Guaraná’s forgotten history: The rise and fall of an Indigenous Brazilian phytotherapy in Anglo-American medicine

Abstract

Tracking guaraná’s transition from a pre-Columbian, caffeine-rich cultivar of the Sateré-Mawé people of the Lower Amazon region to an Anglo-American pharmaceutical during the late nineteenth century, this essay focuses on the historical processes of transmission, adaptation, and erasure surrounding cross-cultural therapeutic transfers. Nineteenth-century scientists, pharmaceutical firms, and health practitioners who promoted guaraná in the Northern Hemisphere – largely to treat so-called sick-headache – stripped the plant of its Indigenous cosmologies, relying on elaborate processes of mediation and reassignment to bind together researchers, providers, and patients in new codes and rituals. Scientists’ reinvention of guaraná streamlined the drug’s adaptation to wealthier foreign markets, where interest spiked but proved unsustainable due to the high cost of the drug, competition with cheaper, mass-produced caffeinated substances such as coffee and tea, and the rise of synthetic medicines. This essay situates the history of guaraná in Anglo-American markets in the context of colonial botanizing and knowledge transfers that expanded in the late nineteenth century with the conquest or exploration of tropical regions. Informed by medical anthropology, the analysis also approaches medicines as social objects whose exchange relies on discrete actors and forms of communication; social attitudes and practices that define appropriate standards and settings for drug consumption; and the centrality of relevant cultural frameworks in affirming the significance and even potential benefits of drug taking. Thus, the forgotten history of guaraná (a “soft drug” that has been curiously orphaned in the extensive literature on stimulants) raises broader questions about the erasures of Indigenous knowledge and botanical medicines from pharmaceutical histories and practices.

Guaraná’s transition from a pre-Columbian cultivar of the Lower Amazon region to an Anglo-American pharmaceutical during the late nineteenth century reveals the historical erasures that have marked cross-cultural therapeutic transfers. ¹ A caffeine-packed plant grown commercially only in Brazil, guaraná was first domesticated by the Sateré-Mawé people. The Indigenous refer to themselves as the “children of guaraná,” reflective of the plant’s centrality to their cosmology; ritual consumption of çapó, a guaraná beverage, accompanies rites of passage and communal decision-making. ² Amid expanding exploration and colonization of tropical regions, promoters in the Northern Hemisphere stripped guaraná of its Indigenous meanings, binding together researchers, providers, and patients in new referents and rituals. ³ Guaraná’s boom-and-bust in Anglo-American therapeutics highlights the constellation of knowledge systems and market forces that constitute histories of medicine. Beyond a “soft drug” curiously orphaned in the historiography on stimulants, guaraná’s nineteenth-century trajectory elucidates the erasures of Indigenous knowledge and botanicals from pharmaceutical histories and practices. ⁴

Although guaraná is best known today as the brand name of Brazil’s “national” soda – and the crop’s principal market as well – it once featured as one of the phytotherapies characteristic of nineteenth-century biomedicine. In the nineteenth-century Global North, purveyors of medicine claimed guaraná in search of therapeutic regimens and monetary profit. Guaraná first appeared in the United States Pharmocopoeia in 1880 and, although lacking legal authority, endorsement of an “officinal” preparation by an esteemed medical committee signaled respectability. ⁵

Administered for ailments spanning from sciatica and dysentery to gonorrhea and urinary tract infections, guaraná was most commonly indicated for “sick-headache.” ⁶ In 1884, for example, Boston physician Francis Brown praised the caffeinated substance as among the most “efficient remedies” for an ailment often brought on by “overwork, which wearies the body while it taxes and worries the mind, and loss of sleep.” ⁷ Turn-of-the-century medical literature also endorsed guaraná to treat neurasthenia, or nervous exhaustion, a somatic condition purportedly afflicting the overly refined and delicate due to the vertiginous pace of modern life. ⁸ Like other “tonic” medicines, guaraná was held to invigorate organs, muscles, and blood vessels, ensuring the balance required for good health. ⁹

Drug manufacturers filled or fueled demand. In 1874, the Parke, Davis Company rolled out its fluid extract of guaraná (or concentrated preparation in an alcohol solution) for use “in sick headache, and pains in the head, and other symptoms, which are caused by a morbid condition of the mucous membrane lining the stomach.” ¹⁰ The British Royal Botanic Gardens even attempted to transplant guaraná to South Asia, albeit without lasting commercial success. ¹¹

