> [!faq] What is this? > This is a deck I put together in March 2022 for a PowerPoint night with some friends, and has seen occasional use since. Hosting it here for ease of use, and because it's just a fun story. ## The Deck and Sources Slides: [[Quinine Quaffs - Quinine in alcohol.pdf|Download the slide deck (PDF)]] Prime source: [Malaria and French Imperialism](https://www.cambridge.org/core/journals/journal-of-african-history/article/abs/malaria-and-french-imperialism/1963187A549099B40711D9DF8F065709) - by William B. Cohen, published in the Journal of African History, 24 (1983) - This is paywalled, my apologies. You may be able to find a copy via some Google-fu. [The Columbian Exchange: A History of Disease, Food, and Ideas](https://www.aeaweb.org/articles?id=10.1257%2Fjep.24.2.163) - by Nathan Nunn and Nancy Qian, published in the Journal of Economic Perspectives, 24 (2010) ## Slides 1-2 - Intro and Outline ![[Quinine Quaffs - Quinine in alcohol-p01-1600w.png]] ![[Quinine Quaffs - Quinine in alcohol-p02-1600w.png]] This presentation was born out of a need for a presentation for a PowerPoint night with friends. Late one night in 2020 I stumbled into a Wikipedia rabbit hole that started with the gin and tonic, and resulted in waaayyy more casual knowledge about colonialism, infectious diseases, and alcohol than I was expecting to learn. I do need you to understand that: - This talk is for fun. - I am not a historian. - There’s a lot of Wikipedia in here. There may be inaccuracies. - I’ve provided a few sources where needed. If you know something is incorrect, let me know, I will correct it. - Trigger warnings. - In all seriousness, there may be some triggers here or at least potential for unpleasant associations. - The intent here is to talk about lesser-known alcohol and have some fun. - Please raise your hand and let me know if something is deeply unsettling and I’ll move past it quickly. ## Slide 3 - Colonialism ![[Quinine Quaffs - Quinine in alcohol-p03-1600w.png]] Colonialism means lots of problems for long term socio-economics that I AM IN NO WAY QUALIFIED to talk about; please consult smarter people than I on this subject. Let's say you’re a European circa 1800 CE. First, congratulations on your promotion to being a world power. Second, you now own, according to European foreign policy at the time, a bit of land in Africa. A colony. - Never mind the people already living there, they probably weren’t using it right anyway. - (Because this is a blog post, I am required to state this is a joke) The main reason you do a Colonialism is to extract resources, i.e. value, from that land you now control. - But you need people you trust to suppress the local—I mean keep a steady hand on the things there on your behalf. - So you go on over to your Civilization tech tree and unlock Middle Management and send a bunch of them to your new colony. There’s just one small problem... ## Slide 4 - Disease! ![[Quinine Quaffs - Quinine in alcohol-p04-1600w.png]] ... There’s just the problem that your royal subjects and said middle managers keep dying from all kinds of fresh, hellish, new (to Europeans) diseases. - **Especially Malaria** See also: yellow fever, scarlet fever, diphtheria, and venereal syphilis. - It's also worth noting that Venereal Syphilis may have existed in Europe BEFORE Columbus' expeditions, but the extent to which it was brought back as a direct result of the Columbian Exchange is debated. This was not a one-sided affair, the native populations were devastated by diseases brought by the Europeans, especially Smallpox, all of which continued to affect the colonizing Europeans as well. ## Slide 5 - Malaria ![[Quinine Quaffs - Quinine in alcohol-p05-1600w.png]] Link: [CDC Fact Sheet on Malaria](https://www.cdc.gov/malaria/about/index.html) **Malaria really, *really* sucks.** - It’s spread by mosquitoes which are EVERYWHERE in equatorial climes. - The symptoms get very bad very fast. - 7 to 30 days incubation period. Two levels of severity for “Malarial attack” - “Uncomplicated” - Chills followed by fever, headaches, vomiting, seizures. - Sweats and fatigue following - “Severe” - Lots of symptoms so we’re just gonna take the greatest hits here: - Acute respiratory distress syndrome - is what it says on the tin. - “Cerebral malaria” - seizures, coma, abnormal behaviors, neurologic abnormalities - Severe anemia - destruction of red blood cells - Acute kidney injury - Low blood pressure and cardiovascular collapse. ## Slide 6 - The Good News ![[Quinine Quaffs - Quinine in alcohol-p06-1600w.png]] The good news is we can treat it ... with Quinine! "*wtf is quinine?