Alberto Bailetti Wiese's research in "El Jesuita Agustín Salumbrino, la malaria y el árbol de quina" highlights the critical role of Agustín Salumbrino, a Jesuit pharmacist, in the discovery and dissemination of the quina (Cinchona) tree as a cure for malaria. This work underscores the importance of preserving traditional medicine and safeguarding plants from extinction due to their potential crucial importance for humanity, as exemplified by the Cinchona tree.
The research details how Salumbrino, leveraging indigenous knowledge, identified Cinchona bark as a specific and miraculous cure for malaria. This resulted in its regular exports and saved countless lives across continents. In the 19th century, it also brought about its massive cultivation to the Neilgherry or Nilgiri Hills in India. The book traces the arduous journey of Salumbrino to Lima, where he established a renowned Jesuit dispensary that became central to the distribution of quina bark.
The text also emphasizes the historical context of malaria as a devastating disease, impacting figures from popes to commoners, and the limitations of traditional Western medicine at the time. The Countess of Chinchón's legendary cure, which led Carl Linnaeus to name the genus Cinchona in her honor, is presented as a testament to quina's efficacy and Salumbrino's work.
Ultimately, the research advocates for the ongoing relevance of natural plant-derived medicines and the need for investment in neglected diseases, drawing a parallel between the historical significance of the Cinchona tree and the potential of other yet-to-be-discovered natural remedies. The overexploitation and near extinction of the quina tree in its native Peru serve as a cautionary tale, reinforcing the urgent need for conservation and sustained research into traditional medicinal plants.
Here is a summary of the book. The full text can be found in blog format at: https://lamalariayelarboldequina.blogspot.com/2013/07/capitulo-1-un-enemigo-invisible.html
It includes several annexes with a compendium of medicinal plants from Peru with their properties as described by the naturalist and Jesuit Bernabé Cobo, products sold by the Jesuit pharmacy in Lima, plants found on the shelves of this pharmacy, and plants from the high Andes where the Jesuits had the Juli mission in Puno.
-I-
The latest editions of Ricardo Palma's
"Tradiciones Peruanas" show his continued refinement of stories like
"Los Polvos de la Condesa." Palma meticulously revised details,
particularly character names, to align with historical sources he acquired over
time. For instance, the palace physician, initially "Cleto Martinez"
in the 1872 publication, became "Juan de Vega" after Palma consulted
works by Sir Clements R. Markham and Félix Cipriano Zegarra. Similarly, the Countess
of Chinchón, first named Leonor, was later corrected to Francisca Henríquez de
Rivera, based on Zegarra's 1879 historical study.
The text highlights Palma's account of a Jesuit
priest, whose name Palma didn't identify, who introduced the Cinchona bark to
cure the dying, Countess. This research suggests the Jesuit was Brother Agustín
Salumbrino, founder and pharmacist of the Jesuit Pharmacy at the San Pablo
College in Lima (now San Pedro Church).
Francisca Henríquez de Rivera, born into
Spanish nobility in the early 17th century, had a lineage connected to
aristocracy and even Saint Francis Borgia, who influenced the arrival of the
first Jesuits in Peru. Her mother, Inés Henríquez, a cousin of the Duke of
Lerma, served as a lady-in-waiting to Ana of Austria in France, secretly
relaying information to the Spanish court. It's plausible Francisca spent time
in Paris, which would later aid her as Vicereine of Peru.
After an initial marriage, Francisca married
Luis Gerónimo de Cabrera y Bobadilla, Count of Chinchón, in 1628 and moved to
Peru, where he became Viceroy. Their journey was arduous; the countess,
pregnant, traveled by land from Paita to Lima, giving birth in Lambayeque.
Historian Fernando de Montesinos confirmed their arrival and later witnessed a
major Auto de Fé in Lima in 1639 where Manuel Bautista Pérez and ten others
were executed.
Nineteenth-century historian Enrique Torres
Saldamando's work, "Los Antiguos Jesuitas del Perú," confirms the
Vicereine suffered from malaria and was cured with Cinchona bark, citing a
17th-century letter from Jesuit General Mutio Vitelleschi expressing
satisfaction that the Jesuits cured the Countess. This letter suggests the cure
occurred early in her time in Peru. Torres Saldamando's close collaboration
with Ricardo Palma at the National Library of Peru makes it highly probable
that Palma read this letter and drew inspiration from it for "Los Polvos
de la Condesa," attributing the cure to a Jesuit.
The hagiography of Agustín Salumbrino, edited
in Madrid in 1666, reveals he was born in Forlí, Italy, in 1564. His father,
possibly a Jesuit infirmarian and apothecary, desired his son to become a
priest, but Agustín showed little interest. The family moved to Milan, where
Agustín studied with the Jesuits at the Brera College, now home to the
Pinacoteca di Brera and the Orto Botanico di Brera, where he likely learned
about medicinal plants. Salumbrino's biographer notes he was not a brilliant
student. At 17, after his father's death, he left his studies to serve Count
Alejandro Aurelio Mansel, a Roman nobleman. The text also mentions Vincenzo
Salumbrino, a Jesuit priest and pharmacist, possibly Agustín's younger brother,
known for his work with antimony, highlighting a family tradition in
health-related professions and the burgeoning Paracelsian medical ideas among
some Jesuits.
-II-
In a historical narrative, an anonymous Jesuit
continues the story of young Salumbrino, whose fate intertwines with that of
Count Alexandro Aurelio Mansel. The period is set during the papacy of Gregory
XIII, a time of significant turmoil in Italy. Leopold Von Ranque's
"History of the Popes" details a peninsula rife with violence,
conflicts involving the Papal States, Turks, Protestants, England, France, and
the Netherlands, and internal aristocratic disputes. Adding to the chaos, bands
of outlaws plundered papal cities, and justice was severely compromised, with
crime tolerated, judges corrupted, and serious offenses often ignored, as
described by Alejandro Dumas in "Celebrated Crimes, the Cenci."
Another pervasive issue was malaria, which
devastated populations in Rome and the Papal States. This disease also hindered
missionary efforts in Asia, a cause championed by Pope Gregory XIII with the
aid of the Jesuits and the support of King Philip II of Spain.
Count Mansel, a Roman noble, found Salumbrino
to be "spirited and alert, of good ability and keen wit," entrusting
him with important business and secrets. Mansel, whose wealth came from
vineyards and wine production, saw Salumbrino quickly excel, becoming his
principal and most trusted servant, which sparked jealousy among other staff.
Young Salumbrino, proud and full of enthusiasm, dreamed of honor, fortune, and
perhaps a family with a mysterious lady who offered him an apple from the
count's orchard. This seemingly innocent encounter, where their hands touched,
left Salumbrino in such remorse that he wept over this "sin" for the
rest of his life, a scene interpreted as a metaphor for temptation or the
worldly life he abandoned.
Tragedy struck when a prince, Pope Gregory
XIII's nephew, was found dead. Due to public animosity between the victim and
Count Mansel, the Count and all his servants, including Salumbrino, were
arrested and subjected to harsh imprisonment in malarial-ridden towers near
Castel Sant'Angelo. During the trial, envious servants falsely accused
Salumbrino, leading to his condemnation to public death. At just twenty years
old, he awaited execution.
