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Article ID: CBB001450778

From Quinaquina to “Quinine Law”: A Bitter Chapter in the Westernisation of Turkish Medicine (2013)

Günergun, Feza (Author)
Etker, Şeref (Author)

Osmanli Bilimi Arastirmalari: Studies in Ottoman Science
Volume: 14, no. 2
Issue: 2
Pages: 41-68

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Pharmacology Quinine Medicine Pharmacy 19th century 20th century, early Turkey Ottoman Empire

Medical theory and therapeutics prevailing in the Ottoman Empire until the 19th century were founded in medieval Islamic medicine. From fifteenth century onwards, however, new treatment modalities and drugs were introduced from West, either by European physicians practicing in Ottoman lands and/or through translations of European medical books. Trade was another vehicle of dissemination. The cinchona bark or quinaquina of South American origin proved to be an effective drug for treating fevers, and was among these European (efrenci) remedies. The earliest work introducing quinaquina (k nak na in Turkish) and promoting its use was a treatise compiled by Ali Münshi (d. 1734), a Turkish court physician. Cinchona bark, however, should have reached the Islamic world well before Ali Munshi's description. Besides conventional antipyretic procedures such as purgatives/laxatives and cooling drinks, Ali Munshi administered cinchona powder to his patients. Apparently, Thomas Sydenham's and Adrien Helvetius's treatments of fevers by quinaquina were known to him. Isolated from cinchona bark in 1820 by P.J.Pelletier and J.B.Caventou, quinine became to be widely used in Europe against intermittent fevers including malaria, in the 19th century. Quinine sulphate -- popularised as solfato -- was included among the pharmaceuticals to be used in Ottoman military hospitals in 1831, if not earlier. The Ottoman Military Pharmacopoeia dated 1844 described the preparation of quinine sulphate from cinchona bark and gave its posology. Quinaquina and quinine sulphate employed in the military and sold in the drugstores were imported from Europe. In mid-nineteenth century, quite a number of apothecaries would sell counterfeited quinine sulphate, as well. By the end of the century, the list of pharmaceuticals that should be kept in Ottoman drugstores counted about twenty-six quinine compounds and pharmaceutical forms of quinaquina. Allegations of impurities and adulteration in quinine compounds were exacerbated by commercial competition, and necessitated for the arbitration of the Imperial Medical Council. Quinine became widely available and its indications specified following its large scale, yet monopolistic, production in South-East Asia, and the elucidation of malaria parasitology. During World War I, German physicians serving under the Ottoman command undertook clinical research in Southern Anatolia/Asia Minor where malaria was endemic. A Quinine Law issued in 1917 enforced control over the quality and distribution of the substance, and established the priority of the drug which symbolised the evolution of traditional Turkish medicine at the turn of the 18th century, and signified the emergence of modern medical treatment with pharmaceuticals at the close of the 19th century, heralding the westernisation of Turkish medicine. Key words: Cinchona bark, quinine, quinaquina, solfato, Ali Mün i, Ömer ifai, Pierre Apey, Zimmer affair, Joseph Zanni, Quinine Law, State Quinine, malaria, iatrochemistry, therapeutics.

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