“Squeeze a serving of bitter oranges”, advised “The True Physician” (El Médico Verdadero), a manuscript recipe collection dated Lima 1771, “strain the juice through a canvas” and “blend that in a clean glazed pot with the same amount of pure water and with four ounces of white sugar”. “Bring that to a boil over the fire, then remove the (…) foam with a spoon (…) and when the decoction is clean you let it seethe a little longer and then remove it from the heat, let it cool, and (…) then add the amount of powdered cinchona they sell in the pharmacy for one real, or two adarmes of the said powder (…), tossing the decoction until it is well blended”. Taken “the day of the fever”, the recipe concluded, this was a most “secure” remedy “for the cure of all kinds of tertian and quartan fevers”. (1)
“The True Physician” is one of a handful of manuscript recipe collections from Lima and its environs that have survived into our present – in archives, private libraries or, as in this particular case, as transcriptions made by early-twentieth century historians. Virtually all of them contain one or several medicines against “tertian and quartan fevers” – afflictions that can retrospectively be diagnosed as plasmodium vivax and plasmodium malariae infections, forms of malaria that haunted the viceregal capital throughout the colonial period. Both vivax and malariae are nonfatal and more benign than the tropical form of malaria, falciparum, but both have relapses as their signature dynamic: large sectors of the Lima population in the late-colonial period would have been accustomed to suffering from bouts of malaria – chills and rigors that extend through febrile paroxysms every 48 or 72 hours – frequently in the course of their lives.
A number of publications in circulation in the city, from the yearly almanac to health advice manuals, counselled Lima’s inhabitants on how to prevent malarial fevers or afford relief if they struck. The anonymous author of “The True Physician” – the manuscript is only signed “un curioso”, a term that referred broadly to persons who practised medicine without a medical degree – appears to have been an avid reader, particularly of the latter format. He had copied several passages from Manuel Gutierrez de los Rios’s handbook version of Francisco Solano de Luque’s 1732 Lapis Lydos Apollinis and of Benito Jerónimo Feijóo y Montenegro’s enlightened Teatro Crítico Universal (1726-1739), though he also adopted advice on nutriments from Ioannes Bruyerinus Campegius and cited a series of treatises on medicinal plants, from Pedanius Dioscorides and Ibn Masawaih to Hieronymus Bock. He probably belonged to the upper stratum of Spanish or elite Indian society in late-colonial Lima, the handful of men and women sufficiently well-off to be able to afford a medical library and not to mind spending a real or two on remedies. Possibly he was a householder, though one who felt called to dispense his knowledge beyond the circle of his family, to the men and women working on his estate and, occasionally – as transpires from his remarks – the priest of the local parish.
Though he cited profusely throughout the collection, the curioso also picked up ideas for recipes in conversation – orange juice to ease bladder irritations, for instance, from a story he heard about “the lawyer Casasola” who had “recovered from strangury accidentally just by eating sweet oranges”. He cited neither written nor oral authority, however, for his reliance on cinchona in the “very secure recipe”, perhaps because the bark was a widely shared empirical tradition by the late-eighteenth century. Cinchona had been part of Andean pharmacopeia long before it entered European materia medica in the mid-seventeenth century and a century later was administered by titled physicians, Indian healers and householders alike in Lima. The curioso found cinchona was a strikingly “infallible and certain” cure against malaria and so it was: the bark contains natural alkaloids that interfere with the growth and reproduction of the malarial parasites in the red blood cells and its administration would have afforded prompt relief from malarial fever. The bark requires no specific mode of preparation to unfold its curative properties. The reason behind the proliferation of culinary variations – especially sugary fruit concoctions – we find in medical notebooks like “The True Physician” presumably lay in the difficulty of getting a weakened sufferer to swallow the bark: cinchona tastes by all accounts sickeningly bitter.
I am still at the very beginning of my “Malaria and Medicine in Lima” project but I hope to have excited your anticipation; I will report more as the project progresses.
(1) Receta muy segura para la curación de toda suerte de tercianas y quartanas de que siempre se han experimentado maravillosos efectos (1777), in: El Medico verdadero. Prontuario singular de varios selectisimos remedios, para los diversos males à que està expuesto el Cuerpo humano desde el instante que nace. You’ll find this and other Lima recipes transcribed in volume three of La medicina popular peruana, ed. Hermilio Valdizán and Angel Maldonado (Lima: Imprenta Torres Aguirre, 1922).
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