*" - Spaniards in Peru began making use of [Cinchona](https://en.wikipedia.org/wiki/Cinchona) tree bark as a treatment for various fevers. - They called it “Jesuit bark.” Quinine is the active ingredient. - There’s an entire world of side quests here with various physicians making their careers because they happened to be in the right place at the right time to give a nobleman powdered bark to treat a fever. ## Slide 7 - The Bad News ![[Quinine Quaffs - Quinine in alcohol-p07-1600w.png]] But there's a problem. The Cinchona bark, and quinine in general, is very bitter. - *Kind of like subjugated colonial living conditions eyyyyyyyy* - Europeans at the time really despised bitter flavors. And at risk of oversimplifying, the bark is only partially effective. Okay so it's only partially effective, and it’s really bitter, but hey it's better than nothing and definitely better than dying right? - Right? - ***Right?*** ## Slide 8 - The Gin and Tonic ![[devin-berko-fqlySC9fXP4-unsplash.jpg]] Photo by [Devin Berko](https://unsplash.com/@devinnn_b?utm_source=unsplash&utm_medium=referral&utm_content=creditCopyText) on [Unsplash](https://unsplash.com/photos/clear-drinking-glass-with-green-leaf-fqlySC9fXP4?utm_source=unsplash&utm_medium=referral&utm_content=creditCopyText) Put a pin in that because we have to give credit where it’s due first. The G&T is ubiquitous for good reason. The history of the British fascination with gin is worth some exploration on its own: - Great Britain had developed a taste for the continental liqueur “Gin” following the November 1688 “Glorious Revolution”. - King James II was deposed and replaced as monarch by his daughter Mary II and her husband William of Orange, de facto ruler of the Dutch Republic. - There’s an undercurrent of Catholic vs Protestant sectarianism to all of this. - This kicked off a series of conflicts called the “Jacobite Rebellions” where strange coalitions of Stuart loyalists, Catholics, and Scots, with backing from the French and Spanish, tried unsuccessfully to restore the Stuarts to the throne of England.  This new regime under William and Mary instituted several import restrictions, e.g. on French Brandy. - Meanwhile Gin came to the fore as a lower cost, available alternative as Britons were exposed to it by their Dutch allies in commerce and warfare.  - Gin was perceived as a drink of the “lower classes” until around the early 1800s when it experienced a surge in popularity. So how did the G&T come about? - The commonly accepted story is that British soldiers in India took to mixing their ration of quinine powder with sugar and water: Tonic Water. - This leads to a logical step of “why should I have my ration of tonic water in the morning, when I can wait until midafternoon and mix it with gin?” If you’re a public health official, this is a **HUGE WIN**. Who cares if they’re adding gin to the quinine ration? These soldiers and colonists are consuming an antimalarial treatment **regularly, proactively, and willingly!** You might be thinking by now: what about other countries? - I asked myself exactly the same question, that’s why this presentation exists. ## Slide 9 - France ![[Quinine Quaffs - Quinine in alcohol-p09-1600w.png]] The French also had West and Central African colonial holdings, also with a lot of malaria. Did they use quinine? - Yes. ….. Ish. - Similar format, similar treatment, similar complaints. It’s bitter. It’s inconsistently effective. The Wikipedia origin story: - the French government ran a competition in the 1840s for a drink that could get French soldiers to drink something with quinine in it. - The submissions to the contest were mostly aromatized or fortified wines (added herbs and spices), and many came onto the French market following this. ## Slide 10 - Quinquinas ![[Quinine Quaffs - Quinine in alcohol-p10-1600w.png]] These French quinine fortified wines were dubbed “Quinquinas”. Dubonnet (1846) - Joseph Dubonnet of Paris - If you're entertained by alliteration, Dubonnet was marketed under a phenomenal French play on words: "Dubo, Dubon, Dubonnet" (roughly meaning "It's nice; it's good; it's Dubonnet") - I choose to imagine a 70s or 80s TV commercial with a ruggedly handsome French actor in a smoky room telling you the drink in his hand is nice, good, Dubonnet. Byrrh (1866) Lillet or Kina Lillet (1887) - Kina Lillet (1920) is the base liquor for the Vesper martini - Some may know Kina Lillet as the original Ian Fleming written drink of James Bond. - Kina Lillet has been discontinued and is largely substituted now by Lillet Blanc or Cocchi Americano. - Kina was dropped from the name because that term/name “Kina” wound up being used in other aromatized wines. So with all of these quinquinas available … did it work? ## Slide 11 - Humans Haven't Changed ![[Quinine Quaffs - Quinine in alcohol-p11-1600w.png]] Photo by [camilo jimenez](https://unsplash.com/@camstejim?utm_source=unsplash&utm_medium=referral&utm_content=creditCopyText) on [Unsplash](https://unsplash.com/photos/people-using-phone-while-standing-qZenO_gQ7QA?utm_source=unsplash&utm_medium=referral&utm_content=creditCopyText) My sourcing on what comes next here is historian William B. Cohen, who wrote an article "Malaria and French Imperialism", published in the Journal of African History in 1983. - This particular piece talked about French usage of quinine in depth. So … did it work? - The French consumed quinine **reactively**, as a cure for malarial fever. Their British peers consumed it **preventatively** as