Schedula Romana

The Schedula Romana was a pharmaceutical handbill published in 1649. Generally assumed to have been designed after the knowledge of the cinchona bark properties brought from South America by Spanish Jesuit Juan de Lugo, the Schedula Romana is considered to be an early example of an efficient antimalarial recipe. The Schedula gives instructions on proper dosages and application of the cinchona bark. The doses recommended are likely to have been established by trial and error, and they are assumed to be relied on results obtained using the various recipes proposed by Roman apothecaries.

In the 1630s a possible treatment for malaria was found in the forests of the Andes in Peru. A such called fever tree, whose bark, made into powder and given as a beverage, cured the fevers and was known to have produced miraculous results in the local population. The bark was obtained from several species of the genus Cinchona, of the Rubiaceae family. Popularized in Europe through the work of jesuits in America, the cinchona tree bark came to be known as Jesuit's bark. Perhaps the most prominent popularizer of the Jesuit's bark was a Spanish Jesuit Cardinal, Juan de Lugo. In 1643, Cardinal Lugo asked Gabrielle Fonseca, physician to the pope Innocent X, to conduct an efficacy study on the bark. Fonseca wrote a report remarking that the bark was the most effective remedy found so far. After the Jesuits were sufficiently satisfied by its efficacy, the bark was recommended for wider use. Finally in 1649, by order of Lugo, Pietro Paolo Puccerini, apothecary to the Pharmacy of the Collegio Romano, wrote instructions on proper dosages and application in a prescription called Schedula Romana.

Although the prescription was recommended to be used under medical supervision, patients often had to administer it themselves because of the indifference of the medical profession. The Schedula Romana gained great popularity due to the success of the bark. The Schedula Romana was the base of at least three centuries of quinine reasonable dosing, until it was suddenly reduced in the 1970s to a dose as low as 5 mg/kg/24 h, which is eight times lower than the amount today recommended.