Quinine

This genus of about 40 species of tender, evergreen trees and shrubs is found on warm moist slopes of the Andes, mostly at 1,500-2,000m (5,000-8,000ft). The species are difficult to tell apart; some authorities consider that there may be as few as 20. Cinchona pubescens is one of several cinchonas, including C. calisaya, C. ledgeriana (both known as yellow cinchona), and C. officinalis, from which the alkaloid quinine, a potent anti-malarial, is extracted. The story of cinchona's discovery by the eponymous Countess of Chinchon, wife of the Viceroy of Peru, after a bout of malaria, has been disproved by historians. It is certain, however, that Jesuits in the Lima area were familiar with its uses c.1630 (hence the name "Jesuit's bark); it was first mentioned in medical literature by Herman van der Heyden (Discours et advis sur les flus de ventre douloureux, 1643). The use of quinine to give protection against malaria played a significant role in enabling Europeans to survive in the tropics and establish colonial empires. Made more palatable by the addition of gin, the daily dose of quinine gave rise to "gin and tonic", the latter containing quinine to this day. By the early 19th century, populations of wild cinchona were severely depleted, leading to competition between the Dutch and English to establish plantations. The Dutch succeeded, cultivating C. ledgeriana in Java, which became the world center for quinine production for many years. Cinchona is now grown in many tropical regions, some 8,000 to 10,000 tons of bark producing 400-500 tons of alkaloids (mainly quinine) annually. Though largely replaced by synthetic drugs toward the end of the 20th century, Cinchona and other plants, such as Artemisia annua (See, sweet annie), are increasingly important, as various strains of malaria become resistant to synthetics. Another alkaloid, quinidine, is also important as a cardiac depressant. Quinine is famous as the first substance that Samuel Hahnemann (1755-1843), founder of homeopathy, tested on himself, leading to the formulation of the Law of Similars (similia similibus curentur, "like cures like").

Quinine, and alkaloid extracted from the bark of the South American cinchona tree, was once the treatment of choice for malaria, until it was replaced by more effective synthetic drugs. However, it is still sometimes used to treat resistant malaria, night-time leg cramps, and fever.

Fast-growing evergreen tree with ovate leaves, about 15cm (6in) long, sometimes flushed red on the undersides. Lilac-like panicles of small, tubular, pink flowers are followed by 2-lobed capsules, 2cm (¾in) long.


Common Name:
Quinine
Other Names:
Cinchona, Jesuit's Bark, Red Cinchona, Peruvian bark
Botanical Name:
Cinchona pubescens
Genus:
Cinchona
Family:
Rubiaceae
Location:
Equador
Cultivation:
Well-drained, moist soil, with high humidity, in sun or partial shade. Commercial plantations are usually coppiced (cut back nearly to the ground) when about 6 years old. In late winter cut back specimen plants hard to encourage strong new growth.
Propagation:
By nodal greenwood cuttings in late spring; by semi-ripe cuttings in summer at 15-18°C (59-64°F)
Harvest:
Bark is collected from May until September, and dried for liquid extracts, tablets, or tinctures, or powder. It may be shaved off in situ or peeled from coppiced branches.
Height:
25m (80ft)
Width:
Variable
Warning:
This herb, especially in the form of quinine, is subject to legal restrictions in some countries.
Hardiness:
Min 15-18°C (59-64°F)
Parts Used:
Stem and root bark
Properties:
A bitter, astringent herb that lowers fever, relaxes spasms, and is anti-malaria (quinine), and slows the heart (quinidine).
Medicinal Uses:
Internally for malaria, acute fevers, neuralgia, muscle cramps, cardiac fillibration; and ingredient of most proprietary cold and influenza remedies. Excess causes cinchonism; headache, rash, abdominal pain, deafness and blindness. Not given to pregnant women unless suffering from malaria. Externally as a gargle for sore throat. Used in homeopathy (as China officinalis) for nervous exhaustion, anemia, and convalescence.
To treat digestive problems, malaria, muscle pain, fever, flu, flatulence, and enlarged spleen. Germany's Commission E has approved the use of quinine to treat loss of appetite and dyspeptic complaints, such as heartburn and bloating.
Typical Dose:
A typical daily dose of quinine in the form of cinchona liquid extract may range from 0.6 to 3.0 gm.
Possible Side Effects:
Quinine's side effects include itching and eczema.
Drug Interactions:
Taking quinine with these drugs may increase the risk of bleeding and bruising:
Abciximab, (ReoPro)
Antithrombin III, (Thrombate III)
Argatroban, (Argatroban)
Aspirin, (Bufferin, Ecotrin)
Aspirin and Dipyridamole, (Aggrenox)
Bivalirudin, (Angiomax)
Clopidogrel, (Plavix)
Dalteparin, (Fragmin)
Danaparoid, (Orgaran)
Dipyridamole, (Novo-Dipiradol, Persantine)
Enoxaparin, (Lovenox)
Eptifibatide, (Integrillin)
Fondaparinux, (Arixtra)
Heparin, (Hepalean, Hep-Lock)
Indobufen, (Ibustrin)
Lepirudin, (Refludan)
Ticlopidine, (Alti-Ticlopidine, Ticlid)
Tinzaparin, (Innohep)
Tirofiban, (Aggrastat)
Warfarin, (Coumadin, Jantoven)
Taking quinine with these drugs may be harmful:
Carbamazepine, (Carbatrol, Tegretol)—may increase blood levels of the drug.
Quinidine, (Novo-Quinidin, Quinaglute Dura-Tabs)—may increase the therapeutic and/or adverse effects of the drug.
Disease Effects:
May worsen gastrointestinal disorders by increasing the risk of bleeding.
Supplement Interactions:
Increased risk of bleeding when used with herbs and supplements that might affect platelet aggregation.
Culinary Uses:
Quinine is used as a bitter flavoring in tonic water, soft drinks, and alcoholic drinks, such as Campari and Dubonnet.
Bibliography:
Encylopedia of Herbs by Deni Brown Copyright ©: 1995, 2001 Dorling Kindersley Limited pg 169
The Essential Herb-Drug-Vitamin Interaction Guide by Geo. T. Grossberg,MD and Barry Fox,PhD Copyright©2007 Barry Fox, PhD. Pp.384-385