"Cinchona" - an Ancient, Wondrous, Less-known Drug in the Treatment of Malaria

A rare herb that is indigenous to South America and some parts of Central America and Jamaica. Although the process of cultivation was undertaken in India, Sri Lanka, and Java, as sources of Quinine, Quinidine (Constituents of Cinchona) after its effect on malaria, and cardiac arrhythmia were known. 

History of Cinchona :

The discovery of Cinchona dates back to the 16th century when the Countess of Cinchona from Peru, was given a concoction of Cinchona bark by Jesuit priests when she fell ill with severe chills and high fever (Classical symptoms of Malaria). She recovered miraculously which led to a ray of hope in others and named the tree "Cinchona" in her honor. Thereafter, it was recognized quickly as an effective treatment for Malaria. But, the species useful in curing Malaria was unclear and finally, in 1820 the alkaloids of Cinchona were extracted and described which then became a standard treatment for Malaria. 

Synonyms: 

Jesuit's Bark, Peruvian Bark, Fever tree

Chemical constituents: 

• Quinine - Has Schizonticidal action (Drugs that act on blood forms of the parasite, ultimately combating Malaria)

•  Quinidine - It is the D-isomer of Quinine which is considered the first antiarrhythmic drug 

•  Cinchonidine 

•  Cinchonine

•  Tannic Acid - A naturally occurring plant polyphenol

Part used:

The bark of the tree, as it yields powerful alkaloids (Quinine, Quinidine)

The bark is usually collected in Autumn from trees that are over six years old.

Method of preparation: Cinchona can be used internally, as well as externally

- The bark is dried, powdered, and used in the form of concoction or medicinal wine, in Malaria, Flu-like symptoms, nervous exhaustion

- The decoction is prepared out of bark and used to wash on scabs, bedsores, and other wounds.

Quinine has been an important anti-malarial drug since the time Jesuit priests discovered its effectiveness. World Health Organization (WHO) guidelines recommended a combination of Quinine with doxycycline, tetracycline, or clindamycin as a second line of treatment for uncomplicated malaria 2010.

Reference:

1. https://www.britannica.com/plant/Cinchona

2. https://www.sciencedirect.com/topics/neuroscience/cinchona

3. http://www.drvikram.com/cinchona.php

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