Members of the Confraternity of San Giovanni
Decollato (Della Misericordia) and a Jesuit confessor visited Salumbrino in
prison to prepare him for death, encouraging him to accept his fate, forgive
his persecutors, and find spiritual solace. Their efforts succeeded; Salumbrino
"first wept for his sins, conforming to the will of God, without turning
against the judges or those who persecuted him."
Miraculously, just as he was about to be
executed, the judges revoked the sentence, and Salumbrino, along with Count
Mansel and the other servants, was set free. His hagiographer attributes this
to divine intervention, claiming the Queen of Angels appeared to Salumbrino in
his cell, promising his freedom. This vision, despite its incongruence with
traditional Catholic apparitions to non-saints, was widely circulated by the
Society of Jesus, recognizing Salumbrino among other Jesuits like Ignatius of
Loyola, Stanislaus Kostka, and Aloysius Gonzaga who experienced such visions.
One explanation is that negotiations and
economic agreements between the families involved, such as a revised offer from
Count Mansel, led to their release. Another possibility is the intervention of
Cardinal Carlo Borromeo, Salumbrino's protector and a friend of Pope Gregory
XIII, who advocated for their freedom. Borromeo, who later died of malaria
himself after traversing swampy areas, symbolized the hidden threats of the
natural world alongside human intrigues.
-III-
Agustín Salumbrino's Life as a Jesuit and the
Scourge of Malaria
After his release from prison, Agustín
Salumbrino was welcomed by the Jesuits in Milan, serving as a nurse and
performing other duties at the Brera College around 1584. This was the same
year Saint Charles Borromeo died, a victim of malaria (Plasmodium). Borromeo,
unaware of the microscopic enemy, succumbed rapidly, highlighting the invisible
yet deadly nature of the disease, far more dangerous than the Calvinist and
Lutheran adversaries he battled. Borromeo contracted malaria at the Sacro Monte
di Varallo, a pilgrimage site near his family's castle in Arona, Lombardy,
which recreated the urban structure of Jerusalem.
The 16th century lacked understanding of
Plasmodium. It wasn't until 1880 that French military doctor Charles Louis
Alphonse Laverán discovered these parasites in the blood of malaria victims
using a rudimentary microscope. Despite scientific advances since then, much
about Plasmodium, its complex biological mechanisms, evolutionary adaptations,
and responses to treatments like quinine, remain unknown. Its ability to mutate
also poses an ongoing threat.
The detailed progression of Cardinal Borromeo's
illness is recorded in the early 17th-century work "Life of S. Carlos
Borromeo." Modern scientific understanding suggests that an infected
mosquito injected Plasmodium into Borromeo, leading to the parasite's
proliferation in his liver cells, then in his red blood cells, causing symptoms
like chills, fevers, and sweats. The destruction of red blood cells led to
obstructed arteries and veins, brain damage, anemia, and loss of consciousness.
The Plasmodium's camouflage tactics evaded his immune system, and medical
treatments failed. Borromeo died at 46, his final days marked by confusion and
continuous fevers, indicating the parasite had reached his brain.
His death was widely mourned, with Pope Gregory
XIII attending the funeral in Milan, where young Salumbrino, recently freed,
was likely among the mourners. Borromeo's legacy extended to Luis Gonzaga, a
17-year-old prince who studied at Brera College, where he formed a close bond
with Salumbrino. Gonzaga, hailing from malaria-endemic areas of northern Italy,
had suffered from recurrent fevers (quartan malaria), a chronic condition that
weakened him throughout his short life, exposing him to other ailments.
In 1585, with his father's reluctant consent,
Luis Gonzaga traveled to Rome to enter the Jesuit novitiate, accompanied by
Salumbrino. This journey, preceding a later trip in 1589, saw them meet figures
like Saint Philip Neri and Saint Felix of Cantalice. Luis Gonzaga entered the Novitiate
on November 25, 1585, while Salumbrino returned to Brera College.
Salumbrino's Dedication to Service and Medical
Knowledge
Salumbrino's hagiography confirms his lifelong
dedication to nursing at the Milan College, highlighting his early and
consistent vocation for aiding the sick. His prior experience with Count
Mansel's vineyards also equipped him with knowledge of plants, facilitating his
work in the college's pharmacy, ensuring the quality of medicines. Brera
College, with its large student body and staff, maintained a well-equipped
infirmary, medicinal garden, and pharmacy, drawing on a vast network within the
Jesuit order. Salumbrino also specialized in cooking, understanding the
importance of diet for patient recovery, especially in the absence of effective
malaria treatments.
In 1588, after four years in Milan, Salumbrino,
dissatisfied with worldly pursuits, decided to join the Society of Jesus, a
choice he attributed to a vision of the Virgin Mary. Count Mansel, eager to
retain Salumbrino's valuable services, tried to dissuade him with offers of
wealth and honor, but Salumbrino remained steadfast in his religious calling.
He entered the novitiate of San Andrés in Rome in 1588, reuniting with Luis
Gonzaga.
In 1589, Salumbrino accompanied Luis Gonzaga as
his nurse on a mission to reconcile a dispute between Luis's brother Rodolfo
and cousin Vicente I over the state of Solferino. Their journey took them to
Mantua, a city strategically located amidst vast swamps, where malaria was used
as a biological weapon against besieging armies. The conflict was resolved
peacefully.
Upon their return to Rome in 1590, Salumbrino
made his simple vows. The same year saw the deaths of Pope Sixtus V and his
successor Urban VII, both succumbing to malaria, underscoring the disease's
devastating impact. In 1591, Luis Gonzaga himself died at 23 from a combination
of malaria, jaundice, and typhoid, likely attended by Salumbrino.
-IV-
The Marvel of Quina: From Indigenous Knowledge
to Global Cure
Ricardo Palma's tradition, "Los Polvos de
la Condesa," credits a Loja indigenous man named Pedro de Leyva for
revealing the fever-reducing properties of the quina tree (Cinchona
officinalis) to a Jesuit. This Jesuit likely passed the knowledge and initial
bark samples to Agustín Salumbrino, founder and pharmacist of the Society of
Jesus's dispensary in Lima, who then used it to cure the Viceroy Countess of
Chinchon Francisca Henríquez de Ribera of malaria. The Cinchona officinalis,
though depleted, still exists in "patches" in Loja, Ecuador, as
confirmed by university studies and personal observation.
The quina tree's fruit, a capsule containing
winged seeds, relies on wind for dispersal, demonstrating nature's intricate
design for regeneration. Cultivating quina is challenging, demanding specific
conditions like acidity, light intensity, and temperature. The plant itself is
resilient, its leaves protecting new shoots from intense sunlight and
predators, possibly by altering its chemical composition. This natural treasure
highlights both its fragility and adaptability, urging us to understand and protect
it.
