Cinchona.
It is not possible to determine from the legends and reports collected by the many competent naturalists who visited Peru in the seventeenth and eighteenth centuries with the special object of investigating the history of the cinchona trees whether it was known or used as a medicine by the natives before its virtues were ascertained by Europeans.
Peru was discovered in 1513, and became subject to Spain about the middle of the sixteenth century. But Hanbury points out that no reference to the bark as a febrifuge has been found earlier than the beginning of the seventeenth century. It was reported by La Condamine, and others who acquired their knowledge on the spot, that the Indians had long used the bark as a dye. The Countess Ana of Chinchon, wife of the Spanish Viceroy of Peru, was cured of a fever by the bark in 1638, but there is evidence that its medicinal value had been experienced by some of the conquering race before that date. One story is that when the Countess was ill and all the usual remedies had been found ineffective, the Corregidor of Loxa, Don Juan Lopez Canizares, who had himself been cured by the bark of a similar illness, brought some of the remedy from Loxa to Lima and staked his reputation on its infallibility. After her cure the Countess became an enthusiastic advocate of the medicine, administering it with uniform success to her dependents and others in Lima, and on her return to Spain in 1640, exerting herself to make it known there.
Another story is to the effect that a native maid in the employment of the Countess had made known the virtues of the bark to the Viceroy out of affection for her mistress, though until then the Indians had concealed the secret from their cruel rulers. The most likely account is that the bark had become known as a valuable medicine to the Jesuit missionaries who had been in the country for fully fifty years when the Countess of Chinchon was cured.
Le Condamine stated, in 1738, that the Indians had a legend that they had become acquainted with the properties of the bark in consequence of an earthquake in the neighbourhood of Loxa which had caused a number of the trees surrounding a lake near the city to be thrown into the water. An Indian violently ill with a fever and consumed with thirst had drunk water from this lake and had been rapidly cured. Another tradition was that the pumas of the country had been observed to eat the bark when they were ill, and that the Indians had learned its value from this circumstance.
The Count and Countess of Chinchon returned to Spain, as has been said, in 1640. They went to live on their estate at Chinchon Castle, about forty miles from Madrid, and their physician, Juan del Vego, followed them and resided at Seville. Vego brought with him a considerable quantity of the bark from Peru, and sold it at 100 reals per pound. Sprengel queries whether the real of Plata or the real of Vellon is to be understood; the latter was worth about 2d., the Plata or silver real being worth about 8d. It is not at all certain that Vego’s bark was the first importation of the medicine into Spain. A Spanish physician named Villerobel, quoted by Badus in 1663 in a work on the Peruvian bark, states that a quantity was received in 1632, but was not tried until 1639 (a year after the cure of the Countess, it will be noted). The patient was an ecclesiastic of Alcala de Henarez, near Madrid. However this may be, Vego’s reports and the experiments with his bark excited lively interest all through Spain, and from then began a controversy almost as bitter as that between the Galenists and Paracelsists. There were a large number of practitioners who could not bring themselves to believe in any medicine which Galen had not described. It was also alleged by some contemporary writers that a prompt cure of intermittent fevers was not by any means desired by a large number of medical men and apothecaries, who consequently allied themselves in opposition to this very effective bark. This statement is no doubt due to the usual uncharitableness of controversy; but it is possible that the adversaries of the new remedy might at least cling to their old prejudices with not less firmness when these and their interests ran on parallel lines.
Fevers were at that time regarded as caused by some morbific principle in the humours which occasioned effervescence, and which it was essential first of all to expel. The patient was, therefore, treated with evacuants and debilitating medicines while the fever continued, and the vital spirits were afterwards restored by a course of cordials and bitters, such as wormwood, chamomile flowers, mace, carduus benedictus, angelica, and valerian. The opponents of the bark insisted that if it palliated the fever it “fixed the humour” and ensured a relapse or some other more dangerous disease. In 1652 Leopold William, Archduke of Austria, and Governor of the Low Countries, who had interested himself in popularising the bark, fell ill with a quaternian fever. He took bark and recovered. A relapse occurred, but the complaint again yielded to the remedy. Some time after he had another attack. This time, perhaps influenced by the views already quoted, he refused to take bark and died. This event was regarded, illogically enough, as evidence of the dangerous character of the medicine.
