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Remedy of the Month - China/Cinchona officinalis

Will Taylor, MDIt all has to begin somewhere and our homeopathic materia medica most surely begins with China, also known as Cinchona officinalis.

Named China (keen'-a) from the Peruvian Quechuan name "queena-queena," roughly translated as "bark-bark," this bark of a native tree of the equatorial Andes was a highly valued medicine in traditional Quechuan culture. It was introduced to Europe in 1640 by Countess Ana de Osoria, wife of the fourth count of Cinchon (Spain), Spanish Viceroy of Peru. The Countess had been cured of tertian fever by Peruvian Bark in 1638 while in South America, through the recommendation of a Jesuit. She subsequently introduced it for this purpose to Europe, naming it "Cinchona" (sin-KO'-na) for her town of Cinchon, Spain, a small village in the region of Madrid.

In Samuel Hahnemann's day (1755--1843), Peruvian Bark was imported to Europe for medicinal use at the rate of 500,000 pounds per year. It was employed early on as a general tonic or stimulant for virtually every disease condition seen. By the late 1700s its use had become somewhat more restricted to the treatment of fevers and periodic conditions, but Teste (1853) reports, "There is not a disease for which this drug has not been recommended."

Hahnemann's experiment with China is an old story, but one that bears repeating; it represents his discovery of the significance of the principle of cure by similars, and the birth of our science of healing—homeopathy. When translating William Cullen's Treatise on Materia Medica, Hahnemann took issue with Cullen's assertion that the curative property of China in malaria rested with its action on the stomach as a bitter and astringent agent. In likely the second most outrageous footnote seen in the history of editing (yes, he owns first prize, as well), Hahnemann added the following to his translation:

"By combining the strongest bitters and the strongest astringents we can obtain a compound which, in small doses, possesses much more of both these properties than the bark, and yet in all Eternity no fever specific can be made from such a compound. The author should have accounted for this. This undiscovered principle of the effect of the bark is probably not very easy to find. Let us consider the following: Substances which produce some kind of fever (very strong coffee, pepper, arnica, ignatia bean, arsenic) counteract these types of intermittent fever. I took, for several days, as an experiment, four drams of good china twice daily. My feet and finger tips, etc., at first became cold; I became languid and drowsy; then my heart began to palpitate; my pulse became hard and quick; an intolerable anxiety and trembling (but without a rigor); prostration in all the limbs; then pulsation in the head, redness of the cheeks, thirst; briefly, all the symptoms usually associated with intermittent fever appeared in succession, yet without the actual rigor. To sum up: all those symptoms which to me are typical of intermittent fever, as the stupefaction of the senses, a kind of rigidity of all joints, but above all the numb, disagreeable sensation which seems to have its seat in the periosteum over all the bones of the body—all made their appearance. This paroxysm lasted from two to three hours every time, and recurred when I repeated the dose and not otherwise. I discontinued the medicine and I was once more in good health …

"Peruvian bark, which is used as a remedy for intermittent fever, acts because it can produce symptoms similar to those of intermittent fever in healthy people."     —Samuel Hahnemann, 1790

Our remedy is prepared from a tincture of the dried bark of the tree. The initial homeopathic provings of China were performed by Hahnemann on himself, with 112 symptoms reported in his first document of proving records, Fragmenta de viribus medicamentorum positivis, published in 1805. Early homeopathic application is described in Hahnemann's article "Some Kinds of Continued and Remittent Fevers" (Hufeland's Journal, 1798; reprinted in The Lesser Writings of Samuel Hahnemann, Dudgeon, ed.).

Several species of the botanical genus Cinchona are considered interchangeably official for medicinal use, including C. succirubra (red Cinchona), C. ledgerian and C. calisaya (both called yellow Cinchona), as well as frequent natural and cultivated hybrids and other less-common species (36 described species in all). The remedy Chin-b (China boliviana, Cinchona boliviana) of our materia medica is sourced from C. calisaya from Bolivia. The species used are broadleafed evergreen trees growing indigenously, 6--24 meters in height, on mountainsides at elevations between 1500-2400 meters, from 10 degrees north to 20 degrees south latitude, on the eastern slopes of the central Andes chain (Bolivia, Peru, Ecuador) and western Cordelleras chain, to the highlands of Colombia, Venezuela, Caracas and the Caribbean.