Ancient Wisdom and Modern Discoveries
Early humans learned to use medicinal plants
through observation, experimentation, and a deep, intuitive connection with
nature "lumen naturae." This innate understanding wasn't exclusive to
humans; animals also exhibit it, just as the Plasmodium parasite showcases a
"genius mechanism" for reproduction. Plants, too, have evolved
sophisticated genetic mechanisms for self-healing and survival, and remarkably,
they produce compounds like quinine that primarily benefit humans, not themselves.
These insights echo the views of 17th-century Jesuit naturalists like
Nieremberg, who saw nature as a divinely ordered system, where imperfections
served a greater, mysterious purpose.
The earliest known written account of quina
bark from the "New Kingdom" (likely Cartagena) appears in Nicolás
Monardes's "Historia Medicinal de las cosas que se traen de nuestras
Indias Occidentales," published in 1571. Monardes, a Seville physician and
merchant who never visited the Americas, described a large tree with
heart-shaped leaves, no fruit (in his understanding), and a thick, bitter,
astringent bark used by indigenous people for fevers and "cámaras" (a
term that likely included malaria). Although Monardes didn't name the tree, his
description aligns perfectly with Cinchona. This means the medicinal properties
of quina were known in Europe before Salumbrino was born, yet it was Salumbrino
who identified it as a specific, miraculous cure for malaria and began its
regular export.
Resistance and Acceptance of Quina
Pedro de Leyva, the indigenous man from Loja,
was likely a curandero shaman. Natives attributed medicinal properties to
spirits residing in plants, a concept that paralleled European Paracelsian
ideas of "lumen naturae" and invisible "germs" (as
described by Jesuit Athanasius Kircher), though these were often dismissed as
superstition.
In 1572, Juan Fragoso, a court physician to
Spanish monarchs, published a work copying Monardes's description of the tree.
Despite its availability, Fragoso never experimented with quina, missing the
chance to save his royal patients, Charles I (who died of malaria in 1586) and Philip
II (who died in 1598, despite being attended by sixty physicians). Both
monarchs relied on religious relics and traditional, ineffective treatments
like bleedings and purges, rather than the "living relic" growing in
the New World.
By the 1630s, quina bark powder was being sold
in Lima as a highly effective fever remedy, as recorded by Friar Antonio de la
Calancha and Jesuit Bernabé Cobo. Cobo's detailed instructions on its
administration suggest a close relationship with Salumbrino's dispensary. He
also noted that the powders were "known and esteemed not only throughout
the Indies but in Europe," with urgent requests arriving from Rome.
The Quina Tree: A Universal Archetype
Across ancient religions, the tree holds a
central place as a symbol of life and connection to the divine. From the
Abrahamic religions' Tree of Life to the Buddhist Bodhi tree and the Hindu
Asvattha, the tree is a universal archetype. In the Andean worldview, trees
mediate between worlds and times, embodying a feminine nature linked to the
moon and water. Indigenous healing practices, often deemed "idolatry"
by colonizers, integrated the physical with the spiritual. For instance, the
Aymara words for "blessed" (qullanätawa, qullanarakiwa) derive from
"qulla," meaning "remedy that cures," signifying a holistic
view where the sacred is inherent in health.
In pre-Hispanic Andean culture, health was a
spiritual concept, deeply intertwined with cosmic harmony. Healing focused on
restoring this balance rather than solely on a plant's chemical properties, a
system that often proved more effective than 16th and 17th-century Western
medicine.
Salumbrino's Enduring Legacy
The specific identification of Cinchona bark as
a malaria cure emerged in the early 17th century, partly driven by the arrival
of the more lethal Plasmodium falciparum strain with African slaves. It
required someone like Salumbrino, with deep experience in treating malaria and
recognizing its unique symptoms, to connect indigenous knowledge with Western
understanding. He transcended traditional Galenic methods, experimenting with
the quina bark to decipher its secret.
Agustín Salumbrino successfully assembled the
puzzle, linking malaria to its remedy. He merged native American wisdom with
contemporary Western medical insights, and crucially, he ensured the continuous
export of quina bark to Europe and beyond, saving countless lives across
continents. This accomplishment is comparable to notable military conquests,
such as those of Alexander the Great, who expanded his empire across Asia yet
ultimately fell victim to a mosquito-borne illness.
Even in 1812, long after Ricardo Palma's time, José
Pastor Larrinaga noted the initial resistance to quina among prominent European
and even Lima physicians. The novelty of the cure challenged two millennia of
established medical practices, leading the Jesuits to initially keep its
benefits secret, hence the term "Jesuit powders." Physicians like Dr.
Juan de la Vega faced ridicule for advocating quina, while others, like French
physician Francisco Blondel, even attributed its effectiveness to a pact with
the devil.
Ultimately, the quina tree represents more than
just a biological entity; it's a profound mystery, a "miracle" that
continues to inspire awe. As Jesuit Anthony De Mello observed, true
understanding of a tree comes not from description but from perceiving it as a
wonder.
-V-
Rome, Malaria, and the Early Days of Quina
In summer and early autumn, the appearance of Sirius,
the brightest star in the Canis Major constellation, coincided with the dreaded
spread of malaria in Rome. Some believed the star emitted malevolent vapors
from the marshy lands, particularly affecting peasants working in fields around
the Pontine Marshes south of the city. Pope Sixtus V himself contracted malaria
while overseeing drainage projects in these marshes, ultimately dying without
achieving his goal.
Malaria in rural areas led to reduced wheat
cultivation and, consequently, famine as sick farmers migrated to the city. The
primary care center for these afflicted peasants was the Hospital of the Holy
Spirit (Ospedale Santo Spirito), located near the prison where Agustín
Salumbrino was once held. This hospital, closely associated with the Society of
Jesus, was overwhelmed during peak malaria season, often housing 400 patients
in beds designed for 150.
Salumbrino, working as a nurse at the Ospedale,
performed myriad tasks: admitting patients, providing first aid, managing
prescriptions, coordinating with the pharmacy, assisting with diets, monitoring
vital signs, and reporting to doctors. He witnessed the ineffectiveness of
traditional Western treatments like bloodletting, purges, and emetics, which
often weakened or killed patients. His extensive experience with malaria in
Milan and Rome, despite not being a physician (a profession forbidden to Jesuits
by rule), made him an unparalleled expert on "paludic fevers" in the
New World. Although he didn't know about Plasmodium, he understood how to stop
the disease's destructive march. Years later, he would send shipments of quina
bark from the Jesuit dispensary in Lima to this very hospital in Rome, where
its therapeutic efficacy would be confirmed and distributed across Europe and
Asia.
Salumbrino's Vocation and the Call to the New
World
From 1588 to 1603, Salumbrino served as a nurse
and pharmacist for the Society of Jesus in Rome. This daily interaction with
the sick and long working hours for two decades honed his attention to detail,
enabling him to discern subtle symptoms and the effects of medicinal
substances. He developed a resilient spirit, a constant drive for solutions,
and the emotional distance needed for calm decision-making, while maintaining a
profound empathy for suffering.
At the Roman College's dispensary, Salumbrino
also gained familiarity with plants from other continents, as Jesuit pharmacies
globally exchanged information and botanical samples. He cared for fellow
religious, stocked medicinal gardens, worked in the dispensary, accompanied
Jesuits on travels, and participated in charity work at urban hospitals,
especially the Hospital of the Holy Spirit.
