By the late 1700s and early 1800s, cinchona bark was, to many, ‘the most important, and the most usual remedy that medicine possessed’. Though of limited repertoire – cinchona trees prospered only on the precipitous eastern slopes of the Andes at the time, in the Spanish American Viceroyalties of Peru and New Granada – and comparatively recent acceptance into Old World materia medica, the bark had, by the turn of the eighteenth century, woven itself into the texture of everyday medical practice in a wide range of societies within, or tied to, the Atlantic World. It was everywhere attributed ‘wonderful’, ‘singular’, even ‘divine’ medicinal virtues, the knowledge of which, so it was said, had come to mankind from its simplest, and humblest, specimens, ‘wild Indians’ close to nature and privy to its most coveted secrets. Bittersweet ‘febrifugal lemonades’ and bottled wines of the bark sat on the shelves of Lima apothecaries, the counters of Cantonese market stands and in the medicine chests of Luanda hospital orderlies. They were routinely concocted, and administered at the bedside, by Moroccan court physicians, French housewives and slave healers alike and they accompanied, tucked into their pouches, Dutch sailors to febrile environs, Peruvian soldiers to the battlefield and North American settlers westward. Scottish physicians, creole botanists and French writers alike were unanimous not only in according the bark ‘singularity’, and ‘the first place among the most effective remedies’ (die erste Stelle unter den würksamsten Arzneimitteln), but also in holding it to be ‘more generally useful to mankind than any in the materia medica’. It was commonly agreed upon that there was ‘no febrifuge of such well-known virtue in all of medicine’ (por que no se halla en la Medicina febrífugo de virtud tan conocida), and that not a single remedy ‘more estimable and precious [than the bark] had been discovered unto this day’.

Chapter 1 exposes and examines the movement of narratives, and cultural imaginaries, about cinchona across the Atlantic World around 1800, by studying the circulation of ‘origin myths’ about how the ‘wonderful’, ‘admirable’ medicinal properties of cinchona had first come to the knowledge of mankind. The chapter scrutinizes the various story elements present in contemporary origin stories – the natives’ alleged secrecy, closeness to nature and unlettered simplicity – exposing them as widespread, and long-lived, topoi, woven from the epistemic fabric of the Atlantic World. Laying ground for subsequent chapters, it argues that these topoi ultimately served to make sense of, promote and propagate the bark’s ‘wonderful properties’ – as much, or more so, as the discerning appreciation of its supposed medical ‘effects’, or the support of prominent regal and religious advocates historians have tended to privilege in their accounts of the bark’s rise.

Millions of men and women in societies rimming or tied to the Atlantic basin – be they Ottoman courtiers, Hamburg paupers or Andean villagers – had, by the late 1700s and early 1800s, come to assign medicinal properties as well as particular therapeutic practices and cultural imaginaries to dried shreds of bark removed from the cinchona tree. From Philadelphia to Rome, from Nagasaki to Rio de Janeiro, people had encountered and espoused that singular remedy, as well as techniques and understandings attendant to its consumption, through exposure to the written word, medical practice or word of mouth. Though coming from a single, limited source in the central and northern Andes, the bark would have been available to them through a variety of mercantile conduits and from a wide range of purveyors the world over: on offer from a Frankfurt apothecary, attainable from a Jesuit dispensary in Macao and buyable over the counter of a Smyrna market stand. Many of the bark’s users, traders and supporters would have been conversant with and, in some measure, tempted into its consumption or advocacy by stories about its discovery by ‘wild Indians’ – ‘natural men’ of whom, in their unlettered simplicity, closeness to nature and ‘divine folly’, mankind could reasonably expect the revelation of nature’s most coveted secrets, its most excellent remedies. Many sufferers and medical practitioners would also have shared recipes and medical practices calculated to render cinchona more effectual and agreeable, with its therapeutic properties, powdery texture and nauseous taste entailing a necessity for solvents, sweeteners and the presence of kindred febrifuges and aligning preparations of the bark the world over. Gentlewomen in the Scottish Lowlands, physicians at the Ottoman Porte and Mexican hospital orderlies alike would have known how to concoct, or where to purchase, the classic bittersweet febrifugal lemonades and aromatic compound wines of the bark. Many consumers would have shared not only fanciful narratives about the bark’s discovery and formulae to concoct preparations of it that were palatable, and efficacious, but also diagnostic experience, expertise in indications and an understanding of the environs and ailments in which the use of the Peruvian bark would be most beneficial. From the fenlands of Cambridgeshire to the river valleys of Lima, sufferers and practitioners from all walks of life, be they sailors, householders or seasonal workers, would most commonly have trusted the bark’s protection and curative properties in fevers, occasioned by insalubrious situations and climates. Knowledge, A Singular Remedy holds, is not bound ineluctably to just one place or locality. As the case of the Peruvian bark shows, by the late 1700s and early 1800s, men and women had come to share expertise and experiences across imperial and social divides at a level as fundamental as that of their body, of sickness and cure.

