Quinine Bark

Therapeutic Uses and Benefits of Cinchona Bark
The native Quechua people, living in what is now Peru, had been using the bark of cinchona trees for treating hypothermia and fever and this is what led to its development as a drug for malaria. The Jesuits in colonial Peru, knowing of the local use of cinchona for treating fever, began to use concoctions of the powdered bark to treat malaria patients, beginning in the 1630s.

The active ingredient against malaria, the alkaloid quinine, was isolated in the 1820s, prompting further cultivation of trees, especially C. ledgeriana and C. succirubra. In the 1940s, after the active alkaloid was isolated and identified drug companies were able to develop synthetic quinine. Some strains of malaria have become resistant to the synthetic quinine which has instigated renewed interest in sourcing natural quinine from cinchona.

In treating malaria, the mode of action of cinchona bark may be both antipyretic (anti-fever), and antimicrobial; that is to say that cinchona might be treating the symptoms of the infection, i.e., the fever, while also combating the microorganism itself. The microorganism that causes malaria is called a protist and not a virus or bacterium. The mechanisms by which quinine interferes with the protist are becoming more clear with advanced research.
The protozoan parasite Plasmodium falciparum, one of five species of protists that cause malaria in humans, has developed resistance to other malarial drugs, sometimes within a year of the drug being introduced. In contrast, quinine remains effective even today, after centuries of use. The protist’s resistance to quinine appears to be only “low-grade”, meaning that quinine does retain some delayed or diminished action against it.

The blood and cardiac disorders that have traditionally been treated with this medicinal herb are anemia, varicose veins and irregular heartbeat (arrhythmia). In the case of arrhythmia, there is an extensive laboratory and clinical evidence to support these claims and some prescription medicines for arrhythmia are in fact derived from cinchona.

Cinchona bark has been used as a remedy for heart palpitations (arrhythmia) since at least 1749 when the French physician Jean-Baptiste de Sénac published his observations. This medicine was sometimes called the “opium of the heart”. The drug contained in cinchona that has these cardiac effects is quinidine, which is the stereoisomer of quinine. (Stereoisomers are chemicals that have the same molecular formula but whose structures differ in three-dimensional space and are essentially mirror images of each other.)

It was not until 2010 that British scientists successfully synthesized quinidine in a lab. Until then this prescription drug used to treat arrhythmia was derived from quinine, extracted from the plant.
Digestive disorders that are supposedly remedied by the use of cinchona bark are dyspepsia (stomach upset), anorexia, gastrointestinal disorders, diarrhea, gallbladder disease, and even flatulence. There are few, if any, scientific studies that would either support or refute these claims.

The antiseptic qualities of cinchona bark have been recognized by native people of the Americas for centuries. In modern research, the antimicrobial activity of compounds found in cinchona bark was found to depend on the virus or bacterium in question and the actual compounds. Certainly, the alkaloid quinine is an effective treatment against the malaria virus. There is less evidence that cinchona bark is useful as a general antimicrobial agent, i.e., antiseptic.

Although cinchona bark is often cited in the ethnobotanical literature of it anti-bacterial properties, the scientific evidence is mixed. Indian researchers, found that cinchona bark was effective in treating these common bacteria: Staphylococcus aureus, Bacillus cereus, andEscherichia coli but not Streptococcus ß hemolytic and Pseudomonas aeruginosa. The cinchona was effective in killing the yeast Candida albicans.

Cinchona Bark (Cinchona officinalis)
Cinchona Bark (Cinchona officinalis)
Biofilms are whole surfaces of micro-organisms (bacteria, yeast cells, or slime) that stick together and undergo cellular changes. They are much more resistant to most available antibiotics and so have attracted the interest of drug researchers. The cinchona alkaloid cinchonidine was tested against Staphylococcus aureusbiofilm and found to be inactive; whereas a synthetic chemical derived from cinchonidine was effective.
It should be noted that antibiotic drugs, whether natural or synthesized, are highly specific to the particular species and strain of microorganism. Therefore, no general conclusions can be drawn one way or the other from these handfuls of studies on whether cinchona is an effective general antibiotic.

Cinchona bark has been used in traditional herbal medicine to treat muscle spasms. This traditional use of cinchona bark has prompted medical studies. There are a few reports of the successful use of cinchona in treating painful leg cramps and spasms, with only tinnitus as a side effect. The mode of action is unknown, largely because it is not certain what (at the chemical level) causes muscle spasms in the leg. The Journal of Family Practice conducted a review of the literature in 2008 and found that there is no clear evidence that quinine salts are an effective treatment. Most doctors recommend general painkillers to alleviate the symptoms.

Another interesting possibility for cinchona as an herbal remedy is in healthy weight maintenance. Cinchona has been used in traditional medicine as an appetite stimulant. It may also help in weight loss — though not through the suppression of appetite. The possible medicinal value of quinine as a weight control herb was investigated in the 1970s in experiments with rodents but there is renewed interest in cinchona for this purpose. A very recent study (2013) showed that the herb suppressed weight gain without affecting appetite and food consumption in adult male mice. The mechanism may be quinine’s interference with nutrient absorption in the intestines, although the mice did not “appear” to be malnourished.

The treatment of malaria is certainly what cinchona is best known for. However, there are a number of other health complaints that have been treated with this herbal remedy. Some, but not all, of these conditions have been shown in laboratory and clinical studies to respond favorably to treatment with cinchona compounds.
There are a variety of health problems that have been traditionally treated with cinchona bark. It should be remembered that it is often the case that a medicinal plant containing one or more highly effective compounds is then reputed to cure a host of illnesses and becomes a panacea. Among the list of other maladies purportedly treated by cinchona are: hair loss, alcoholism, hemorrhoids, enlarged spleen and the common cold.