient compensation. After considerable haggling, the secret was purchased for the sum of forty-eight thousand livres, and an annuity of two thousand francs, a large remuneration when we take into consideration the value of money at that time as compared with the present. The title of Chevalier was also conferred upon the doctor, and his recipe was given to the world. It was an alcoholic or vinous tincture of Peruvian bark. Au official description ² of the medicine was published by order of the king, and La Fontaine composed a poem in honor of the event. Peruvian bark was for a time more fashionable in Paris than it had ever been at Madrid, and its properties became gradually known throughout the greater part of Europe. Many years, however, seem to have elapsed before its value was generally acknowledged, for in the year 1740 another conspicuous example of the ignorance or the timidity of the medical profession regarding the use of the bark was presented in the case of a most illustrious personage. Frederick the Great, riding hither and thither, from one end of his kingdom to the other, during the months of a rainy summer, was suddenly seized with a fever. It proved to be an “ aguish, feverish distemper,” a “ quartan ague, it seems; occasionally very bad; but Friedrich struggles with it; will not be cheated of any of his purposes by it. ... A most alert and miscellaneously busy young king, in spite of the ague.” ³ We accordingly find him writing, September 6th, to his friend Voltaire, whom he had intended to visit: —

Mr DEAR VOLTAIRE, — In spite of myself, I have to yield to the quartan fever, which is more tenacious than a Jansenist; and whatever desire I had of going to Antwerp and Brussels, I find myself not in a condition to undertake such a journey without risk. I would ask of you, then, if the road from Brussels to Cleve would not to you seem too long for a meeting; it is the one means of seeing you which remains to me. . . . Let us deceive the fever, my dear Voltaire, and let me at least have the pleasure of embracing you.

Whereupon Voltaire “ at once decided on complying. . . . Arrives, sure enough, Sunday night (September 11th); old Schloss of Moyland, six miles from Cleve; moonlight, I find, — the harvest moon.”

“ I was led into his majesty’s apartment,” writes Voltaire. “ Nothing but four bare walls there. By the light of the candle, I perceived, in a closet, a little truckle-bed, two feet and a half broad, on which lay a little man muffled up in a dressing gown of coarse blue duffel : this was the king, sweating and shivering under a wretched blanket there, in a violent fit of fever. I made my reverence, and began the acquaintance by feeling his pulse, as if I had been his chief physician. The fit over, he dressed himself, and took his place at table, (where we) discussed, naturally in a profound manner, the Immortality of the Soul, Liberty, Fate, the Androgynes of Plato, and other small topics of that nature.”

Some talk there may’ have been also of the experience of the Grand Monarque with the ague, and of the manner of his cure ; but if so, nothing came of it then, for we find Friedrich impatiently shaking through the month of September and far along into October, begging for “quinquina,” and bitterly reviling his physicians because they would neither give him the drug of which he had heard, nor cure him of the fever, having nothing better than Pyrmout water to offer for his relief.

Thus the weeks dragged wearily on, the king growing “lean and broken down, giving up court life at Berlin, and taking refuge in his country-seat at Reinsberg, when, says Carlyle, one Tuesday forenoon, October 25, 1740, express arrives, “ direct from Vienna five days ago; finds Friedrich under eclipse, hidden in the interior, laboring under his ague-fit: question rises, Shall the express be introduced, or be held back? The news he brings is huge, unexpected, transcendent, and may agitate the sick king. Six or seven heads go wagging on this point. They decide, ’ Better wait! ’

“ They wait, accordingly; and then, after about an hour, the trembling-fit being over, and Fredersdorff having cautiously7 preluded a little, and prepared the way, the dispatch is delivered.” The Emperor of Austria was dead. “ Friedrich kept silence; showed no sign how transfixed he was to hear such tidings ; which, he foresaw, would have immeasurable consequences in the world.” He arose from his bed, dressed himself, and sent at once for the general of the army and for the chief minister of the state. No more trifling with Pyrmont water now, but immediate prescription by7 the king himself of Peruvian bark in good round doses, which were taken with such effect that the ague was driven out “like a mere hiccup,— quite gone in the course of next week; and we hear no more of that importunate annoyance ” during the remainder of Frederick’s life.

Still, in spite of all these brilliant triumphs, the general introduction of Peruvian bark progressed but slowly. The frightful wars which sundered the different nations and the backward state of chemistry and pharmacy were, no doubt, the principal causes of this delay. The extreme bitterness and bulkiness of the dose as formerly given must also have constituted no inconsiderable barrier to the general recognition of the virtues of the drug. It was not before the year 1820 that final success crowned the effort to separate its alkaloids from the inert constituents of the bark. I well remember the curious interest with which, when a very small boy, I watched the good family physician as he prepared at my mother’s bedside her first dose of the new French medicine, quinine. It was an ordinary acid solution, illuminating the water into which it was dropped with a most beautiful tinge of fluorescent blue, — but oh, how bitter! Even after this great pharmaceutical victory, ancient prejudices lingered long. But these are now for the most part traditions of the past, and, after a trial of two hundred and fifty years, we have exalted the once-despised pulvis ignotus into a panacea for almost every ill to which flesh is heir, — a great and durable triumph, slowly but surely won.

Henry M. Lyman.