Pestilence, Sacred Trees And A Glass of Tonic Water

I have a soft spot for tonic water. Maybe because it’s the only soda beverage with a taste I never fully understood, impossible to describe: an ambiguous aroma, a strange contrast between that pinch of sugar and a sour vein that makes your palate dry.
Every now and then, during summer evenings, I happen to take a sip on my balcony while I watch the Alban Hills, where the Roman Castles cling to a long-dead volcano. And as I bring the glass to my lips, I can’t help thinking about how strange history of mankind can be.

Kings, wars, crusades, invasions, revolutions and so on. What is the most powerful cause for change? What agent produced the most dramatic long-term modification of human society?
The answer is: epidemics.
According to some historians, no other element has had such a profound impact on our culture, so much so that without the Plague, social and scientific progress as we know it might not have been possible (I wrote about this some time ago). With each stroke of epidemic, the survivors were left less numerous and much richer, so the arts and sciences could develop and flourish; but the plague also changed the history of medicine and its methods.

“Plague” is actually a very generic word, just like “disease”: it was used throughout history to define different kinds of epidemic. Among these, one of the most ancient and probably the worst that ever hit mankind, was malaria.

It is believed that malaria killed more people than all other causes of death put together throughout the entire human history.
In spite of an impressive reduction of the disease burden in the last decade, the World Health Organization estimates that as many as 300 million people are infected by the disease every year. That’s about the size of the entire US population. Of those who fall sick, more than 400,000 die every year, mostly children: malaria claims the life of one child every two minutes.

Malaria takes its name from the Italian words “mala aria”, the bad air one could breathe in the marshes and swamps that surrounded the city of Rome. It was believed that the filthy, smelly air was the cause of the ague. (Giovanni Maria Lancisi suggested in 1712 that mosquitoes might have something to do with the epidemic, but only at the end of the Nineteenth century Sir Ronald Ross, an English Nobel-awarded gentleman, proved that malaria is transmitted by the Anopheles mosquito.)

Back in Medieval Rome, every summer brought back the scourge, and people died by the hundreds. The plague hit indistinctively: it killed aristocrats, warriors, peasants, cardinals, even Popes. As Goffredo da Viterbo wrote in 1167, “When unable to defend herself by the sword, Rome could defend herself by means of the fever”.

Malaria was widespread throughout Europe, Asia, and Africa. Yet, no one knew exactly what it was, nor did they know how to treat it. There was no cure, no remedy.

Well, this is the part that really blows my mind. I cannot shake the feeling that someone was playing a bad joke on us humans. Because, actually, there was a remedy. But the mocking Gods had placed it in a land which had never been attained by malaria. Worse: it was in a land that no one had discovered yet.

As Europe continued to be ravaged by the terrible marsh fevers, the solution was lying hidden in the jungles of Peru.

Enter the Jesuits.
Their first mission in Peru was founded in 1609. Jesuits could not perform medicine: the instructions left by the founder of the order, St Ignatius of Loyola, forbade his followers to become doctors, for they should only focus on the souls of men. Despite being expressly forbidden to practice medicine, Jesuit priests often turned their attention to the study of herbs and plants. Father Agustino Salumbrino was a Jesuit, and a pharmacist. He was among the firsts missionaries in Peru, and he lived in the College of San Pablo in Lima, putting his knowledge of pharmacy to good use as he built what would become the best and biggest pharmacy in the whole New World. Jesuits wanted to convert the natives to Catholicism, but understood that it couldn’t be done by means of force: first they needed to understand the indios and their culture. The native healers, of course, knew all sorts of plant remedies, and the priests took good notice of all this knowledge, picking never-before-seen plants and herbs, recording and detailing their effects.
That’s when they noted that the Indians who lived in the Andes sometimes drank infusions of a particular bark to stop from shivering. The Jesuits made the connection: maybe that bark could be effective in the treatment of marsh fevers.

By the early 1630s Father Salumbrino (possibly with the help of another Jesuit, Bernabé Cobo) decided to send a small bundle of this dried bark back to Rome, to see if it could help with malaria.
In Rome, at the time, there was another extraordinary character: Cardinal Juan De Lugo, director of the pharmacy of the Hospital Santo Spirito. He was the one responsible for turning the pharmacy from an artisan studio to something approaching an industrial production line: under his direction, the apothecary resembled nothing that had gone before it, either in scale or vision. Thousands of jars and bottles. shelves filled with recipes for preparations of medicines, prescriptions for their use and descriptions of illnesses and symptoms. De Lugo would cure the poor, distributing free medicine. When the Peruvian bark arrived in Rome, De Lugo understood its potential and decided to publicize the medicine as much as he could: this was the first remedy that actually worked against the fever.

Peru handing Science a cinchona branch (XVII C. etching).

