Quinine: Malaria and the Quest for a Cure That Changed the World

by Fiammetta Rocco

The fascinating story of the intensive search to discover and possess quinine—the only known cure for malariaMalaria kills someone every 12 minutes in Africa. Now known mostly as a disease of the tropics, malaria led to the demise of the Roman Empire 2,000 years ago and ravaged Europe for years afterwards. At the start of the 17th century, Jesuit priests developed quinine, an alkaloid made out of the bitter red bark of the cinchona tree from the Andes. When quinine arrived in Europe, the Protestant powers resisted the medicine fearing that it was a Popish poison. Quinine’s reputation improved, however, when King Charles II was cured of malaria through its offices. Through the centuries, wars were fought to control the supply-through the building of the Panama Canal and into WWII--until Americans synthesized quinine for the first time in 1944.Rocco describes the ravages of the disease, the search for a cure, and the quest to steal and smuggle cinchona seeds out of South America. The Miraculous Fever Tree deftly illuminates the religious and scientific rivalries, intrepid exploration and colonization evinced by the search for quinine.

Genres: History, Nonfiction, Science, Medical, Medicine, Health, Microhistory

348 pages, Paperback

First published June 16, 2003

Reviews

[Ashley · Rating 2 out of 5]

After seeing all the four and five-star reviews for this book, I had very high hopes. Perhaps this is a case of expecting a different book than the one the author wrote. I thought that The Miraculous Fever-Tree felt incomplete, poorly structured, and thinly researched. Rocco's first chapter made me think this would be part memoir, but I couldn't figure out why her family's history was especially relevant to the story of malaria and/or quinine. That information, presumably included to indicate that she's an "authentic" voice on the topic, should have been included in a forward or preface. The rest of the book moves unevenly through 400+ years of history and shifts between telling the story of quinine and the story of malaria. While I recognize that one is meaningless without the other, I felt that Rocco could have done a better job organizing these two parallel stories. She also doesn't explain the biology and pathology of malaria until the last chapters-- and never *really* explains how quinine works. She's clearly more comfortable in the history than the medicine/science portions of the story.

Finally, the book fails to problemitize colonization and the relationship between European scientists and colonial subjects. This oversight obscures an enormous component of the 18th and 19th century malaria research and motivation to find a cure.

[GoldGato · Rating 4 out of 5]

Engrossing. For centuries, malaria played a pivotal role in ensuring mankind didn't get too full of itself, as explorers and armies and civilians died by the millions. When a papal election resulted in the deaths of ten malaria-stricken cardinals, a serious search for a cure began. This book takes the reader on a round-the-world journey to the tree that held the answer.

The author never loses the reader, as we learn about insects, flora, armies, empires, and leaders affected by malaria. For instance, 82% of the workers digging the Panama Canal had malaria parasites in their blood. Yikes. Still, there is a reason for everything...sugar and gin had to be added to water to tolerate the bitter taste of quinine. The original Gin & Tonic.

Book Season = Summer (tropics)

[Nicole · Rating 4 out of 5]

Really interesting! I enjoyed how the author highlighted specific places and times to show how malaria affected the population.

[Clare O'Beara · Rating 5 out of 5]

This covers the history and uses of the Chinchona tree of the Peruvian Andes, which was observed by a Jesuit to be used by native peoples when they were shivering. He suggested it could be useful in helping people in Europe who had agues and fevers, which caused shivering. The resulting bark medicine became a cure for malaria and a spur to science.

The start of the book is rather jumbled with various locations and times mixed in one chapter. The author's family mingles with ancient history. After that the book settles into a timeline, which explores a period and skips decades or centuries to the next chapter.

We don't hear much now about malaria in Europe. Yet much of Italy, even parts of Rome near the Tiber, were plagued by malarial mosquitoes making the place unfit for habitation during the warm months. We learn of a Vatican Conclave to choose a Pope, during which the bishops hoped to be decided as quickly as possible because they couldn't leave and were likely to get malaria. France too had malaria, as did the Low Countries (of course, all that reclaimed river delta) and the marshier parts of England. The mosquitoes now found in the New World are considered to have been brought there, one by European explorers, the other and more deadly by African slave ships.

