Peruvian Bark (Cinchona)
Other names: Jesuits bark, yellow bark, jacket bark, red bark
Scientific name: Cinchona officinalis, cinchona calisaya (yellow), cinchona succurubra (red)
Arabic names: الكينيا (keeniah)
Approximate number of species known:
Common parts used: Bark from stem and branches
Height: 15 to 20 m
Actions: Anthelmintic, astringent, febrifuge, heart relaxant, tonic
Known Constituents: Alkaloids, quinine, cinchonidine, cinchonine, quinidine, hydrocinchonidine, quinamine, homocinchonidine, hydroquinine, quinic and cincholannic acids, bitter amorphous glucoside, starch and calcium oxalate
Evergreen – keeps its leaves all year round
Native to South America but cultivated in India. Tends to grow in hot climates like the tropics. It’s believed to have been known in Europe since around 1640. The name Jesuit bark comes from the Jesuits who had control over it’s sale from 1640. One of the brothers of the Jesuits first observed a tribe of Indians in Peru, called the Quechua use the bark for malaria. IN the 19th century, once Peru realised it was losing control over the cinhona bark monopoly it began to ban the export of the seeds, but the Dutch government managed to keep cultivatin plantations and in the 1930’s were believed to be responsible for 97% of the world’s production.
The problem of lack of quinine extended to the second world war where US and Japanese soldiers died due to lack of access to quinine. It was only in 2006 that the World Health Organization no longer recommended quinine as the first recommendation for malaria.
Quinine can come in many forms such as hydrochloride, dihydrocholoride, suylfate, bisulfate and gluconate. Because each salt has a different weight
quinine base 100 mg
- quinine bisulfate 169 mg
- quinine dihydrochloride 122 mg
- quinine hydrochloride 111 mg
- quinine sulfate (actually (quinine)2H2SO4∙2H2O) 121 mg
- quinine gluconate 160 mg.
For adults in the Uk standard oral dose is The adult dose in the UK is 600 mg quinine dihydrochloride IV or 600 mg quinine sulfate orally every eight hours
It’s believed it’s use by Europeans to control malaria was one of the reasons they were able to inhabit Africa.
The name Cinchona name was from the Countess of Chinchon whose life was saved by the bark, and she instructed large quantities of the bark to be collected. It has a strongly bitter taste.
This bark of this tree is probably most known for being a source of quinine, which was a popularised treatment of malaria.1 The name quinine means medicine of medicines or bark of barks. Quinine was first isolated in 1820 in France by two chemists. One of the chemists Joseph Bienaimé Caventou also isolated Chlorophyll (whose primary purpose is to absorb light, and transfer it) in 1817, caffiene in 1821, nitrgoen from Alkaloids as well as two components from Nux Vomica. He has a circular crater on the moon called Caventou named after him.
Quineine is a white crystalline alkaloid, having analgesic (pain killing) and anti-inflammatory properties. Apart from synthetic production, the Peruvian bark is the only known natural source for it. It was used as a treatment for malaria from the 17th century to the 1940’s. Malaria is a parasire believed to come from a mosiquito bite.
Quinine has long been used in Peru has a muscle relaxant.
, which is a steroisomer of quinine (meaning it has the same molecular formula, but the three dimensional layout of the atoms diffe) is used as as anti-arrythmic agent on the heart.
An overdose of quinine or Peruvian bark is called Cinchonism. It’s side effects are consistent with any poisoning and resolve once quinine is out of the system. Even when a dose isn’t at the level of an overdose it’s not uncommon for symptoms of cinchonism to occur while treatment is continued.
Quinine is not always administered orally due to the bitter taste
Sometimes quinine has been taken under the false belief it is an abortifacient which it is not. Sometimes quinine is used as a cutting agent in street drugs such as cocaine or heroin.
It has been used for fevers and as a general tonic.1 It’s common for herbalists to believe that Peruvian bark is a valuable source of quinine, without the list of side effects that goes with taking taking quinine on its own.1
Quinine is still used as a bitter flavouring in tonic water.
Its potential action in cauing contractions in the uterus mean it should not be used during pregnancy.1
Its bitter action is used as a digestive stimulant. Used to ‘quiten’ the heart.
It’s sometimes used on toothache. It tends to be used as a tonic. Too much is believed to produce headache, dizziness and deafness.
In an attempt to avoid the complications associated with intramuscular quinine administration, the intrarectal route was assessed. Sixty-six children aged from 2 to 10 years with Plasmodium falciparum malaria were included in the study, which took place in Niamey, Niger.
Fifty-five children were given 20 mg/kg of the diluted injectable form of Quinimax (a quinine, quinidine, cinchonine, cinchonidine association) intrarectally. A further 11 children with malaria were treated with 12.5 mg/kg of the same Quinimax solution by the intramuscular route.
All the children were treated twice a day for 3 d. Blood samples were drawn from 20 children (15 treated intrarectally and 5 intramuscularly) for a kinetic study. Both modes of administration were well tolerated.
Mean parasite clearance times were similar after intrarectal and intramuscular administration. Compared to the intramuscular route, intrarectal Quinimax bioavailability was 40%.
Barennes H, Kahiatani F, Pussard E, Clavier F, Meynard D, Njifountawouo S, Verdier F. “Intrarectal Quinimax (An Association Of Cinchona Alkaloids) For The Treatment Of Plasmodium Falsiparum Malaria In Children In Niger: Efficacy And Pharmacokinetics.” 1995 July-August. http://www.ncbi.nlm.nih.gov/pubmed/7570885