Cinchona tree

Family Rubiaceae. Parts used: bark of cultivated trees. Pharmacopoeial name: cinchona bark - Cinchonae succirubrae cortex (formerly: Cortex Chinae).

Botanical description. The native habitat of the cinchona tree is the Andean valleys in the northern part of South America; however, it is now cultivated on Java, in India and in the Congo. The cinchona tree reaches a height of about 30 m, with a straight trunk and a dense rounded crown. Leaves are large, ovate, petiolate. Dense clusters of red flowers are gathered in loose panicles.

Collection and preparation. The cultivation of cinchona trees is interesting. Seed is used to raise seedlings, which are then planted in plantations. After 6 years the plantation begins to be utilised: the plantation is thinned and the bark is taken from the trunks and roots of the removed trees. In subsequent years such thinnings are carried out regularly until about 20 years later only a quarter of the originally planted trees remain. Then the last ones are removed and the plantation is replanted. Obtaining bark for medicinal purposes is very labor-intensive. First ring-like incisions are made, which are then connected by longitudinal cuts. By giving a series of blows to the bark, it is separated from the wood and then peeled off with horn spatulas. It is dried first in the sun and then at about 80°C in special dryers. In another method, about 8 years after planting the trees are cut down at ground level. Shoots form, which are used in a few years in the same way.

Active constituents: The most important active constituents are bitter alkaloids, the content of which in the raw material can vary greatly. The best known of these are quinine and quinidine. In addition, tannins, cinchonic acid and bitter glycosides should be mentioned.

Therapeutic effects and uses. The cinchona tree became famous because of its bark — after it was discovered that it could be used to treat malaria (this effect is due to quinine). Alongside this, many galenic preparations made from it (cinchona wine, cinchona tincture) were used as a tonic and strengthening remedy, especially for children. Pure quinine (now obtained synthetically) and quinidine are included in many remedies for influenza, which act especially well in high fever. These alkaloids are also used as cardiac remedies.

The German Public Health Service recognises the following indications for cinchona bark: for stomach disorders caused by insufficient gastric juice secretion, and to stimulate appetite.

Cinchona bark should not be used during pregnancy, in cases of gastric or intestinal ulcers and, of course, in those allergic to quinine.

Tea from cinchona bark: Infuse 1 level teaspoon of bark with 4 l of boiling water and let stand for 10 minutes, then strain. Daily dose: about 3 cups of freshly prepared tea half an hour before meals.

Use in homeopathy. China — that is the name of the homeopathic remedy from the bark of the cinchona tree — is very widely used in homeopathy. Its low dilutions (D2 and D3) are recommended for insufficient gastric juice secretion, general weakness and the convalescent period after debilitating illness. In these dilutions cinchona acts as a true tonic. Slightly higher dilutions (D4–D6) are used for periodic headaches, neuralgias, bronchitis and whooping cough, rapid pulse, stomach disorders, poor digestion, biliary tract complaints, fever and gout.

When investigating the action of cinchona bark, Samuel Hahnemann found a regularity: he himself (being healthy) after taking cinchona always began to suffer from high fever, while patients with fever were cured by cinchona. Homeopathic physicians know the so-called cinchona type of person: these are people unusually weakened, suffering from lack of appetite and increased sensitivity, irritable and unbalanced, with ailments of the stomach and biliary tract.

Side effects. Here it is important to distinguish clearly between cinchona bark and pure quinine. Cinchona bark in galenic preparations and in therapeutic doses when taken as a tea does not cause side effects, but quinine must be treated with caution. At higher doses poisoning can be expected in some patients. 10–15 g of quinine are life-threatening. Poisoning begins with nausea and vomiting, agitation, impairment of hearing and vision, dizziness and ends with loss of consciousness and death from cardiac and respiratory arrest. In case of poisoning, a doctor must be called immediately. Until his arrival the toxin should be removed from the stomach (see).

The German Public Health Service names fairly rare side effects observed with tea made from cinchona bark — above all a tendency to bleed due to a reduction in the number of platelets involved in blood clotting. In such cases one should consult a doctor immediately.

based on material from the site www.medicina.kharkov.ua