The bark of the cinchona tree contains 4 different alkaloids that act against the malaria parasite, the most important of which is quinine. Quinine’s secret is that it calms the fever and shivering but also kills the parasite that causes malaria, so it can be used both as a cure and a preventive treatment.

But not everyone was happy with the arrival of this new, miraculous bark powder.

First of all, it had been discovered by Jesuits. Therefore, all Protestants immediately refused to take the medicine. They just could not accept that the cure for the most ancient and deadly of diseases came from their religious rivals. So, in Holland, Germany and England pretty much everybody rejected the cure.
Secondly, the bark was awfully bitter. “We knew it, those Jesuits are trying to poison us!

But maybe the most violent refusal came from the world of medicine itself.
This might not come as a surprise, once you know how doctors treated malaria before quinine. Many medieval cures involved transferring the disease onto animals or objects: a sheep was brought into the bedroom of a fever patient, and holy chants were recited to displace the ailment from the human to the beast. One cure that was still popular in the seventeenth century involved a sweet apple and an incantation to the three kings who followed the star to Bethlehem: “Cut the apple into three parts. In the first part, write the words Ave Gaspari. In the second write Ave Balthasar, in the third Ave Melchior. Then eat each segment early on three consecutive mornings, and recite three Our Fathers and three Hail Marys”.

Even after the Middle Ages, the medical orthodoxy still blindly believed in Galen‘s teachings. Traditionalists who wanted to preserve the ancient doctrine of Galenic medicine at any cost felt the cinchona bark would overturn their view of the human body – and it was actually going to. According to Galen, fever was a bile-caused disorder: it was not a symptom but a disease in itself. A patient with a high fever was said to be suffering from “fermentation” of the blood. When fermented, blood behaved a little like boiling milk, producing a thick residue that to be got rid of before the patient could recover. For this reason the preferred treatments for fever were bleeding, purging, or both.
But Peruvian bark seemed to be curing the fever without producing any residue. How could it be possible?

The years passed, and the success of the cure came from those who tried it: no one knew why, but it worked. In time, cinchona bark would change the way doctors approached diseases: it would provide one of decisive blows against Galen’s doctrine, and open the door to modern medicine.

A big breakthrough for the acceptance of Jesuits Bark came from a guy named Robert Tabor. Talbor was not a doctor: he had no proper training, he was just a quack. But he managed to become quite famous and fashionable, and when summoned to cure Charles II of England of malaria, he used a secret remedy which he had been experimenting with. It worked, and of course it turned out to be the Jesuits powder, mixed with wine. Charles appointed Talbor as his personal physician much to the fury of the English medical establishment and sent him over to France where he proceeded to cure the King’s son too. Without really realizing it, Talbor had discovered the right way to administrate cinchona bark: the most potent mixtures were made by dissolving the powder into wine — not water — as the cinchona alkaloids were highly soluble in alcohol.

By the end of the 18th century, nearly three hundred ships were arriving in Spanish ports from the Americas every year — almost one each day. One out of three came from Peru, none of which ever failed to carry cinchona bark.

Caventou & Pelletier.

And in 1820, quinine was officially born: two scientists, Pelletier and Caventou, succeeded in isolating the chemical quinine and worked out how to extract the alkaloid from the wood. They named their drug from the original Inca word for the cinchona tree bark, quina or quina-quina, which means “bark of barks” or “holy bark”.

Many other battles were fought for quinine, lives were risked and lost. In the 1840s and 1850s British soldiers and colonials in India were using more than 700 tons of bark every year, but the Spanish had the monopoly on quinine. English and Dutch explorers began to smuggle seeds, and it was the Dutch who finally succeded in establishing plantations in Java, soon controlling the world’s supplies.

During WWII the Japanese occupied Java, and once more men wnt to war over tree bark extract; but fortunately this time a synthetic version of quinine was developed, and for the first time pharmaceutical companies were able to produce the drugs without the need for big plantations.

Troops based in the Colonies all consumed anti-fever, quinine-based pharmaceuticals, like for instance Warburg’s Tincture. This led to the creation, through the addition of soda, of several  QuinineTonic Waters; in 1870 Schweppe’s “Indian Tonic Water” was commercialized, based on the famous carbonated mineral water invented around 1790 by Swiss watchmaker Jacob Schweppe. Indian Tonic Water was specifically aimed at British colonials who started each day with a strong dose of bitter quinine sulphate. It contained citric acid, to dissolve the quinine, and a touch of sugar.

So here I am, now, looking at the Alban Hills. The place where I live is precisely where the dreaded ancient swamps once began; the deadly “bad air” originated from these very lands.
Of course, malaria was eradicated in the 1950s throughout the Italian peninsula. Yet every time I pour myself a glass of tonic water, and taste its bitter quinine flavor, I can’t help thinking about the strange history of mankind — in which a holy tree from across the ocean might prove more valuable than all the kings, wars and crusades in the world.