A turning point came in 1600 with the arrival
of Father Diego de Torres Bollo, procurator for the Peruvian Jesuits. Torres
Bollo, known for defending indigenous rights and confronting Spanish abuses,
was tasked with bringing an experienced nurse and pharmacist to Lima for the
costly infirmary being built at the San Pablo College. This also presented an
opportunity to gather more information on Peruvian medicinal plants, as
European doctors Monardes and Fragoso had raised questions about a mysterious
fever-curing tree. Salumbrino, highly valued in Rome, was not initially
considered for this mission.
However, Torres Bollo fell gravely ill in Rome
and was nursed back to health by Salumbrino. Torres Bollo, deeply impressed by
Salumbrino's care and amiable, cheerful demeanor, lobbied for him to be
assigned to his mission. This request, coming from a priest entrusted with
founding the new Jesuit Province of Paraguay, was not to be refused.
This decision profoundly changed Salumbrino's
life. At forty, he was an established Jesuit, content in Rome. Unbeknownst to
him, he was about to embark on one of the most important missions in the
universal history of medicine.
The Journey to the New World and the Quest for
Quina
Torres Bollo, still convalescing, began his
journey from Rome to the New World, accompanied by Salumbrino, who provided
care along the way. Their itinerary included visits to revered sites: the
Sanctuary of Our Lady of Loreto, Assisi (for relics of St. Clare), Milan (for
relics of the not-yet-canonized Charles Borromeo), and Turin (to obtain a copy
of the Shroud of Turin).
In Spain, they met King Philip III and the Duke
of Lerma, who was related to the Countess of Chinchón, famously cured by quina
bark. They also visited the Castle of Loyola to pray in St. Ignatius's
birthplace. Torres Bollo, a skilled diplomat, secured King Philip III's
permission for fifty religious to travel to Peru, including Salumbrino,
overcoming restrictions for foreigners. He also advocated for the rights of
indigenous people and the protection of African slaves, though these pleas met
with limited practical success.
The group traveled to Andalusia, birthplace of
Jesuit naturalist Bernabé Cobo, and then to Seville. They spent two months in a
small hospital in Sanlúcar de Barrameda awaiting embarkation on Royal Armada
ships bound for Cartagena de Indias. This epic journey underscored Salumbrino's
transition from a respected Roman healthcare provider to a pivotal figure in
the global dissemination of a life-saving cure from the Americas.
-VI-
A Treacherous Journey to the New World
In 1604, a majestic fleet of the Royal Armada
set sail from Seville, carrying Agustín Salumbrino and other Jesuits on a
fateful voyage. They navigated the Guadalquivir River to Cádiz, then headed
towards the Canary Islands before venturing into the vast Atlantic. Their first
stop was Dominica in the Antilles. Onboard, the priests and novices devoted
themselves to prayer and theological study, eager to spread the Gospel. As the
ship's nurse, Salumbrino had his hands full, as many missionaries suffered from
seasickness.
After six weeks, dwindling water and food
supplies became critical, but hope reappeared with the sighting of Dominica.
Natives traded turtles, seafood, fish, and fruits for knives, glass beads, and
silk ribbons. After two weeks, the fleet crossed the Caribbean, reaching Cartagena
de Indias, the gateway to the Viceroyalty of Peru. The journey was arduous, and
three missionaries died, one succumbing to a relentless fever and losing his
sanity.
Cartagena: A Crossroads of Wealth, Disease, and
Injustice
Cartagena de Indias, a port surrounded by
jungles and malarial swamps, served as the primary exit point for gold, silver,
and other riches from the Viceroyalty of Peru, along with emeralds and pearls.
However, it was also the entry point for thousands of enslaved Africans. These
men, women, and children were transported in dark, unventilated, overcrowded,
and unsanitary slave ships. Unbeknownst to anyone, these "floating
dungeons" also carried the highly lethal Plasmodium falciparum, the most
dangerous strain of malaria, along with other diseases.
The reality of the New World was a shock to
many young Jesuits. They expected to evangelize "savages and
infidels," ready to face martyrdom. Instead, they found a native
population in Cartagena decimated by diseases from the Old World, replaced by
enslaved Africans. Father Diego de Torres Bollo founded the Jesuit College in
Cartagena, whose members soon condemned the brutal treatment of slaves, a
stance increasingly divergent from some European Jesuit theologians who held
prejudiced views about Black people.
Father Alonso de Sandoval documented these
atrocities in his seminal work, "A Treatise on Slavery," emphasizing
that the Jesuits' priority upon slave ships' arrival should be providing water
and medical care, not baptism, to save their lives. Another Jesuit, Luis de
Frías, even faced Inquisition charges for preaching in 1614 that striking an
enslaved person was a greater sin than striking an image of Christ, as the
former was a "living image of Christ."
The Scourge of Malaria in the New World
Cartagena, a city of mostly wooden and cane
houses, had an estimated Spanish population of 8,000, nearly matched by African
slaves and their descendants, with a minimal indigenous population. The Plasmodium
found a fertile ecosystem for unchecked expansion, becoming endemic and
wreaking havoc across Spanish America. Cartagena was also a gateway for other
epidemics, such as smallpox.
Juan Méndez Nieto, the first physician to
arrive in Cartagena in 1569, documented the presence of tertian and quartan
fevers (malaria) in his "Discursos Medicinales" (1606-1609). He
detailed his extensive, though often ineffective, 50-year treatment regimen for
malaria, which included bloodletting, purges, enemas, emetics, and even the
application of leeches to hemorrhoids, all guided by astrological beliefs.
In contrast, Salumbrino did not practice
bloodletting. An anecdote recounts how a fever-stricken priest in Cartagena was
bitten by a bat, which was seen as performing the necessary bloodletting,
leading to his recovery, a testament to the blind faith in such methods at the
time.
Genetic studies confirm that Plasmodium
falciparum, responsible for malignant tertian malaria, arrived in Peru in
the 16th and early 17th centuries, primarily via African slaves through
Cartagena and also via Brazil. These studies, involving international
collaborations, traced two distinct genetic groups of the parasite to their
African roots, providing scientific evidence for the historical accounts of
slave trade routes.
The Perilous Inland Journey and Salumbrino's
Arrival in Lima
Torres Bollo and his missionaries continued
their journey from Cartagena to Portobelo, a port notorious for fevers. They
then crossed the Isthmus of Panama overland, marveling at the lush vegetation
and wildlife but enduring ant infestations and crocodile-infested swamps. They
navigated through heavy downpours, often riding through rivers and wetlands,
sleeping in precarious shelters, and facing the risk of snakebites. After four
days, they reached Panama City, another fever-ridden port with a small Spanish
population and a large enslaved African community.
Upon arriving at the port of Paita in Peru,
Torres Bollo was instructed by the provincial of Lima to travel overland to
Trujillo to welcome the new Viceroy of Peru, Gaspar de Zúñiga, Count of
Monterrey, who was ill and convalescing there. Torres Bollo, accompanied by two
companions (likely including Salumbrino to care of them), diverged from the
main group. They arrived in Trujillo around October 1604, with Torres Bollo
reaching Lima on November 22, 1604, while the rest of the group, delayed by sea
conditions, arrived a month later, celebrating Christmas together.