Through the mid-1800s, the sole source of bark was wild trees in the equatorial Andes, principally the eastern slope of the Bolivian Andes. Culbreth* describes gangs of cascarilleros riding from the Pacific coast up into the distant mountains on donkey-back, setting up an encampment, planting corn and beans for subsistence, then felling the trees and stripping them entirely of bark to be dried in the sun. Bark was carried back to the coast in 70-kilogram canvas bundles on donkey-back. At the coast these bundles were sewed up in fresh hides which, when dried, formed tight seroons for shipping around Cape Horn and back to Europe. In 1859, seeds and cuttings were introduced to cultivation in India, Ceylon and Java, which by the early 1900s were providing 3/4 of the world's supply of bark. Hybridization and selective breeding produced trees with increased medicinal activity, raising alkaloid content from 1% in wild trees to nearly 15% in cultivars.

Beginning in the mid-1800s, allopathic medicine's focus shifted from the use of the bark itself to the use of isolated alkaloids. Thirty-two natural alkaloids have been described in Cinchona bark, but four—Quinine, Quinidine, Cinchonine, and Cinchonidine—have been considered of principal interest. Our remedy Cinch (Cinchoninum sulphuricum) is the sulphate salt of the isolated alkaloid Cinchonine, and the Chininum salts (Chininum arsenicosum, hydrocyanicum, muriaticum, salicylicum and sulphuricum) are the respective salts of the isolated alkaloid Quinine.

The genus Cinchona belongs to the botanical family Rubiaceae; other Rubiaceaid remedies in our homeopathic materia medica include: Cahinca racemosa, Cephalanthus occidentalis (button bush), Coffea (cruda and tosta), Galium aparine (cleavers), Ipecacuanha, Mitchella repens, Rubia tinctorum (madder), and Yohimbinum.

Below are some pearls from E.B. Nash (1838--1917) in Testimony of the Clinic:

"The Cinchona, as well as its alkaloid, has been well proved and can be applied in potency with great success in the cure of intermittents [intermittent fevers] if the symptoms indicate. If it is not indicated it will, like other not indicated remedies, not cure and the Quinine in massive doses will only suppress temporarily and establish a Quinine cachexia often more difficult to cure than the original disease. Ipecac, Arsenicum, Natrum mur., Pulsatilla, Ignatia, Eupatorium and many other remedies can each cure cases that Quinine cannot touch in the way of a permanent cure. I have written more at length upon this drug here, in hopes that some allopath, or only-in-name homeopath, may profit thereby. The treatment of intermittents is a good field in which to demonstrate the power and truth of the single remedy, the simillimum and the minimum dose. And intermittents is only a small part of the field of operation where this valuable drug in its two forms is wonderfully efficacious.

  1. Debility and other complaints after excessive loss of fluids; blood-letting, leucorrhoeas, etc.
  2. Haemorrhages profuse with fainting, loss of sight and ringing in the ears.
  3. Great flatulence, with sensation as if abdomen were packed full, not ameliorated by passing flatus up or down.
  4. Painless diarrhoea; stools yellow, watery, brownish, undigested.
  5. Periodical affections; especially every other day.
  6. Excessive sensitiveness, especially to light touch; draft of air; pain; special senses too acute.
  7. Modalities: worse from light touch, least draft of air; every other day; much better by hard pressure.

Quite fittingly to the central importance of China in the development of homeopathy, carvings of the leaves and blossoms of Cinchona decorate the Hahnemann Monument in Washington, DC.

A China case

Here's a China case, from Erastus Case presented at the Connecticut Homoeopathic Medical Society, 1893 (reprinted in Some Clinical Experiences of Erastus E. Case, MD, Jay Yasgur, ed.; Van Hoy Publishers, Greenville, PA).

Dec. 3, 1890. A tall, emaciated man, aged sixty-eight years, has suffered several days from sharp, stitching pains from one temple through to the other.

     Worse from a slight draft of air.
     Worse in the forenoon, when there is a dull aching of the head and stupid sleepiness.
     Sleepless through the first part of the night.
     The face is sallow, yellow.
     He has had Intermittent fever several times, treated with Quinine.
     Rx: China officinalis 12C B.&T., a dose four times a day.
     He reported himself on the third day as cured.

* A Manual of Materia Medica and Pharmacology, by David Culbreth, MD—one of the principle Eclectic Materia Medica authors. A great book. The 7th edition (1927) has been republished by Eclectic Medical Publications, Portland, Oregon (1983) and is also available for downloading in PDF format from Michael Moore's website, at (in 11 sections, at 5MB each—pretty bulky, 450+ pages in print). It contains interesting info on many of the substances that have made it into the homeopathic materia medica, from the perspective of the Eclectic school.

About the author:

Will Taylor has a practice devoted to classical homeopathy in a small coastal community in downeast Maine. Initially trained in conventional medicine, he received his MD from the University of Vermont, did a residency in Milwaukee, Wisconsin, and returned to rural Maine to practice as a family physician. His own intractable case of shingles led him in desperation to homeopathy and to the discovery of his own "true and highest calling" as a homeopathic practitioner.