Most of the info in this post are taken from Fiammetta Rocco, The Miraculous Fever-Tree. Malaria, medicine and the cure that changed the world (2003 Harper-Collins).

The Museum of Failure

I have a horror of victories.
(André Pieyre de Mandiargues)

Museums are places of enchantment and inspiration (starting from their name, referring to the Muses). If they largely celebrate progress and the homo sapiens‘ highest achievements, it would be important to recognize that enchantment and inspiration may also arise from contemplating broken dreams, misadventures, accidents that happen along the way.

It is an old utopian project of mine, with which I’ve been flirting for quite a long time: to launch a museum entirely dedicated to human failure.

Lacking the means to open a real museum, I will have to settle for a virtual tour.
Here is the map of my imaginary museum.


As you can see, the tour goes through six rooms.
The first one is entitled Forgotten ingenuity, and here are presented the lives of those inventors, artists or charlatans whose passage on this Earth seems to have been overlooked by official History. Yet among the protagonists of this first room are men who knew immense fame in their lifetime, only to fall from hero to zero.
As a result of an hypertrophic ego, or financial recklessness, or a series of unfortunate events, these characters came just one step away from victory, or even apparently conquered it. Martin F. Tupper was the highest grossing anglo-saxon XIX Century poet, and John Banvard was for a long time the most celebrated and successful painter of his era. But today, who remembers their names?
This introduction to failure is a sort of sic transit, and pushes the visitor to ask himself some essential questions on the ephemeral nature of success, and on historical memory’s inconsistency.


John Banvard (1815-1891)

The second room is entirely dedicated to odd sciences and wrong theories.
Here is a selection of the weirdest pseudoscientific ideas, abandoned or marginalized disciplines, complex systems of thought now completely useless.
Particular attention is given to early medical doctrines, from Galen‘s pneuma to Henry Cotton‘s crazy surgical therapies, up to Voronoff‘s experiments. But here are also presented completely irrational theories (like those who maintain the Earth is hollow or flat), along other ones which were at one point influential, but now have an exclusively historical value, useful perhaps to understand a certain historical period (for instance, the physiognomy loved by Cesare Lombroso, or Athanasius Kircher‘s musurgy).

This room is meant to remind the visitor that progress and scientific method are never linear, but rather they develop and grow at the cost of failed attempts, dead-end streets, wrong turns. And in no other field as in knowledge, is error as fundamental as success.

The third room is devoted to Lost challenges. Here are celebrated all those individuals who tried, and failed.
The materials in this section prove that defeat can be both sad and grotesque: through multimedia recreations and educational boards the visitors can learn (just to quote a few examples) about William McGonagall, the world’s worst poet, who persisted in composing poems although his literary abilities were disatrous to say the least; about the clumsy and horrendously spectacular attempt to blow up  a whale in Florence, Oregon, or to free a million and a half helium balloons in the middle of a city; and of course about the “flying tailor“, a classic case of extreme faith in one’s own talent.


Next, we enter the space dedicated to Unexpected accidents, often tragic-comic and lethal.
A first category of failures are those made popular by the well-known Darwin Awards, symbolically bestowed upon those individuals who manage to kill themselves in very silly ways. These stories warn us about overlooked details, moments of lessened clarity of mind, inability to take variables into account.
But that is not all. The concept behind the second section of the room is that, no matter how hard we try and plan our future in every smallest detail, reality often bursts in, scrambling all our projects. Therefore here are the really unexpected events, the hostile fate, all those catastrophes and fiascos that are impossible to shun.

This double presentation shows how human miscalculation on one hand, and the element of surprise “kindly” provided by the world on the other, make failure an inevitable reality. How can it be overcome?



The last two rooms try to offer a solution.
If failure cannot be avoided, and sooner or later happens to us all, then maybe the best strategy is to accept it, freeing it from its attached stygma.

One method to exorcise shame is to share it, as suggested by the penultimate room. Monitors screen the images of the so-called fail videos, compilations of homemade footage showing common people who, being unlucky or inept, star in embarassing catastrophes. The fact these videos have a huge success on the internet confirms the idea that not taking ourselves too seriously, and being brave enough to openly share our humiliation, is a liberating and therapeutic act.
On the last wall, the public is invited to hang on a board their own most scorching failure, written down on a piece of paper.


The final room represents the right to fail, the joy of failing and the pride of failure.
Here, on a big bare wall, failure and fortune are represented as yin and yang, each containing the other’s seed, illusory opposites concealing only one reality – the neverending transformation, which knows no human category such as success or failure, indifferent, its vortex endlessly spinning.
To take failure back means to sabotage its paralyzing power, and to learn once again how to move and follow the rythm.


Above the exit door, an ironic quote by Kurt Vonnegut reminds the visitor: “We are dancing animals. How beautiful it is to get up and go out and do something. We are here on Earth to fart around. Don’t let anybody tell you any different“.