In a matter of decades, however, guaraná’s luster in the North Atlantic faded: the drug was removed from the United States Pharmacopoeia (USP) of 1920. At the USP convention attendees noted that prescriptions had waned, because its efficacy as a “nervine and stimulant derived from its caffeine content, which if unassayed was untrustworthy, and which could be more convenient and economically obtained from other sources.” ¹² Scientists’ rebranding of guaraná had facilitated adoption in wealthier foreign markets, but high cost and limited supply, competition with mass-produced caffeinated substances, and the rise of synthetic medicines doomed the trade. Thus, we can speak of a second erasure of guaraná: the obfuscation of Indigenous-centered knowledges and practices by nineteenth-century biomedical practitioners was followed by the subsequent marginalization of the botanical drug by the Anglo-American pharmaceutical industries.

Historiographical approaches to guaraná’s Anglo-American boom

Historians have offered multiple explanations for the varied success of psychoactive drugs in North American and European markets: pharmacological effect, scale of production, cultures of reception, and temporal juncture. ¹³ Indeed, a tropical drug’s fad in wealthier nations invites multiple historiographical perspectives. Historians of medicine might situate guaraná’s U.S. market splash in the context of soaring, unregulated postbellum drug consumption. ¹⁴ High rates of disease and poor diets fueled drug demand, railroad expansion facilitated distribution, and tumultuous urbanization fostered multiple ills, real and perceived. ¹⁵ Wounded Civil War infantrymen downed medicines often laden with high percentages of alcohol, opium, or morphine. ¹⁶ Whereas in 1859 the patent medicine industry netted $3.5 million, by 1900 sales were estimated at $59 million, a sevenfold increase in per capita expenditure. ¹⁷ Indigenous medicines’ long-standing appeal owed to faith in the “simple” cures of peoples seen as closer to nature. ¹⁸ In this competitive market, guaraná became a provisional, albeit ultimately unsuccessful, contender. It joined the ranks of other phytotherapies from Latin America displaced by corporate manufacture of synthetic medicines based on the bioactive compounds of natural products. ¹⁹

Historians of science might view guaraná’s intercontinental dissemination in the context of colonial botanizing and the production of knowledge hierarchies. Colonial botany, or “the study, naming, cultivation, and marketing of plants in colonial contexts,” of course, stretched back to early modern European mercantilist trade and scientific investigation: Portugal’s empire operationalized a global dissemination of medicinal plants and pharmacological knowledge – including guaraná. ²⁰ Yet European and North American botanizing expanded in the late nineteenth century with novel or renewed forays into tropical regions. ²¹ From the eighteenth century, Western science also came to be organized according to disciplines based on specialized procedures and classification systems whose universal methods touted the transposability of knowledge and the improvement of society. Quantification allowed things to be “objectively” compared and ordered – or at least by those who mastered these techniques, and whose selectivity in categorization was mediated by social structures and political resources. ²² Advances in biochemistry, bacteriology, and epidemiology facilitated and justified the “benevolence” of military occupation and settler colonialism, while scientific investigation of “new” plants or the commercial transplant of old ones buoyed imperial capacities and racial ideologies. ²³ From a sacred plant and the fount of knowledge of the Sateré-Mawé, botanists reclassified guaraná through Linnaean taxonomy as a species in the Sapindaceae family, while chemists identified and assayed the plant’s active principles. Scientists erased or disparaged Indigenous understandings of therapeutic plants, although the cachet of Native American botanicals might have favored flashing guaraná’s Amazonian origins.

Lastly, economic historians of Latin America might register guaraná’s late nineteenth-century Anglo-American blip as another instance of export-led growth volatility. From the 1870s to the 1930s, Latin America’s global integration boosted commodity exports and direct foreign investment, yet commercial supply and product substitution consistently tempered market value. In Latin America’s “commodity lottery,” guaraná would not prove a long-term winner in the turn-of-the-century markets above the Equator. ²⁴ With coffee and tea promising cheaper jolts amid well-established gastronomic and social practices, European and North American markets confined guaraná to the pharmaceutical sector, the clearinghouse whence its caffeinated peers had long ago exited to capitalize on the mass beverage market. Their emerging soft drink industries too bypassed guaraná, opting for other stimulants, such as coca or cola. Tellingly, at the London International Exhibition of 1862, Brazil’s delegation pitched guaraná as a drink and a medicine, but a decade later in the Philadelphia Centennial Exposition apparently opted only for display as a pharmaceutical, alongside other medicinal plants. ²⁵ Even as a therapeutic, guaraná foundered due to cheaper caffeinated substitutes and the advent of synthetic medicines. Guaraná’s history, in this sense, exemplifies the legendary boom–bust cycles of Latin America’s primary sector.