The Hidden World of Slave Trade and
Salumbrino's Future
Linda A. Newson and Susie Minchin's "From
Capture to Sail" offers valuable insights into Cartagena's early
17th-century slave market, detailing the operations of Manuel Bautista Pérez, a
prominent slave trader. Pérez, a Portuguese New Christian, was a teenager when
Torres Bollo and Salumbrino arrived in 1604. He later became immensely wealthy
through a network trading slaves, textiles, and other goods between Africa,
Lima, and beyond. Slave traders and their staff, unlike missionaries, often knew
African languages, exemplified by Tomé Quaresma, a physician who attended
Pérez's slaves and communicated with them in Guinea languages even when they
were imprisoned by the Inquisition.
Cartagena was one of the few Spanish-authorized
ports for slave trading, facilitating both legal and contraband human cargo
through extensive bribery. Slaves were medically inspected, housed in barracks,
and then sold at auctions or fairs, with many transported to Lima. This
intricate and brutal system of the dark trade, unknowingly facilitated the
spread of diseases like malaria, which Salumbrino would later fight with the quina
tree.
-VII-
Salumbrino's Arrival in Lima and the Endemic
Malaria
Agustín Salumbrino arrived in Lima, the
"City of Kings," in November 1604, amidst preparations for the
arrival of Viceroy Conde de Monterrey. The city was laid out in a grid, with
each block containing four plots, allowing ample space for gardens irrigated by
an ancient system of canals. These gardens were fertile grounds for introducing
European, African, and Asian plants, including grapes, olives, and medicinal
herbs. However, this flood irrigation also created ideal breeding grounds for
mosquitoes and, consequently, Plasmodium.
Deforestation for firewood further exacerbated
the problem, pushing mosquitoes towards the burgeoning city, where the
concentration of people facilitated the spread of malaria. Surrounding
haciendas, with their intensive irrigation for new crops like wheat, olives,
and sugarcane, also created stagnant water pools, making them malaria hotspots
for workers, primarily enslaved Africans. Ricardo Palma's tradition "La
Casa de Francisco Pizarro" notes that "terciana fevers"
(malaria) were common among newly arrived Spaniards ("chapetonada"),
often proving fatal before the discovery of quinine.
Saint Rose of Lima, a contemporary of
Salumbrino, lived in a modest home with a garden abundant in malaria-carrying
mosquitoes. Testimonies for her beatification recount a miraculous pact she had
with these insects, preventing them from biting her—anecdotes that highlight
the concept of lumen naturae, the inherent connection between light and
darkness in nature. Notably, most of the miracles attributed to Saint Rose
during her canonization process were healings of malaria (tercian and quartan
fevers), suggesting a potential, yet scientifically unproven, link to the
burgeoning use of quina bark from the Jesuit dispensary during the same period.
Malaria in Colonial Lima: A Public Health
Crisis
When Salumbrino reached Lima, Africans and
Afro-Peruvians made up 40% of the city's 25,000 residents, outnumbering
Spaniards. Many enslaved Africans,
brought via Cartagena and Panama, carried Plasmodium falciparum, which
became entrenched in Lima's ecosystem. The city even had a district named Malambo
(and a street, Malambito) where malambo trees (Canella winterana), with
anti-fever properties, were planted to combat the disease among newly arrived
enslaved people.
In the 19th century, Chinese laborers suffered
greatly from malaria, especially on the guano islands off the Peruvian coast.
By the early 20th century, El Comercio newspaper lamented malaria as a
"scourge" rampant across Peru, despite the country being the origin
of quina. The newspaper urged the state to promote local quina exploitation, as
Peru, ironically, imported quinine from Italy and England. The common phrase
"le entró frío como de terciana" (he got chills like tertian fever)
illustrates malaria's pervasive presence in daily life.
Healthcare in 17th-Century Lima: Challenges and
Traditional Practices
Unlike Rome, Lima's climate and abundant fresh
food supply, from internal gardens and surrounding haciendas, likely bolster
the population's immune systems, aiding recovery from milder malaria cases. The
city lacked Rome's periodic famines, and its benevolent climate for agriculture
provided ample produce, meat, and seafood. This vitality, particularly evident
in the festive Christmas season, likely charmed Salumbrino.
However, the city's healthcare system in the
early 17th century was precarious. Before Salumbrino founded the Jesuit
dispensary, Lima had about a dozen pharmacies, many attached to hospitals.
These pharmacies often stocked adulterated or spoiled European medicines, and
locally produced remedies by untrained pharmacists were unreliable. A 1603 Lima
City Council agreement highlights the poor state of pharmacies and the concern
over ineffective or harmful medicines.
Most of the population could not afford
doctors, of whom there were only nine for over 40,000 people in 1630, alongside
ten surgeons and 53 barbers who performed bloodletting. Hospitals were
primarily charity centers run by confraternities. Enslaved Afro-descendants
often relied on public charity or were simply abandoned. The Jesuit order,
however, maintained a dedicated infirmary for its enslaved population. The
Hospital of San Bartolomé for Black people, founded in the mid-17th century by
Augustinian friar Bartolomé de Vadillo with Jesuit support, addressed this dire
need. Indigenous populations migrating from the highlands to work in the fields
were also highly susceptible to malaria.
Folk Remedies, Medical Theory, and the Quina
Revolution
Faced with this limited formal healthcare,
Lima's population relied on custom and home-based remedies. Everyday health and
malaria management were family matters. Dietary rules, influenced by Galenic
humoral theory, dictated what to eat and drink. Malaria was treated with
bloodletting by barbers, warm baths, frictions, or cupping to induce sweating,
purges, and emetics to expel "harmful humors." Even decades after
Salumbrino, physicians like Francisco de Vargas Machuca still advocated
bloodletting for all fevers, including malaria.
Lima's residents also used popular recipes from
handwritten notebooks, some predating quina's widespread use. These included
drinking celery juice or clover leaves for tertian fevers, and specific diets
for quartan fevers. Strict rules govern meal and water intake, often guided by
church bells. The color of milk (black cow's milk for cooling properties) also
played a role in folk medicine. Favorite saints like Cosmas and Damian were
invoked for protection against plague.
The Jesuit dispensary in Lima became a central
source for reliable ingredients for home remedies. During the 17th century,
prescriptions in recipe books began explicitly referring to the Jesuit
dispensary and quina bark (cascarilla) for tertian and quartan fevers,
providing detailed instructions, including prices. A recipe calls for mixing
sour orange juice, water, sugar, and quina bark powder, to be taken before
chills begin.
This blend of traditional knowledge, Galenic
theory, and the eventual widespread adoption of quina bark highlights a period
of significant transition in medicine, where empirical observation, championed
by individuals like Salumbrino, slowly began to transform healthcare practices.
