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Cinchona Trees Witness Taiwan's Century of Epidemic Prevention: The Predecessor of Hydroxychloroquine in the Liugui Forest

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The New Star in the Fight Against COVID-19 - Hydroxychloroquine - Had Its Predecessor in the Liugui Forest! Cinchona Trees Witness Taiwan's Century of Epidemic Prevention

In order to combat COVID-19 (commonly known as "Wuhan pneumonia"), experts around the world have been racking their brains. Didier Raoult, a European authority on infectious diseases, discovered that hydroxychloroquine, a drug commonly used in rheumatology and immunology, can effectively fight the epidemic. Following China, South Korea, France and the United States, Taiwan's Central Epidemic Command Center also announced on March 26 that patients may use hydroxychloroquine as long as it is approved by a physician.

Hydroxychloroquine is a synthetic drug with a long history; it is cheap and easy to manufacture. Its predecessor, quinine, was extracted from the bark of the cinchona tree and was once the only miracle drug used to treat malaria in Taiwan during the Japanese colonial period. Cinchona trees were introduced to Taiwan during the Japanese colonial period, and were planted most extensively in Liugui, Kaohsiung. It was not until the mid-1940s, when synthetic quinine gradually became available, that cinchona trees faded from the stage of history.

The cinchona trees on the mountain have not disappeared. As long as you walk into the Fenggang Forest Trail of the Liugui Experimental Forest, cinchona trees can be seen standing proudly everywhere along the roadside. After blooming, bearing fruit and dropping seeds that sprout year after year, they have become part of the Liugui forest. Although malaria is no longer present, new viruses have arrived. Hydroxychloroquine, like its predecessor quinine, brings hope to humanity and also unveils the mysterious veil of Taiwan's malaria epidemic history from a century ago.

The fruit of the cinchona tree. (Provided by the Liugui Research Center of the Taiwan Forestry Research Institute)

Malaria Raged During the Japanese Colonial Period, More Terrifying Than War; Japanese Turned Pale at the Mention of Malaria

At the end of the 19th century, the Japanese Empire, which was eyeing Taiwan covetously, ignored the Qing government and did not fear the Indigenous peoples of the mountains. Its only greatest fear was the tropical miasma disease - malaria.

In 1874, Japan attacked the tribes of southern Taiwan in what is known in history as the "Mudan Incident." At that time, the Japanese army numbered nearly 6,000, of whom only a little more than 20 died in battle, but 561 died from malaria. In 1895, Japan formally ruled Taiwan. Eleven years later, Japan sent 75 camphor workers to Jiaxian and Liugui to extract camphor, and in less than a year as many as 40 people died from malaria. For the Japanese government, malaria was the greatest enemy of imperialism entering a colony.

Lin Wenzhi, associate researcher at the Liugui Research Center of the Taiwan Forestry Research Institute under the Council of Agriculture, said: "I remember once during a field survey, I heard an elderly person in his seventies or eighties mention that he had four older sisters when he was a child, but not one of them grew up safely, because all of them died of illness (malaria)."

Spreading out more than a dozen old publications, related books and papers from the Forestry Research Institute with one hand, Lin Wenzhi looked through them while recalling, and he mentioned that Liugui's camphor industry was also deeply affected by malaria. He said: "In the past, when Hakka people from the north came to Liugui to cut camphor and make camphor blocks, the Japanese would require them to sign contracts. The Japanese government worried that these people would flee back to the north out of fear of malaria."

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