Interweaving these historiographical strands, this essay situates nineteenth-century Western scientists’ scrutiny, dissemination, and erasure of guaraná within the context of competing knowledge regimes, social hierarchies, and forms of commercial healthcare. ²⁶ Particularly useful is Charles Rosenberg’s conceptualization of science as a form of historically specific knowledge and techniques that define and legitimize the discipline, provide its peers with a shared set of values to motivate and justify behavior, and uphold tenets of selflessness and objectivity in explaining problems such as illness, social difference, and the vagaries of the life cycle. ²⁷ Drawing from medical anthropology, the analysis approaches medicines as social objects whose exchange relies on discrete actors and forms of communication, and social practices and cultural frameworks that define appropriate standards and settings for drug consumption. ²⁸ In these iterations, biomedicine bears resemblance to Indigenous healing practices. Guaraná’s trajectory in late nineteenth- and early twentieth-century Anglo-America illuminates the economies and epistemologies surrounding the appropriation and erasure of Indigenous pharmaceutical knowledge as well as biomedicine’s subsequent marginalization of a one-time ballyhooed botanical.

The reclassification of guaraná by nineteenth-century botany, chemistry, and pharmacy

The integration of guaraná into nineteenth-century pharmacy entailed the plant’s reinvention as a botanical species and chemical compound. In Sateré-Mawé cosmology, the ancestral burial of a deceased child’s eyeball gives rise to the guaraná plant – a myth deriving not only from the berries’ ocular resemblance, but the belief among Native Amazonian peoples in the transmutability of beings and the interchangeability among all living things during primordial times. ²⁹ Over the course of the nineteenth century, however, scientists reclassified guaraná according to the “universal” standards of botany and chemistry. As Europeans voyaging outside their continent encountered many new plants and medicines – with the 6,000 plant species recorded by Caspar Bauhin in 1623 increasing to 50,000 by Georges Cuvier in 1800 – botanists, pharmacists, doctors, and collectors sought to systematize the classification of flora. ³⁰ On the basis of morphological comparison, Karl Linnaeus (1707–88) rationalized the placement of plants within a universal taxonomic system, thereby facilitating the global exchange of knowledge. A Swedish university professor and practicing physician, Linnaeus was also interested in the therapeutic and commercial value of plants and apprehension of the Divine in nature. Moreover, chemistry’s formation as a modern science associated with Antoine Lavoisier (1743–94) reshaped the practice of pharmacy, while the development of physiology and pharmacology contributed to the field of drug development. Analysis of plant substances, particularly by French and German pharmacists due to their knowledge of chemistry, specialized equipment, and institutional support, led to the discovery in 1817 of alkaloids, a class of organic compounds composed of carbon, hydrogen, nitrogen, and usually oxygen that often possess both poisonous and curative properties. ³¹ The isolation of the chemical composition of drug molecules and their relationship to physiological activity allowed for the development of new therapeutic agents netted from the expansion in European scientific voyages and global trade. ³² Parsing living organisms according to “objective” properties and quantifiable standards allowed for greater commensurability in scientific knowledge and global interconnection, as well as social hierarchization. ³³

Spearheading the nineteenth-century scientific reclassification of guaraná were the Bavarian brothers Karl and Theodor von Martius. During his three-year voyage to Brazil from 1817 to 1820, botanist Karl von Martius collected thousands of fauna and flora, including ninety-two native medicinal species from the Amazon. First published in 1843 and in Portuguese translation in 1854, Martius’s Systema de Materia Medica Vegetal Brasileira described the therapeutic value of 730 species; his fifteen-volume Flora Brasiliensis, containing information on 22,267 plant species, would take over sixty years to complete. ³⁴ Accompanying botanical drawings were produced over decades (some at the time of the journey and others in Europe based on collected materials), representing species’ diagnostic and morphological characteristics for scientific classification. ³⁵