VIII
Early Jesuit Missionary Medicine in Peru
The Jesuits arrived in Peru in March 1568, led
by Provincial Father Jerónimo Ruíz del Portillo. A primary focus was
ministering to indigenous people at the Hospital of Santa Ana. Records from
1568 show that young Creole men, sons of nobles and conquerors, would shed
their capes and swords to make beds and serve the indigenous patients. This
practice, emphasizing that Christ's face could be seen in every sick person,
inspired many Spaniards and Creoles to form lay confraternities to support
hospitals.
A decade-long inspection of the Hospital of
Santa Ana, led by Jesuit Father Esteban de Ávila and later Father Francisco de
Vitoria, revealed severe problems. These included: pharmacy shortages,
negligence, mismanagement of medicinal herb gardens and poultry farms,
chaplains unable to speak indigenous languages, corruption, personnel
irregularities, and mistreatment and deaths of enslaved Africans working at the
hospital, which were often concealed. The Jesuit commissioners rigorously
investigated and reported these issues to the Viceroy.
By the late 16th century, the Jesuits also
established their own well-funded infirmary at the Colegio Máximo de San Pablo
in Lima. Their first infirmary and dispensary in the Viceroyalty of Peru,
however, was in the Juli mission near Lake Titicaca, established decades
earlier in 1576. Here, indigenous people, usually reluctant to enter hospitals,
eagerly sought care and Jesuits became familiar with indigenous pharmacopoeia.
Lima Jesuits also provided crucial aid during a devastating smallpox epidemic
in 1586 after a major earthquake. These experiences highlight why Procurator
Diego de Torres Bollo was tasked with bringing an experienced nurse and
pharmacist, like Agustín Salumbrino, to Peru in the early 17th century—a
decision that unexpectedly led to the global discovery and spread of quina for
malaria.
Salumbrino's Impact and the Rise of the Jesuit
Dispensary in Lima
Shortly after Salumbrino's arrival in Lima in
November 1604, a major earthquake struck, which was witnessed by Bernabé Cobo
(then 22) and Antonio Vásquez (26), who would later write Salumbrino's
hagiography. Salumbrino, already in his forties, brought a wealth of
experience.
Under the new Provincial, Father Esteban Paez
(appointed in 1604), Salumbrino significantly improved the College's healthcare
facilities. He "with his good industry improved things in such a way that
he formed a good dispensary, which until then they had not had, and planted the
necessary herbs for it." He also organized patient offices and
meticulously cared for all, from religious to enslaved Africans and servants,
treating everyone with utmost dignity.
Salumbrino's activities in Lima, particularly
his work at the renowned dispensary he founded before the arrival of the
Countess of Chinchón in 1629, were deeply intertwined with the Jesuit
Provincials' terms. During Father Juan Sebastián de la Parra's tenure
(1608-1617), Salumbrino notably assisted at the Hospital of Santa Ana for
indigenous people and helped establish two confraternities for the Hospital of
San Andrés. He also witnessed the death of Saint Rose of Lima in 1617, who
lived near the dispensary.
Under Father Diego Álvarez de Paz (1617),
Salumbrino played a critical role during a measles and smallpox epidemic,
preparing medicines and guiding Jesuits who risked their lives to aid the
indigenous population. From 1620 to 1626, under Juan de Frías de Herrán,
Salumbrino participated in the canonization festivities for Ignatius of Loyola,
Francis Xavier, and his friend Saint Luis Gonzaga.
Father Diego de Torres Vázquez, the Provincial
who received Viceroy Conde de Chinchón and his wife Francisca Henríquez de
Rivera, became the Viceroy's confessor. The Vicereine's family ties to
Francisco de Borja, a former Jesuit General, likely fostered her close
relationship with the Society of Jesus. She would famously be cured of malaria
with quina bark, a testament to Salumbrino's work.
Salumbrino's Enduring Legacy in Lima's
Healthcare
For 37 years until his death, Salumbrino
oversaw the College's infirmaries. The main infirmary, built in the late 16th
century, likely occupied the area of today's Colonial Patio of Peru's former
National Library. A separate house across the street served as an infirmary for
enslaved Africans.
In these early decades, Salumbrino cared for
many prominent Jesuits, including those who defended native populations and
enslaved people, such as Antonio Ruiz de Montoya, Luis de Valdivia, Diego de
Avendaño, Alonso de Sandoval, and Diego Gonzales Holguín. He assisted
dying Jesuits like Esteban Paez (1617), Juan Sebastián de la Parra (1622),
Ludovico Bertonio (1626), and Juan de Frías de Herrán (1634). Although little is known about the Jesuits'
daily involvement in Lima's main hospitals (Santa Ana for indigenous people and
San Andrés for Spaniards), records suggest Salumbrino significantly contributed
to managing their pharmacies. He also oversaw the health of students at the
Royal College of San Martín and seminarians at the Jesuit novitiate and in
Santiago del Cercado, whose indigenous population also benefited from Jesuit
care.
Jesuit missionaries were crucial sources of
information for Salumbrino on native medicine. Bernabé Cobo, who lived
intermittently with Salumbrino at San Pablo, shared his knowledge of native
medicinal plants, compiled in his "Historia del Nuevo Mundo." Cobo
specifically mentioned the "fever tree" from Loja, described its
cinnamon-like bark, and noted its effectiveness in curing fevers when ground
into powder—information likely sourced from Jesuits in Quito.
Cobo documented over a hundred native medicinal
plants, including quinoa (anti-inflammatory), maca (fertility), chicha (for
kidneys), and coca (for asthma, digestion, toothaches). Jesuit naturalists,
like José de Acosta, Ludovico Bertonio, and Diego Gonzales de Holguín,
emphasized the inherent value of plants beyond their utility.
The Society of Jesus fostered deep connections
with native cultures, learning their languages and inculturating the Gospel,
leading to a progressive unity between European and American traditions. This
"Policy of Accommodation," while later criticized by some within the
Catholic Church, allowed Jesuits to adapt to native customs, including healing
rituals like the Mapuche's machitun. This approach was pivotal in Asia
too, where two French Jesuits cured Chinese Emperor Kangxi of malaria with
quina bark, leading to the Jesuits' establishment in Beijing.
However, this adaptation ultimately led to
accusations of being overly sympathetic to indigenous "superstitious
rites," contributing to the Jesuit expulsion from Spanish territories in
1767. This expulsion caused severe damage to public health in the Viceroyalty,
halting the development of medicine informed by native knowledge and ending the
compassionate missionary medical practice.
Salumbrino's Enduring Influence and Miraculous
Healings
Agustín Salumbrino established relationships
across Lima society. He worked with doctors and surgeons, supplied free
medicines to missionaries, and provided care at San Pablo and in people's
homes, including the Viceroy and other high-ranking officials who sought his
guaranteed remedies.
His connection with Saint Rose of Lima is
particularly notable. Her frequent attendance at the Jesuit church, her
association with Jesuit priests, and her proximity to the Jesuit dispensary
suggest a link. Saint Rose also practiced missionary medicine, distributing
medicines and alms (presumably from the dispensary) to the sick. The close
relationship between her miraculous healings, often involving "sweat as a
sign of successful healing," and Salumbrino's quina, which induces
sweating, is striking. This overlap raises questions about the interplay
between spiritual intervention and pharmacological efficacy, particularly given
the large number of malaria cures attributed to Saint Rose's tomb soil during
the same period when quina began to be widely distributed by the Jesuits.
