ABOUT THE COVERPortrait of the Coveted CinchonaByron Breedlove and Paul M. ArguinEnglish Victorian botanical artist Marianne North iscelebrated for her meticulous attention to detail, form,and color. Her collection of 833 paintings, which portraymore than 900 species of plants, comprises her life’s workand is on permanent display in the Marianne North galleryat the Royal Botanic Gardens, Kew, United Kingdom. BecauseNorth painted with oils, rather than with watercolors,and because she predates color photography, her body ofwork offers an enduring visual record of these plant species,some of which are quite rare or extinct.North did not take lessons in oil painting until 1867or begin her odyssey to paint flora from around the worlduntil 3 years later when she was 40 years of age, whichmakes the quality and volume of her work more remarkable.After exhibiting her paintings in a London gallery in1879, North wrote to Kew director Sir Joseph Hooker, offeringto build a gallery if he would agree to display herlife’s work there. He consented, and North then devoted ayear arranging her paintings inside her eponymous gallerybefore its public opening in 1882. Her paintings still hangin this gallery, which was faithfully restored to its originalcharacter in 2009.Earlier in her life, North had traveled broadly withher father Frederick North, who had been a member ofparliament for Hastings. Following his death in 1869, hersubstantial inheritance and many political connections allowedher free rein to travel and pursue her passion forpainting. During the next 13 years, she visited 16 countrieson 6 continents, including Brazil, Japan, Singapore,Sri Lanka, and South Africa. Following a recommendationof Charles Darwin, a friend both of her late fatherand Hooker, North also explored Australia, New Zealand,and Tasmania.Author affiliations: Centers for Disease Control and Prevention,Atlanta, Georgia, USADOI: http://dx.doi.org/10.3201.eid2107.AC2107Marianne North (1830–1890), Foliage, Flowers, andSeed-vessels of a Peruvian Bark Tree, 1870s. Oil on card.20 × 11.5 in/50.8 × 29.2 cm © Royal Botanic Gardens Kew.1280 Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 21, No. 7, July 2015
ABOUT THE COVERNorth was not interested in mingling with politicalleaders or ambassadors or splurging on indulgences.Strange, even unwelcoming terrain teeming with botanicalspecimens beckoned her. She preferred to paint images ofher specimens where they naturally grew. This free spiritfavored solitary travel—she was known to elude travelcompanions or guides assigned to her—and did not mindsimple, primitive accommodations that enabled her to beclose to local flora. She did, however, consider a supplyof paper and oil paints to be indispensable. In her autobiography,she notes that painting for her was “a vice likedram-drinking, almost impossible to leave off once it getspossession of one.”North painted this month’s cover image, “Foliage,Flowers, and Seed-vessels of a Peruvian Bark Tree,” whiletraveling in South America during the early 1870s. North’sgraceful painting captures many key facets of her specimen.In the center, a small branch is clustered with whiteflowers thrusting about a number of examples of this specimen’soval leaves. Her palette of greens, reds, and brownsamply juxtaposes the leaves in various stages from shinynew growth to older leaves. Many of the coveted cinchonaseeds cling to twigs to the right of the flowers. A smallbranch in the upper right corner provides our only closelook at the much-valued and bitter tasting bark. A tree-coveredridge juts above the lower forest, and clouds and mistswirl across the sky and down the ridge, showing the lushnessof this tree’s natural habitat.The Peruvian bark tree, also known as the Jesuit tree orthe fever tree, is a cinchona 1 of the family Rubiaceae, nativeto the western forests of the South American Andes. Its barkproduces several alkaloids, including quinine, which has potentantimalarial properties, and quinidine, which has antiarrhythmicproperties. The medicinal properties of the cinchonatree are thought to have been discovered by the Quechua,indigenous people from Peru and