Guaraná was one of the Amazonian plants that Karl von Martius reclaimed. In an 1829 lecture at the Royal Bavarian Academy of Sciences, he related popular usage of the plant as a “stomachal, febrifuge and aphrodisiac,” though confessing uncertainty regarding the bitter drug’s “dominant character.” ³⁶ His pharmacological assessment of guaraná revealed the continued primacy of Galen’s humoral theory in early nineteenth-century European notions of etiology that focused on stabilizing the balance among the four liquid “humors” of the body: blood, associated with heat and moisture; phlegm, with moisture and cold; black bile, with cold and dryness; and yellow bile with dryness and heat. ³⁷ In Systema de Materia Medica Vegetal Brasileira, Martius noted of guaraná:

It prevents the excessive sensitivity of the intestinal plexus, thus reducing febrile attacks, supports the stomach and intestines, and mainly prevents the excessive evacuation of mucus, somewhat excites the movements of the heart and arteries and increases diaphoresis. It is therefore regarded as a noble remedy: in fevers, or a state of sensibility, increasing as a result of cooling or heat stroke, excessive agitation of the body, sufferings in the soul, prolonged vigils, and sometimes in cramps, flatulence, anorexia (fasting), nervous migraine, skin dryness. It is contraindicated for the state of fullness of the abdominal viscera, saburra, and the disposition of blood to the head. It excites the venereal appetite, but is said to decrease sperm fecundity. ³⁸

For Martius, Brazil’s Indigenous peoples may have been well-versed in botanical therapies but offered little systematized knowledge for the advancement of Western science or Christian morality. ³⁹ As “relics of an erstwhile cultured and flourishing race,” Indigenous medical knowledge represented “a miserable fragment of ancient science accommodated to nature” and a gross deviation from European medical understandings of the sick body. Through the “enlightened experimentation” of “competent persons” – namely, Europeans who occupied a “more advanced stage of social life” – the chemical components of Brazilian plants and their physiological effects could be ascertained, instead of subjection to “mere domestic traditions, or the hoaxes of ignorant men.” ⁴⁰ Alongside Indigenous peoples’ purported failure to “occupy” their lands (terra nullius), Martius’s disparagement of their knowledge systems cohered with contemporary scientific discourses that legitimized territorial dispossessions and socioracial hierarchies. ⁴¹

Martius’s reclassification of guaraná in 1819 as Paullinia sorbilis, honoring a seventeenth-century Danish botanist, was not without historical irony: Simon Paulli’s Commentarius De Abusu Tabaci Americanorum Veteri, Et Herbæ Thee Asiaticorum in Europe Novo (1661) deplored the foreign stimulants then overtaking Europe. Sorbilis, deriving from the Latin to “suck in,” referenced the species’ consumption as a beverage. Guaraná became another genus of flowering shrubs and lianas in the Sapindaceae, or soapberry, family (today with approximately 140 genera and 2,000 species, almost entirely restricted to tropical and subtropical America). ⁴²

Much has been written on the practice of binomial nomenclature advocated by Linnaeus. ⁴³ Once identified, a specimen would represent similar plant types based on component parts regardless of ecological or historical–cultural context. Linnaeus called for naming genera after botanists, rewarding their heroic pursuit of science with “immortal renown,” though scientists from other fields might likewise be memorialized, alongside explorers, monarchs, and patrons. Framing science as the creation of great European men, Linnaeus championed the notion of priority: the individual who first published a name and exact description of a plant would be considered to have established its identity. ⁴⁴

Indeed, based on the principle of priority, Martius’s own authorial claim to Paullinia sorbilis proved contentious. Prussian geographer Alexander von Humboldt and French botanist Aimé Bonpland had collected guaraná from Venezuela’s upper Orinoco between 1799 and 1804, and the plant had been classified in 1821 as Paullinia cupana in Nova genera et species plantarum by German botanist Karl Sigismund Kunth. (Cupana referenced its local indigenous name). Only in 1937, after Brazilian botanist Adolpho Ducke gathered samples of cupana from the upper Rio Negro, would Martius’s identification of a new species variety be recognized, based upon significant morphological differences in the Maués plants from those in the upriver locations. The scientific name of guaraná from the Lower Amazon region is Paullinia cupana Kunth var. sorbilis (Mart.) Ducke, the only variety that is commercially used. ⁴⁵ As Angélica Márquez-Osuna demonstrates in this special section in her study of the evolving taxonomies of the Yucatán stingless honeybee, classifications of the natural world are power-laden acts fundamentally mediated by material and cultural factors. ⁴⁶