Salumbrino's reputation extended to cases where
conventional medicine failed. He was known to assess critically ill patients,
sometimes predicting their recovery against medical odds, and was even
attributed with the gift of prophecy, as in the case of a couple mourning their
deceased children, whom he comforted by prophesying future births.
One of Salumbrino's first tasks in Lima was to
establish the College's dispensary. He began cultivating medicinal plants for
self-sufficiency, collecting native species, and building infrastructure for a
laboratory, preparing the ground for quina's introduction to Lima's public.
-IX-
The Jesuit Pharmacy in Lima: A Sanctuary of
Health and Faith
In November 1604, Agustín Salumbrino arrived in
Lima, a city of 83 blocks that, according to Jesuit Gerónimo Pallas, could be
circumnavigated in 14,900 steps (counted for a planned wall in 1619). On
December 8th, a month after Salumbrino's arrival, the newly appointed Viceroy,
Conde de Monterrey, entered the city. Salumbrino would later care for Saint
Rose of Lima, then 18, who lived on the Viceroy's entry street.
The Jesuit Dispensary (Botica), easily
accessible from anywhere in Lima, was more than just a pharmacy. Its main hall,
filled with the characteristic scent of herbs, featured a counter with scales,
weights, and mortars, preparing medicines in full view of customers, ensuring
transparency and trust. A niche dedicated to the Virgin Mary underscored the
blend of health and spirituality, reflecting the era's belief in the feminine
archetype of divine healing. The Botica was considered a sacred space.
Salumbrino's hagiography states that he
"formed a good dispensary that they had not had until then and planted the
necessary herbs for it." Initially, the dispensary operated behind closed
doors, serving the Jesuit College's infirmaries, novitiate, and haciendas
(primarily for enslaved Africans). Medicines were also distributed as charity
to the poor in hospitals, the city, and the indigenous town of El Cercado, a
practice rooted in Saint Ignatius's model of compassion.
Jesuit missionary medicine was crucial for
evangelization among indigenous and African populations. Father Gerónimo Pallas
recounted how in the 1618 measles/smallpox epidemic, Jesuit brothers, skilled
in healing, distributed medicines across vast areas to assist the indigenous.
Salumbrino was central to this operation. He also likely worked closely with
urban hospitals, providing medications and organizing their pharmacies,
addressing deficiencies documented in Jesuit supervisory reports.
Salumbrino's Public Role and Enduring Legacy
The growing demand from political and religious
authorities, including the Viceroy and Archbishop, led the dispensary to open
its doors to the public, eventually serving the entire Viceroyalty and beyond. Salumbrino
himself was a major attraction due to his humility, amiable nature, charity,
skill in preparing medicines, and reputation for sanctity and miracles,
including visions of the Virgin Mary. His discretion made him a trusted
confidant of court secrets and local affairs. His rigor, discipline, diligence,
and leadership were evident in the dispensary's order and cleanliness. He was a
remarkable figure, and his life story was documented shortly after his death,
reflecting the profound gratitude of those he served.
The dispensary stocked over a thousand
substances, from common herbs to exotic compounds like quina bark (for malaria)
and fossil unicorn (mammoth tusk). Salumbrino incorporated native medicinal
plants, learned from missionaries like Bernabé Cobo, and from the people of
Lima. These included pumpkin seeds, quinoa, rosehip, tara, and many others,
often found in colonial recipe books that explicitly mentioned the Jesuit
dispensary as a source. Many products were prepared by Salumbrino in the dispensary's
laboratory and kitchen, using ingredients from Jesuit haciendas, adding
significant value.
A 1782 invoice from the Jesuit dispensary (even
after the Jesuit expulsion in 1767) to a monastery in Arequipa showcases its
extensive inventory, including traditional European compounds, rare minerals,
and indigenous plant extracts. It also sold confectionery, preserves,
chocolate, coffee, spices, and hygiene products like soap and toothpaste,
highlighting its diverse commercial activities. A dedicated room for producing
licorice (orozuz) for sweetening the bitter quina bark further illustrates the
scale of operations.
Salumbrino's private office, which also served
as his bedroom, was the hub for major wholesale transactions with other
dispensaries, convents, the Viceroy's court, and distant regions like Quito and
Argentina, as well as for exporting quina to Europe. These large-scale dealings
drove the pharmacy's economic success, surpassing the profits of Jesuit
haciendas. Salumbrino faced aggressive suppliers and buyers with remarkable
patience and humor, often deflecting insults as "roses without
thorns."
Personal Challenges and Miraculous Encounters
Later in life, in his sixties, Salumbrino
contracted a severe fever in Lima. Although the hagiography doesn't explicitly
state he used quina, he recovered and resumed his duties. The dispensary was
also the site of his weekly visions of the Virgin Mary and even visits from
Saint Philip Neri. However, it was also where the devil Chapín tormented him,
causing terrifying noises and physical assaults. These demonic encounters,
often described similarly in other hagiographies of the era, highlight the
prevailing supernatural beliefs in Lima.
Around 1624, Lima received news of the
devastating malaria epidemic in Rome in 1623, which killed Pope Gregory XV and
eight cardinals and infected the new Pope Urban VIII, illustrating the
widespread impact of the disease. Despite the city's precarious health system,
Salumbrino's dispensary, with its range of services and emphasis on both
spiritual and physical healing, provided a crucial resource for the diverse
population of Lima. His holistic approach, drawing from both European and
indigenous knowledge, made him an extraordinary figure in the history of
medicine.
-X-
Ricardo Palma and the Unveiling of Quina's
History
The first chapter delves into Ricardo Palma's
meticulous revisions of his famous tradition, "Los Polvos de la
Condesa." As new information emerged, Palma incorporated it, leading
to the posthumous identification of Agustín Salumbrino as the Jesuit who cured
the Countess of Chinchón with quina bark. Palma, known for blending history
with imagination, would "guess what history silences" in his
"Peruvian Traditions."
Palma's final version of "Los Polvos de la
Condesa" places the Countess's illness in June 1631. However, Juan Antonio
Suardo's "Diario de Lima" reveals that it was the Viceroy, not the
Vicereine, who suffered from malaria during May and June 1631. Evidence
suggests the Vicereine was in good health, attending public events throughout
that month.
A letter from Jesuit General Mutio Vitelleschi
to Father Nicolás Durán Mastrilli, the Peruvian Provincial, confirms the
authenticity of the Countess of Chinchón's malaria legend. Both the Vicereine
and the Viceroy were indeed afflicted: the Vicereine in 1630 and the Viceroy in
1631.
It is suspected the Countess contracted malaria
in the spring of 1630, a season when "trumpet mosquitoes" (Anopheles)
were abundant in Lima, less than two years after her arrival in Peru. Suardo's
diary, discovered by Father Rubén Vargas Ugarte in the early 20th century, was
unknown to Palma.