a matter of routine to prevent the fevers in the first place. - Cohen draws a conclusion that many Frenchmen, who did not use quinine prophylactically (to prevent disease), died as a result of fevers experienced shortly after arriving in the colonies for which their preferred reactive treatments were not effective. Efficacy of this quinine powdered bark stuff as a medical treatment was openly doubted by the French public. - ... in addition to claims of side effects ... - ... and it tasted bad. This in turn was amplified by what you might call “Influencers” in French society. - In the 1830s the Duke of Orleans publicly called quinine a "poison" to what you might call his social media following of the day. - A common French concern about quinine was that it may cause baldness. French physicians seemed to be concerned about preventative use of quinine creating an immunity to quinine as a treatment. - Quinine was also used to treat misdiagnoses, such as typhus and yellow fever, both of which at the time were attributed to malaria, but did not respond to quinine as a treatment. - Some suggested dosing amounts and schedules were too low to be effective. Meanwhile proponents of quinine couldn't agree on a known-good, effective dosing regimen. All of this builds in the common French perception creating a frame of **Fear, Uncertainty, and Doubt** as to quinine’s efficacy. Some other notes on Quinine: - It has mostly been replaced by Chloroquine and other antimalarials that are simpler to dose and administer. - If chloroquine sounds familiar, that’s probably because a certain US President circa the year 2020 was recommending consumption of hydroxychloroquine as a treatment for COVID-19. - No, it is not effective against COVID-19. - It IS effective at causing irregular heart behavior, and it is used in FDA approved treatments of malaria, lupus, and rheumatoid arthritis.  Now, with all of this in mind: I need you to know I went down this rabbit hole in late 2020. - COVID was still very much a real and present danger, and vaccinations hadn’t even been approved for critical industry personnel yet. - My wife was pregnant at this time with our first kid. We couldn’t go out anywhere. I had lots of time on my hands to doomscroll and drink, including G&Ts. - At some point the ADHD obsession bit that if G&T was the favored antimalarial of the Britons, did the other colonial European powers have anything similar? - Learning about French attitudes towards quinine, and the direct lineage from that to hydroxychloroquine really hammered it home to me that humans have literally never changed. - **I am cursed with this knowledge, and now you are too.** ## Slide 12 - What about other countries? ![[Quinine Quaffs - Quinine in alcohol-p12-1600w.png]] What about $Country_Name? - Great question. I don't know. - Only so many hours, we're all busy, etc. Dig in, let me know if you find something cool. - You may see these kind of wines called "Quinquinas" or Quinine Liqueurs. - The Italians have a few: - Cocchi Americano (1891) – described as an apertif wine, bittersweet, tasting of sweet citrus, stone fruit, and honey. - Contratto (1867) – Multiple products and I’m not exactly sure which are quinquinas, but most likely Contratto Americano Rosso is. Why did gin and tonic catch on and fortified wines not? - Next slide. ## Slide 13 - Cultural Victory ![[Quinine Quaffs - Quinine in alcohol-p13-1600w.png]] Why did gin and tonic catch on and fortified wines not? - My personal and amateur opinion is that gin and tonic has been something of a British cultural export, and that to live in an English-speaking country and not encounter the gin and tonic is near unavoidable. The BBC's Tom Geoghegan in a 2009 article ["Who still drinks Dubonnet?"](http://news.bbc.co.uk/2/hi/uk_news/magazine/8159201.stm) interviewed one Graham Page of the marketing firm Nielsen. He posited: - That the surge of cheaper table wines have largely replaced fortified wine. - Dubonnet has struggled to attract a younger consumer. - Young people tend to prefer drinks that are easy to consume and easy to mix (hence vodka's dominance in the spirits market) and quinquinas are really neither of those things. ## Slide 14 - Dubonnet ![[Quinine Quaffs - Quinine in alcohol-p14-1600w.png]] We'll talk about Dubonnet because it's what I have. Variants - Rouge - Red wine base - Blanc - White wine and Vanilla - Gold - Orange Dubonnet Rouge costs about the same as a mid-tier bottle of wine in the US. - $17 @ Total Wine - $17 @ Binny's (Chicago) And the flavor is pleasant. - If you try it expecting something like a G&T that wants to be a nice Syrah when it grows up, it's quite good. - If you go into it expecting a deep, sophisticated red wine, I fear you'll be disappointed. My cocktail: - I have no idea if this has a formal name, ideas welcome. - 1 part Dubonnet Rouge, - 1-2 parts cranberry juice - Add a wedge of citrus of your choice (I prefer lime but orange is also excellent) - Build over ice in a rocks glass and stir. ## Slide 15 - Close, Q&A, Chitchat Questions and chitchat welcome.