Guaraná’s renaming by Martius reflects not only the precepts of botanical nomenclature but the historical exchanges that produce colonial knowledge and hierarchies. ⁴⁷ Indigenous peoples’ purported absence of systematic scientific classification served to impugn their intellectual and civic capacity. ⁴⁸ And in place of a model of collective Indigenous knowledge production stood one that prized individualized authorship and transformative application – the ideological roots of Western patent laws that continue to prejudice traditional knowledge in the marketplace of “individual” ideas and corporate profits. ⁴⁹

From a sample provided by his brother, Theodor von Martius, a professor of pharmacy at Erlangen, isolated the drug’s active principle in 1826, which he called guaranine. ⁵⁰ The alkaloid’s structure was later shown to be a tetramethylxanthine nearly identical to caffeine, which German physician Friedlieb Ferdinand Runge identified years earlier. ⁵¹ European scientists furthered phytochemical research over the ensuing decades. In 1851, naturalist Richard Spruce noted of specimens he shipped to the Kew Botanical Gardens: “The essential principle of this substance is said to be identical with Theine and Caffeine, which I can well believe, for the immoderate use of Guaraná relaxes the stomach and causes sleeplessness; precisely the effect which result from the abuse of tea and coffee.” ⁵² In Brazil, guaraná was extensively analyzed by Theodor Peckolt, a Prussian pharmacist who arrived in 1847 at the suggestion of Karl von Martius to study native flora and remit samples to Europe, and who published several books and more than 400 scientific works in national and international journals on Brazil’s materia medica. ⁵³ In 1868, the American Pharmaceutical Association reported that Peckolt “has analyzed the seeds of this plant, which yield the guaraná, and finds them to contain caffeine, yellow fixed oil, brown-green soft resin, red resin, resinous matter, nitrogenous extractive, red coloring matter, amorphous bitter principle, guaranic acid, saponin, gallic acid, iron-greening tannic acid, albuminous matter, starch, glucose, dextrin, pectin, mucilage, malic acid, and cellulose.” ⁵⁴

As Stephen Hugh-Jones notes, the delinking of food and drug arose in the context of the industrial revolution that enabled societies to manufacture chemically refined products, and in expanding economies where these products might circulate as commodities. ⁵⁵ The process was tied to the formation of specialized medical and pharmacological professions and an established judiciary and police force. ⁵⁶ Through the publication and dissemination of specialized journals, scientists buttressed global networks and frameworks of knowledge in which guaraná reemerged as a botanical species and industrial pharmaceutical. Scientists’ ‘universal’ language rendered guaraná commensurable with better-known stimulants. ⁵⁷ The plant’s “principles” were itemized and ranked, shorn of Indigenous understandings.

Anglo-American pharmaceutical ‘discovery’ of guaraná

Anglo-American commercial interest in guaraná surged following the endorsement by Samuel Wilks of Guy’s Hospital in London. In an article in the British Medical Journal and The Lancet in 1872, the esteemed physician touted guaraná as “a most valuable remedy in sick-headache.” Wilks reported only “doubtful effect” on his own migraine – he preferred cannabis – but called for an extended trial in light of his patients’ “encouraging” results. As one affirmed: “I have every reason to believe them a complete preventive of headache, as on the least symptoms I have taken a powder, sometimes a second, in two hours of a time, and in no case have they failed as an effectual cure. I have not had a bad headache since I saw you.” ⁵⁸

Guaraná appeared on Wilks’s desk circuitously. Apparently, Dr. Gavrelle, Brazilian Emperor Pedro I’s physician, took guaraná home with him to France, where he touted the drug for diarrhea and “tedious convalescence” before the Society of Medicine in 1840. ⁵⁹ In ensuing decades, the Parisian Grimault company marketed several guaraná medicines developed by professor of medicine and pharmaceutical chemist M. Leconte. ⁶⁰ From France, guaraná landed in Montreal, where one Mr. Wood dispatched samples to Wilks. ⁶¹ Two years after Wilks’s endorsement blanketed medical and pharmaceutical journals on both sides of the Atlantic, Parke, Davis launched the first guaraná medicament manufactured in the United States. Several others followed, including John Wyeth and Brothers’ Elixir Guaraná in the 1880s. ⁶²