Chapter 5 frames the book’s narrative in the style of a lengthy coda. It is concerned with how the bark’s prevalence, wide fame and general ‘usefulness’ in therapeutic practice among geographically disperse and socially diverse societies affected its natural habitat in the central and northern Andes. The bark’s very ‘mobility’ and the popular demand that arose for it, the chapter argues, altered the harvest areas’ landscape of possession, commerce and demographics, the distribution and abundance of vegetation, and the livelihood, health and fate of the men and women implicated in harvesting, processing and conveying the bark. The chapter reminds readers, at parting, how plant trade, therapeutic exchange and epistemic brokerage are not extricable from time and space. Consumption and the imaginaries, therapeutic practice and medical understandings attendant to it invariably begins with changes to the material world, to physical nature and society.

Chapter 3 examines how medical formulae for ‘preparations of the bark’ traversed Atlantic societies over the late 1700s, and early 1800s – through practitioners’ and sufferers’ exposure to the written word, medical practice, or word of mouth. The chapter argues that methods for arranging and administering the bark had by that time coalesced into identifiable formulae – ‘bittersweet’ ‘febrifugal lemonades’, and ‘aromatic’ ‘compound wines of the bark’, most notably – that would have been familiar, and ‘agreeable’ to men and women the Atlantic World over: home-made in a Lima household, available from an Italian apothecary and popular at the Moroccan court. The chapter contends that these formulae, though they commonly exhibited structural similarities in the composition, also accommodated a measure of variability. Indeed, medical practitioners tinkered with their particulars, subtly adapting them to the sufferers’ palate, creed or means, in ways that would frequently have accounted for these preparations’ prevalence and appeal.

Chapter 4 exposes and explores the prevalence and movement of knowledge of the bark’s effectiveness in ‘fevers’ and other ailments occasioned by ‘insalubrious’, ‘febrile’ environs. Bark knowledge, the chapter contends, spread to various Atlantic localities not only in the form of imaginative stories or culinary practices, as the previous chapters have shown, but also in that of diagnostics, of expertise in indications for the bark and of a topographic literacy of sorts that associated even widely different environments with the same, familiar kind of ‘febrile’ threat. Men and women from all ranks across the Atlantic World and beyond, who inhabited or moved temporarily into ‘insalubrious’ environs, shared an understanding that their ability to preserve or restore bodily well-being was contingent on a litany of precautions and cares. Cinchona bark, this chapter contends, had become a fundamental element of that register by the late 1700s and early 1800s.

Chapter 2 studies the movement of various material forms of medical knowledge about cinchona – bottled compound wines, or powdered bark – by setting out the structure, volume and reach of world commerce in cinchona. Based on trade statistics, pharmaceutical inventories and medical treatises as well as the extensive Spanish administrative record on the subject, the chapter charts the bark’s availability across the Atlantic World by means of commerce and contraband as well as concomitant, non-commercial forms of distribution – charitable giving, medical relief programmes and diplomatic gift exchange. Preparing the ground for subsequent chapters concerned with the movement of consumption practices and expertise in indications, it exposes and examines both the bark’s geographic reach, along the veins of Atlantic trade, proselytizing, and imperialism, and its more elusive social reach within consumer societies.