Rubiaceae
Cinchona pubescens
Quinine bark · Red cinchona · Jesuit bark
- Part used
- bark
- Native range
- Andean South America — Ecuador, Peru, Colombia, Bolivia
- Morphology
- An evergreen tree to fifteen metres with large opposite leaves and fragrant pink tubular flowers. The bark is the part taken, which is why the trees were destroyed rather than harvested.
- Also known as
- Cinchona succirubra
What is in it
Evidence
Quinine is an effective antimalarial and remains in use for severe and resistant Plasmodium falciparum. Its use for nocturnal leg cramps was withdrawn or restricted in several countries after regulators judged the harms to exceed the modest benefit.
Safety
Cinchonism — tinnitus, deafness, visual disturbance, nausea — at therapeutic doses and worse above them. Can cause severe thrombocytopenia, haemolysis in G6PD deficiency, and dangerous cardiac arrhythmia. Quinidine is a potent antiarrhythmic in its own right and a serious interaction hazard.
Interactions: Prolongs QT interval; serious with other QT-prolonging drugs; Raises digoxin levels; Potentiates anticoagulants
Regulatory: Prescription-only as a drug. Tonic water contains quinine at a small fraction of a therapeutic dose.
Historical use
Used in the Andes and brought to Europe by Jesuit missionaries in the seventeenth century, where it became the first specific remedy for a specific disease in Western medicine — bark that reliably broke the fevers of malaria. Whether it was an indigenous antimalarial before contact is genuinely disputed, since malaria was probably not present in the pre-Columbian Andes.
Recorded as history and attributed where possible. Long use establishes that a plant was widely used, not that it worked, and not that it was safe.
Worth knowing
Cinchona is the first time Western medicine had a remedy that worked on one disease and not on others, and it broke the humoral system open — a bark that cured a specific fever did not fit a framework in which all fevers were an imbalance to be corrected.
It is also an early lesson in what demand does to a wild population. Harvesting killed the trees, Andean stands were stripped through the eighteenth and nineteenth centuries, and the solution was botanical theft: seeds smuggled out to Dutch and British plantations in Java and India, which then controlled world supply. The countries the tree came from received nothing.
Nomenclature verified against GBIF backbone taxonomy.