Wars and medics, colonists and traders, all needed cures for malaria. The Jesuit bark or Peruvian bark from a variety of subspecies worked so well that a giant industry sprang up to exploit it, which overrode the original teaching of the Jesuits that for every tree felled five should be planted. So many tonnes of quinine were shipped worldwide that the trees were becoming scarce. Enter the plant hunters of Kew and the Chelsea Physic Gardens, who made sure to obtain seeds, smuggling them out of the continent and to India or Java for a diversity of production and to save the species from extinction. Quinine was needed while building the Panama Canal or settling in Africa. And then, of course, in WW2 the Germans and Japanese between them managed to seize almost all the world's quinine.

We also get the studies of malarial mosquitoes under the new microscopes to understand how the disease was transmitted, the discoverer of the life cycle of the plasmodium parasite being awarded a Nobel prize.

The author has examined records which she says had never seen the light of day since being written and stored, has travelled and hunted for correspondence from the wide variety of people - almost all men, apart from a fable about a Countess - involved from medieval Italy to modern Congo. Whether your interest is plants, history, warfare, medicine, cultural anthropology, or science, you will find entertainment and enlightenment in The Miraculous Fever Tree.

Notes and index P315 - 348. I counted 14 names which I could be sure were female.
I borrowed this book from the Royal Dublin Society Library. This is an unbiased review.

[LNae · Rating 4 out of 5]

I read this right after reading The Fever Trail by Mark Honigsbaum. This one is an easier read with personal stories intermixed with the history of malaria and the search for the cure. Rocco gives an overview of malaria - from the time of the Romans into today.

[Warreni · Rating 4 out of 5]

Ms. Rocco's book tells an interesting if somewhat disjointed history of the use of quinine to prevent and treat malaria and illustrates what a dramatic impact Plasmodium has had and continues to have on Man. The early chapters, which describe the Jesuit missionaries who brought the bark of the cinchona tree to the Old World, gave the cynic in me a greater appreciation for the fact that there were individuals within the Church who did great work in service of humanity. The narrative is peppered with fascinating stories like that of the Conclave following the death of Pope Gregory XV, when most of the cardinals and their servants became ill with the ague (as it was then known; the broad strokes are familiar to anyone who's seen Angels and Demons but the backroom dealings that lead to one man gaining the throne of Peter are Machiavellian, to say the least. Other intriguing tales include the tragic story of the life's work of Jose Mutis, who compiled a prodigious amount of material over the course of two decades of botanical fieldwork in northern South America, none of which has been published in the intervening two centuries since his death; the story of William Gorgas, Chief Sanitary Officer for the American effort to finish the Panama Canal, who used a combination of chemical and physical controls (adulticide fogging and destruction of larval habitats) to get local mosquito populations under control--a program that is pretty much the same thing we use today; and the collaboration between legends of medical entomology Ronald Ross and Patrick Manson while investigating the life cycle of the malaria parasite.

[John Gaudet · Rating 5 out of 5]

Books about things that "change the world," are still popular and relevant to the non-fiction reader. A classic example is Fiammetta Rocco's, Quinine: Malaria and the Quest for a Cure That Changed the World (Harper Collins, 2003), a book that traces the history of quinine from its discovery in the 17th Century by Jesuit missionaries in Peru to its use by expanding European colonial powers and its role in the development of modern anti-malaria pills. The priests learned of the bark of the cinchona tree, which was used by Andean natives to cure shivering, at a time when malaria, then known as Roman ague or marsh fever, was devastating southern Europe. The Jesuits eagerly began the distribution of the curative bark, which also helped European explorers and missionaries survive the disease as they entered new territories. The interest generated by Rocco's book is due to her delving into the relationship between man and plant and that as she demonstrates so well, a plant substance can be dealt with at a personal level. She also is the great-granddaughter of Phillipe Bunau-Varilla, a soldier and engineer and at one time the Panamanian ambassador to the United States. A genius in the art of lobbyist statecraft, he has been referred to as the "Inventor of Panama," and was called one of the most extraordinary Frenchmen to ever live, and he, like his granddaughter survived malaria, so Rocco knows about malaria and quinine from street level, so to speak. She also has the advantage of being a really good writer and having travelled or lived in many interesting places. Well-crafted, beautifully written, it is book well worth the read.

