Malaria is one of the few infectious diseases for "Which we possess a positive specific. What an inestimable blessing quinin has been to humanity can be realized only by reading the writings of former times, when physicians were powerless against malaria and wore themselves and their patients out with useless and fantastic endeavors, and comparing them with Morton's or Torti's jubilations over their success with the wonderful drug.
Let us turn back a little and examine how malaria was treated in the ancient times. The therapy of the Greeks consisted principally in dietetic regulations. What should be eaten and drunk at every hour of the day was accurately determined for every kind of fever. They recommended also the drinking of large quantities of wine, baths, and inunctions.
Cleophantus in tertian fever advised wine internally and the pouring of hot water on the head for a long time before the paroxysm. Asclepias repudiated these doubtful curative measures.
According to Celsus, the therapy of Rome followed that of Greece. Before the outbreak of the chill patients were put in a warm bath. If this did not suffice, onions or warm water with pepper were administered, or warm poultices, warm potsherd, or inunctions with warm oil were employed. The regulation of diet was also important. In especially obstinate cases the patients were put on board vessels and sent to sea. They appear to have attributed the result of sea voyages not to the change of place, but to the movement; consequently patients were carried about in the streets or even in their dwelling. These simple regulations, at least, did not injure the patient.
The physicians of the middle ages, not content with this treatment, set up in its place a conglomeration of measures which recall more the Inquisition than medical treatment. It makes one shudder to read, for instance, the method by which Ludovicus Mercatus, otherwise so gifted, treated pernicious fever. He began with purges of manna, cassia fistula, and infus. rhei, followed by venesection of the right basilic vein, frictions, fumigations, constriction of the extremities, cuppings, etc.
Torti, who had the good fortune to be one of the first to employ Peruvian bark to any extent against malaria , writes in relation to the pernicious cases which he was previously forced to treat without it: "Nonnullas equidem, antequam in iisdem curandis Cortice uterer, etiam sine illo sanatas vidi; at paucas et difficillime."
In 1639, with the introduction of cinchona bark, a new age opened for malarial patients. The following is the memorable history of this great discovery, according to Markham (translated by Binz):
"In 1638 the Countess of Cinchon, the wife of the Viceroy of Peru, lay very ill with tertian fever at Lima, the capital city. The news was carried to Canizares, then Corregidor of Loxa, a town among the Andes in the present Ecuador. Though the natives in Peru were unacquainted with the curative power of the bark, those of the more northern lying countries appreciated its worth, and from them Canizares obtained the secret. He therefore sent a parcel of it to the vice queen. Her physician, de Vega, agreed to its employment and she recovered in a short time. In 1640 the Countess returned to Spain and carried with her a large quantity of the precious bark, which she distributed about her native place in the vicinity of Madrid. De Vega followed and brought likewise a large amount of the bark to Spain, which he sold at Seville for a hundred reales a pound. The Countess employed the bark so extensively that for a long time it bore the name 'Countess's powder' (pulvis comitissse), and Markham asserts that even to day the fame of her deeds in that region of Spain continues. The Jesuits, who were the missionaries to South America, also did good service in introducing the bark and spreading a knowledge of it.
"In the year 1642 the first paper appeared on it, and though in the beginning frequently condemned as useless, fraudulent, and injurious, the bark was admitted to be indispensable before the end of the century. La Fontaine sung it in 1682 in a two stanza poem, Poeme du Quinquina/ because it had cured Louis XIV; and Mme. de Genlis (1746-1831) wrote an interesting novel on the manner of its discovery. Having passed the period of skepticism, it eventually stood beside opium, undisputed."
According to Jos. Jussieu, who visited America in 1735, the first knowledge of the antifebrile action of Peruvian bark was manifested by the Indians of Malacotos, in the vicinity of Loxa.
Apart from the previously mentioned paper of Barba's, the first publications of any importance in regard to the employment of Peruvian bark in intermittent and pernicious fevers were those of Sydenham (1676), Morton (1692), and Torti (1712). The immortal works of these three men, from a clinical as well as a therapeutic standpoint, constitute the richest treasures of malarial investigation.
What enthusiasm and gratification these three felt are shown by their frequent assaults on the skeptics, who imputed various injurious effects to the new remedy. Morton, with touching piety, says: " ... Non possum non gratias maximas referre Deo Opt. Max. qui tantis viribus hunc simplicem Corticem instruxit . . . "
From these struggles the bark came out victorious, and the number of its followers grew from year to year. Still the opposition did not remain speechless, and Stoll and de Haen found themselves obliged to take up the cudgel again in defense of if. Even in our day we hear an occasional voice in favor of the old prejudice, but it is always feeble and usually attracts no attention. The discovery of quinin in the cinchona bark was the work of Pelletier and Caventou (1820).