Palma's tradition begins with news of a galleon
arriving in Callao with "important news from Spain." This
"important news" might have been the birth of Prince Baltasar Carlos
on November 3, 1630, leading to city-wide celebrations. Curiously, the
Vicereine's explicit absence from these festivities is striking. Suardo's diary
notes the sudden cancellation of a bullfight on November 26, 1630, due to the
Vicereine's "inflamed throat," which Palma interpreted as a serious,
perhaps malarial, illness that confined her to bed. This abrupt cancellation
for a seemingly minor ailment suggests a more severe, unstated condition,
possibly malaria, explaining her absence from public celebrations.
The Viceroy's Illness and Quina's Covert
Journey
Suardo's diary extensively documents the
Viceroy's ailments, including his severe malaria attack in May 1631. Unlike the
Vicereine's case, Suardo provides a meticulous description, noting the
Viceroy's confession and communion with Jesuit Provincial Diego de Torres
Vázquez, and his preparations for death. Despite treatment with bloodletting
and purges, his condition worsened.
The Countess, desperate, sought divine
intervention, distributing silver coins to convents and hospitals and donating
valuable candlesticks to a church, pleading for her husband's recovery. The
Viceroy temporarily recovered on May 9, 1631, allowing him to attend to the
urgent shipment of gold and silver to Spain. However, he relapsed on May 25,
necessitating more bloodletting and purgatives, preventing him from overseeing
the loading of treasure at Callao.
It's plausible the Jesuits, wary of challenging
Galenic medicine or risking a new treatment on the Viceroy, discreetly
administered quina. The initial plan might have been to send the cure to the
Hospital of the Holy Spirit in Rome before publicly introducing it in Madrid.
On May 31, 1631, the Royal Armada sailed for
Panama, carrying not only the precious gold and silver but also bundles of
powdered quina bark prepared by Agustín Salumbrino in the Jesuit dispensary.
This invaluable medicine, though unnoticed amidst the treasure, eventually
reached the Jesuit-controlled Hospital of the Holy Spirit in Rome after a
six-month journey fraught with peril.
The Viceroy recovered from his fevers by June. Suardo's diary notes the treatments but does not
identify a physician responsible for the cure. Peruvian doctor and researcher Hugo A. Dejo,
analyzing Suardo's account through modern medical knowledge, concludes that the
Viceroy's recovery was due to quina, likely administered secretly by his
confessor, Jesuit Diego Torres, from Salumbrino's dispensary.
The news of the Countess's cure did not
immediately spread. Medical discoveries, especially those involving
"naturalist treatments" unknown to conventional medicine, often
lacked the dramatic impact of military events. The Jesuits, aiming to establish
quina's efficacy in Rome's respected Hospital of the Holy Spirit, preferred to
keep the discovery low-profile, avoiding political entanglement with the
Spanish crown—a cautious approach that would later have dramatic consequences
for the order.
The Legacy of Quina and Salumbrino's Final
Years
In 1663, Genoese physician Sebastián Bado's
"Anastasis corticis peruviae" attested to the Countess's malaria cure
with quina bark, based on a merchant's account. The Countess, known for her
generosity, reportedly distributed quina freely, likely sourced from
Salumbrino's dispensary, the sole supplier of this remedy for her charitable
work. Salumbrino's biography, published two decades after his death, further
popularized this account. The story gained such traction that Carl Linnaeus, in
the 18th century, named the genus Cinchona in honor of the Countess. The
Countess's story has since been retold in various literary forms, symbolizing
the female archetype of divine healing.
In the ensuing decade, Salumbrino witnessed the
growth of the Jesuit dispensary, now a hub for quina trade and export. He also
lived through the "Prisión Grande" (1634-1635), where many local
merchants, including the wealthy slave trader Manuel Bautista Pérez, were
imprisoned and accused of being Jewish. Ricardo Palma's traditions, "La
Casa de Pilatos" and "Los Buscadores de Entierros," allude to
the immense wealth associated with these figures.
Salumbrino also saw the inauguration of the
impressive San Pedro Church in Lima in July 1638, next to the dispensary. In
1639, the Condes of Chinchón departed Lima, after witnessing a devastating Auto
de Fe where eleven people were executed for being Jewish. The Vicereine,
present with her son, was reportedly distressed by the public burning. The
Countess died on January 14, 1641, in Cartagena de Indias on her return journey
to Spain.
Agustín Salumbrino passed away on August 3,
1642, at 78, after a period of intense illness. His funeral at the San Pablo
College chapel saw an unusual turnout, attended by countless people from all
social strata—Spanish, mestizos, Black, and indigenous—who regarded him as a
beloved family member. Despite his humble offices as a nurse, cook, and
pharmacist, the public revered him, attempting to touch his body and take
relics, a testament to his sanctity and the miracles attributed to him. His
remains rest in the crypt of San Pedro Church in Lima.
The Jesuit order immortalized Salumbrino in a
portrait displayed in the dispensary, a testament to his "greater
legacy" as the instrument through which the world was finally awakened
from the "somber sleep" of malaria.
Epilogue: The Enduring Battle Against Malaria
The Jesuit expulsion from Peru in 1767, ordered
by King Charles III, led to the confiscation of their assets, including the San
Pablo College and its dispensary. This severely impacted public health and the
development of medicine, which had benefited from native knowledge and Jesuit
compassion. Though the beautiful dispensary building was largely demolished in
the 20th century, with some sections replaced by modern concrete structures,
the San Pedro Church and a few dispensary rooms remain.
The invisible world of Plasmodium remained
hidden until the late 19th century when Charles Louis Alphonse Laverán observed
its forms under a microscope. Ronald Ross later demonstrated the mosquito's
role in its transmission. This revealed a parallel world where humans are food
for the parasite, highlighting the interconnectedness of all living beings, yet
emphasizing humanity's unique capacity for discernment and action.
In 1861, English explorer Sir Clements R.
Markham brought Cinchona from Southern Peru to India, initially
to the Neilgherry or Nilgiri Hills in South India leading to massive quina
plantations in Asia to combat malaria among the local population and the
British colonial army. Ironically, the quina tree, native to Peru, was
overexploited and nearly extinguished in its homeland.
1881
photograph of a branch of the Cinchona tree, quina, flowering in Ootacamund, in
the Neilgherry or Nilgiri Hills, southern India (from the book Travels in Peru
and India by Sir Clements R. Markham published by Project Gutenberg)
By the mid-20th century, Bayer synthesized chloroquine,
a quinine derivative, and mosquito control efforts began. However, malaria
eradication remains elusive. Today, it is a disease of poverty, causing between
500,000 and 1 million deaths annually, predominantly among children in
sub-Saharan Africa. With global warming, malaria could once again become a
universal challenge. Bill Gates has highlighted the systemic imbalance, where
more is spent on hair care research than on malaria vaccines, underscoring the
urgent need for investment in neglected diseases.
Varro E. Tyler emphasizes the continued
importance of natural plant-derived medicines, even in modern pharmacology.
However, research into natural compounds faces significant financial hurdles,
particularly the high cost of FDA approval and the difficulty of patenting
natural substances, making them less attractive to pharmaceutical companies.
The Jesuit dispensary, especially through the case of quina, exemplifies the
enduring potential of natural products in medicine.