[K. · Rating 4 out of 5]

I honestly wasn't expecting to, given that medical history books can often be incredibly dry, but I thoroughly enjoyed this. It's really well researched and engagingly written book that details the history of malaria and its natural cure, quinine, through the ages and around the globe. It gives a good balance of the medical and historical sides without feeling too dense or too detailed for lay persons to understand. And I particularly appreciated how the story came full circle, with the importance of quinine plantations in Central Africa in the twenty first century.

My one main gripe would be that at times it seemed like there was too much emphasis on the author's personal family history. But it was effectively explaining her interest in malaria and its cure - she grew up in Africa, having to take anti-malarials on a regular basis, her grandfather suffered malaria repeatedly while in an internment camp during World War II, and her great-grandfather (I think...) was an engineer on the Panama Canal. So while the family oriented sections did feel like they were somewhat oddly placed in the big picture history of malaria, their inclusion was understandable.

[Ahmar · Rating 4 out of 5]

Excellent read. Really, 4 and a half stars. I'm a fan of books that look through the lens of a commodity and give it it's historical due (Cod by Mark Kurlansky comes to mind). It's more fun to find out about how different societies and cultures view, understand, and intersect upon a given "thing" (eg cinchona bark). It makes for far more interesting historical writing than the mundane geocentric approach. Learn about how quinine was first "discovered" and put to use by the Fransiscan missionaries, hear how malaria once weighed in on Vatican politics, follow Sir Ronald Ross as he identifies the culprit, and learn more about the problem of malaria (and its treatment) today.

[Erin · Rating 3 out of 5]

This book dives into the fascinating history of the use of quinine to treat malaria and how the disease impacted major world events over the centuries. From the election of Popes to Jesuits in Peru to power struggles in WWII Rocco shows how malaria and its treatment played more of a part than we realize. The author also takes pains to highlight the unsung heroes whose involvement in history has thus far been overshadowed by greed, jealousy or Euro-centric thinking. While the contents of the book were fascinating I was constantly irritated by the way the book was edited. The flow was often abrupt and there was not enough detail on how malaria is treated today. Content four stars, editing two stars, so I averaged them to get three stars for the overall rating.

[Sean · Rating 4 out of 5]

It's easy to get distracted by the major events, movements, and so-called "great men" of history. But tracing a small but significant series of events as Rocco does lends itself to fascinating reading.

I did not know much about malaria or quinine before starting this book: just that the miracle tree was found in the mountains of South America and that it "saved" the British Empire, and that attempts to synthesize the drug led to the first artificial dyes. And that quinine is an essential element of the gin 'n' tonic.

I did not know the extent of malaria's reach or its impact on politics, trade, medicine, or world history. Rocco's done her homework and spins a highly detailed yet entertaining narrative. This is a great read with lots of substance.

[Anna Engel · Rating 4 out of 5]

This is a very accessible – and compelling – history of malaria and quinine and of their effects on the world. The author's historical research is amazing in its breadth and depth. She synthesized information from numerous primary documents (be still my heart!), as well as from many secondary sources. The result is an engrossing history that will appeal to nonfiction readers who enjoy science and/or history. (I enjoy both - win!)

I hadn't realized how extensively malaria reached geographically in the past. Nor had I realized how fundamental quinine was in Europe's colonization of the world (for good or ill; that's not a judgment I want to get into at this point). Quinine effectively changed the world, from exploration to the construction of the Panama Canal to warfare.

[Stacy · Rating 4 out of 5]

Fascinating history intersecting disease, mosquitos, geography, botany, science, politics, and personalities. Who knew, for instance, that Union attempts to establish a bridgehead along the Atlantic coast were stopped largely because of outbreaks of marlaria, typhoid, and yellow fever? Or that Napoleon used his knowlege of malaria, or "Walcheren" to defeat the English: "We must oppose the English with nothing but fever, which will soon devour them all." Later, Napoleon would himself cause the worst epidemic of malaria ever seen in Europe, breaching the dykes to flood the Scheldt estuary, thereby creating a perfect mosquito breeding ground.