Bolivia. After the Jesuitslearned about cinchona and brought it to Europe, its bark waswidely used there to treat fevers starting in the 17th century.Not long after French scientists Pierre Joseph Pelletier andJoseph Bienaimé Caventou isolated quinine from cinchonabark in 1820, the governments of Bolivia, Columbia, Ecuador,and Peru unsuccessfully attempted to embargo the exportationof cinchona seeds, seedlings, or trees.Smuggled seeds enabled Europeans to establish cinchonaplantations in Southeast Asia, and the Dutch soon held a1A common story about the discovery of the fever-reducingproperties of this tree’s bark centers on the wife of a Viceroy ofPeru, Countess Ana of Chinchonm who contracted malaria in1638 and was reputedly cured of fever by a powder made fromcinchona bark. Despite its popularity, evidence does not supportits veracity. Regardless, Linnaeus named the genus Cinchonain her honor but with a misspelling that in 1866 the InternationalBotanical Congress opted to retain.monopoly on supplies. In 1942, Japan gained control of thecinchona trees cultivated for quinine in parts of Asia, andGermany captured the quinine reserves in Amsterdam. Alsoin 1942, confronted by advancing Japanese troops, ColonelArthur Fischer boarded the last plane to leave Mindanao, thesecond largest island in the Philippines, with a tin can filledwith cinchona seeds. These seeds were used to establishplantations in Costa Rica and Ecuador, but those plantingswere too late to benefit the war effort. The scarcity of quinineduring the war led to the development of alternate antimalarialdrugs, some of which are still in use today. During the1960s, several strains of the malarial parasite Plasmodiumfalciparum developed resistance to some synthetic drugs,particularly chloroquine. The parasite remained sensitive,however, to quinine, leading to a resurgence of its use, despitepotential side effects from large doses.The World Health Organization (WHO) documentsthat 198 million cases of malaria occurred globally in2013 (uncertainty range 124–283 million) and that malariawas responsible for 584,000 deaths (uncertainty range367,000–755,000). WHO further reported that in 2014,malaria transmission was ongoing in 97 countries and territoriesand ≈3.3 billion persons remained at risk for malaria.However, recent increases in resources, political will,and commitment have led to great improvements in malariacontrol in many parts of the malaria-endemic world. Theseefforts must be sustained to ensure progress toward malariaelimination and ultimately eradication.Bibliography1. Cambridge University Library. Products of the empire. Cinchona:a short history [cited 2015 May 19]. http://www.lib.cam.ac.uk/deptserv/rcs/cinchona.html2. Honigsbaum M. The fever trail: in search of the cure for malaria.London: Farrar, Straus and Giroux; 2001. p 221−6.3. Hughes K. Marianne North: the flower huntress [cited 2015May 19]. http://www.telegraph.co.uk/gardening/5012141/Marianne-North-The-flower-huntress.html4. Kew Royal Botanic Gardens. The Marianne North Gallery[cited 2015 May 19]. http://www.kew.org/visit-kew-gardens/explore/attractions/marianne-north-gallery5. Motley C. Cinchona and its product—quinine [cited 2015 May 9].http://www.ethnoleaflets.com/leaflets/quinine.htm6. North M. A vision of Eden: the life and work of Marianne North.New York: Webb & Bower/The Royal Botanic Gardens; 1980.7. Prabhakaran Nair KP. The agronomy and economy of importanttree crops of the developing world. 1st ed. Burlington (MA):Elsevier; 2010. p. 111.8. Rideout R. The radical Victorian lady behind an essential collectionof botanical art [cited 2015 May 19]. http://www.atlasobscura.com/articles/marianne-north-and-botanic-art9. World Health Organization. WHO World Malaria Report, 2014[cited 2015 May 19]. http://www.who.int/malaria/publications/world_malaria_report_2014/en/Address for correspondence: Byron Breedlove, EID Journal, Centersfor Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop C19,Atlanta, GA 30329-4027, USA; email: wbb1@cdc.govEmerging Infectious Diseases • www.cdc.gov/eid • Vol. 21, No. 7, July 2015 1281
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