Meanwhile, the Jesuits had been busy propagating the new remedy and proving its virtues. The provincial father brought a large supply to Rome, and explained the method of using it to a congress of Jesuits then assembled in that city. The fathers administered it all over Europe, giving it gratuitously to the poor and to their own order, but charging its weight in gold to the rich. It is said that they endeavoured to keep it as a secret medicine, and would only supply it in powder so that it might be more difficult to identify. The Procurator-General of the order, Father (afterwards Cardinal) de Lugo, making a journey to Paris in 1649, found the king, Louis XIV, himself suffering at the time from an intermittent fever. He recommended to him the use of the bark, and Louis took it and quickly recovered. The powder of the Cardinal, the Powder of the Fathers, the Jesuits’ Powder, by which names among others it was known, consequently came into strong demand. But these titles were largely responsible for the reaction which almost drove cinchona out of practice. Protestant fears and prejudices were added to the orthodox opposition of the Galenists, and besides, many practitioners administered the bark ignorantly, in too small or too large doses, while the high prices at which it was sold led to fraudulent substitution, which more than anything else discredited the bark as a medicine. Sprengel quotes complaints from the Cardinal de Lugo, the apothecary of the College of Medicine at Rome, and Vincent Protospatario, a physician at Naples, who alleged that the Spanish merchants were sending into Italy instead of the true Peruvian bark various other astringent barks devoid of any aromatic taste, but flavoured up to the necessary bitterness by aloes.
Although Sydenham in England, and a number of eminent physicians on the Continent, studied the proper methods of administration and the suitable doses of bark, it fell to a practitioner whose methods went a long way to justify charges of charlatanry firmly to establish cinchona in professional and popular favour.
Robert Talbor was assistant with an apothecary at Cambridge named Dear. It has been ascertained that in 1663 he had been entered as a sizar at St. John’s College for five years, but there is no indication that he took a degree. In his writings he states that he was largely indebted to a member of the University of the name of Nott for suggestions relative to the administration of bark. The next heard of him is that he was practising in Essex. This was about 1671. He wrote a book in 1672, which he called “Pyretologia,” a rational account of the cause and cure of agues. In this he refers to his own secret remedy, which, he says, consists of four ingredients, two indigenous and two exotic. He mentions Peruvian bark and intimates that it is an excellent remedy, but one that should be employed with prudence, as in the hands of inexperienced doctors it might occasion serious evils. He does not say that it was contained in his specific.
Talbor moved to London and set up his sign next door to Gray’s Inn Gate, in Holborn. His treatment brought him into fame, the climax of which was that having cured the daughter of Lady Mordaunt he was sent for when Charles II was ill with an ague and cured him. He was knighted, appointed a royal physician with a salary of £100 a year, and the king caused a letter to be written to the College of Physicians asking them not to interfere with his practice in London.
Talbor next figures in Paris, and there leaped into eminence. For French convenience he assumed the name of Talbot, an English name with which they were historically familiar. He soon became a favourite in high circles. Mme. de Sévigné refers to him several times in her letters of 1679. In one she says, “Nothing is talked of here but the Englishman and his cures.” In November, 1780, the Dauphin was dangerously ill with a fever. Talbor had plenty of friends at court who wanted him to be sent for. Mme. de Sévigné is again the chronicler. She writes:—“The Englishman has promised on his head to cure monseigneur in four days.” If he fails she believes he will be thrown out of the window. She further states that the King (Louis XIV) insisted on seeing Talbor prepare his wine; and when she reports the fulfilment of his promise and the cure of the Dauphin she notes with malicious glee the discomfiture of the king’s head physician, Antoine d’Aquin.
D’Aquin wrote bitterly against Talbor, insisted that his treatment of the Dauphin and of other persons had been founded on a mistaken diagnosis, and that in the Dauphin’s case he had made a bilious fever into a dangerous disorder. Another critic suggested that his remedy given to the Duke of Rochefoucauld in an arthritic asthma had had fatal consequences.
Louis agreed to buy Talbor’s formula, but nothing was published until after the death of the latter. Two thousand guineas and an annual pension of £100 were granted to the English doctor, and he was made a Chevalier. Shortly afterwards he went to Spain and cured the queen of that country of a fever. Then he returned to London and died in 1781, at the early age of forty.
His official formula, published after his death, directed 6 drachms of rose leaves to be infused in 6 ounces of water with 2 ounces of lemon juice for four hours. A strong infusion of cinchona was added to the above, together with some juice of persil or ache. He also made alcoholic tinctures and wines of cinchona. The French doctors were sure that he was in the habit of adding some opium to his speciality. If he did he invented a valuable combination.
Another contemporary writer, John Jones, gives the following as Talbor’s process. He digested finely-powdered bark in juice of persil and decoction of anise separately. The mixture was placed in an earthen vessel, and having been stirred frequently he added red wine and macerated for a week. He also made a tincture of cinchona by adding 8 ounces of alcohol to 2 ounces of powdered bark.
From a handbill in a collection of quack advertisements in the British Museum Library, dated “1675, &c.,” it appears that Dr. Charles Goodal, who gave his address “at the Coach and Horses, near Physician’s Colledge, Warwick Lane,” offers “for the public good a very superior sort of Jesuit’s Bark, ready powdered, and papered into doses” at 4s. per ounce, or in quantity £3 per lb., and as evidence that this is a reasonable price he refers to Mr. Thain, druggist, of Newgate Street, to whom he had paid 9s. per lb. for a considerable quantity. Possibly it was Mr. Thain who was advertising.