[Ali Barrah · Rating 5 out of 5]

This is a very well written book about the history of quinine. I feel the author is correct in saying that quinine changed the world, for as everyone is aware malaria is the biggest killer in Africa and exploration could not have been done had quinine not been discovered, nor could the Panama Canal have been built. I was also fascinated to know that Napoleon used biological warfare against the British, and various battles were fought in the South Seas during WWII to gain control of quinine plantations. What I would like to know .... are there any quinine trees left in their native habitat, South America? or are the only surviving ones found in the Belgium Congo?

[Sue Chaplin · Rating 3 out of 5]

While I found the book interesting I wanted to know more about how quinine actually worked much earlier. There is a short description towards the end. This throws up questions as to why the plasmodium does not seem to become resistant to quinine but it has done to chloroquinine which was a chemically produced drug.
There were some interesting points about several wars including WWII where the lack of quinine and malaria had more of an effect than I was aware of including a story about us invading a part of the continent in order to try and put a stop to Napoleon but all he did was wait for us to land and then order the dykes to be broken and let Malaria do the rest.

[Alene · Rating 4 out of 5]

The Jesuits were the bomb. They did a lot of damage, but remarkably, they were much better at business than they were at conversion--they always ended up somewhere and starting an apothecary and learning local treatments for everything. Only a portion of the book talks about that, but still, I had to mention it. Totally fascinating to read about this disease that still is a major threat in huge parts of the world and how little we've known about it and how to treat it for so long.

[Cathy · Rating 3 out of 5]

I think I'd find this book more interesting if I'd had malaria or something. It was a little too dry for me and I had a hard time following the timeline as it didn't seem to follow any type of order. I didn't end up reading it all the way through because I was so confused about where I was in time. The one thing that I did enjoy was learning more about the popes and how they tried to deal with the disease. I wouldn't recommend the book unless it's a subject that you're really interested in.

[Nicole · Rating 3 out of 5]

Detailed account of the western civilization's "discovery" of how quinine can cure malaria and the ramification this had on future imperialistic pursuits. This book probably has a limited appeal to those with a background in biology, medicine, or history but it is well-written and an interesting read.

[Erica · Rating 5 out of 5]

An amazing and brilliantly written medical, environmental, and global history of malaria and quinine. Especially loved the Rome chapter, "From America to Panama," and the final chapters about establishing monitored forests for quinine production. If I taught a global environmental history course, I'd use this book.

[Suzanne Frank · Rating 5 out of 5]

Fantastically well written. The intrigue of a novel with the content of detailed research, underscored by the author's personal experiences with malaria and quinine. Fascinating stories. Read it in one sitting.

[Lissa Johnston · Rating 4 out of 5]

Enjoyable and informative. Admire the determination of the scientists working in primitive conditions to link the mosquito to the disease. Hope today's scientists make as much progress synthesizing and replicating the original remedy.

[Gina · Rating 5 out of 5]

I just really enjoyed this book. I like these one-subject books like Amy Butler Greenfield's "A Perfect Red," or Siddhartha Mukherjee's "The Emperor of All Maladies" that give the scope of a subject over a period of a few centuries. It's well written and narrative. Highly recommended.

[Sarah · Rating 4 out of 5]

great, but didn't cover the chemist who was trying to make synthetic quinine and came up with a great purple dye.

[Jack Kuespert]

still reading

[Chris · Rating 4 out of 5]

An interesting history of quininine... and how its lack shaped historical battles while its use assisted with colinization.

[Sarah]

Good so far.

[Shell · Rating 5 out of 5]

Well done non fiction.

[Graham Crawford · Rating 3 out of 5]

I thought this was going to be really boring but it turned out to be a great read.

[Victoria · Rating 3 out of 5]

Interesting reading - especially if you've suffered malaria

[theworldawaits · Rating 4 out of 5]

I read this while vacationing in Africa. I love to read books that are relevant to the place I am visiting while visiting... Suppose it made me enjoy the book that much more.