For patients in the Global North looking for relief from a migraine or stomach ache, guaraná was no cheap fix. Among Parke, Davis’s hundreds of botanical fluid extracts, guaraná was one of the priciest: In 1878, the company’s guaraná fluid extract cost $10.00 per pound, its coca leaves sold for $6.50; damiana (to treat male sexual dysfunction) for $4.00; and kava kava (indicated for gonorrhea, gout, and rheumatism) went for $6.00. ⁶³ Likewise, the guaraná medication of the Cincinnati-based Lloyd Brothers was one of the firm’s most expensive preparations. ⁶⁴

The Wyeth Company’s correspondence with Lanman & Kemp, a patent medicine firm well-connected to Latin America, reveals the obstacles to acquiring the drug for pharmaceutical production. In 1877, the New York-based Lanman & Kemp supplied Wyeth with guaraná from traders in the Amazonian port city of Belém, but fell short of the monthly target of 100 pounds. ⁶⁵ A British pharmaceutical journal offered an explanation for the shortfall: “The consumption in Brazil is known to be very large, and, apart from the paste which is brought into commerce by the Indians of the Amazon territory, the guaraná is cultivated to some extent in the districts of Maués, Villa Bella, and Imperatrix [sic] only.” ⁶⁶ Amazonian drug supply chains were also bedeviled by a dearth of willing or available labor. ⁶⁷ Efforts of the Royal Botanical Garden to transplant guaraná to British colonies in Asia likewise failed: as environmental historians note, price incentives alone typically fail to ensure cash crop increases in the absence of demographic pressure or the deterioration of existing agrarian systems. ⁶⁸ Adaptation of know-how and technology and food preferences also determine crop transfer success. ⁶⁹

Marketing guaraná to Anglo-American consumers

Marketing the medication presented another challenge for Anglo-American drug manufacturers: selling consumers on an obscure Amazonian botanical. In launching “new” remedies from ‘exotic’ locales, the Detroit-based Parke, Davis, founded in 1866, aimed to upstage more established East Coast rivals. ⁷⁰ By the mid-1880s, the firm had launched more than forty-five products to the U.S. public, principally fluid extracts and plants obtained from expeditions to Latin America and the Caribbean, Fiji, and the Pacific Northwest. ⁷¹ These included “Eucalyptus Globulus,” “Grindelia Robusta,” “Yerba Santa,” and “Boldo,” alongside “Guaraná.” ⁷² Like other ‘ethical firms’, Parke, Davis also condemned the puffery and secrecy of the patent medicine industry and its direct-to-consumer advertising. ⁷³ Instead, the company trumpeted scientific know-how, altruism, and transparency. Hierarchies of race and gender likewise sustained claims of knowledge. Parke, Davis, for example, bewailed that

the claim that a remedy was obtained from an obscure tribe of negroes in Central Africa, or from some “Celebrated Medicine Man” among the Indians – parties regarded by intelligent people of not more than average scientific attainments in anything but therapeutics – is often sufficient to give a proprietary medicine popular favor and extensive sale. ⁷⁴

Likewise, the company’s Pharmacology of the Newer Materia Medica affirmed that “the first knowledge of nearly every medicinal plant official in the pharmacopoeia was obtained from Indian medicine-men, ignorant natives, quacks, and old women.” Although such “unscientific” sources were not unimportant, the journal added, the information obtained from medical professionals at large was more valuable: the worthiest issued from hospital practice based on “careful observation.” ⁷⁵

The 1885 scientific expedition by Henry Hurd Rusby to Bolivia, Brazil, Colombia, Chile, Ecuador, and Peru, sponsored by Parke, Davis to identify “new” plant therapies and improve provisions for current drugs elucidated additional strategies for marketing guaraná. ⁷⁶ The Amazonian initiative was hailed for advancing scientific knowledge and collaboration between doctors and pharmacists. ⁷⁷ The medium was also the message: botanical expeditions exemplified classic notions of scientific discovery in the public’s mind, glamorizing U.S. pharmaceutical companies that lagged behind European advances in laboratory research. ⁷⁸ As Parke, Davis boasted in 1892, knowledge of the “newer materia medica” was accrued from clinical studies, physiological research, and “reports from special botanists traveling in the habitats of many of the more important of the newer drugs.” ⁷⁹ Rusby’s voyage also played to science’s gendered stereotypes, that of the male hero sacrificing health and safety to battle ignorance and superstition. ⁸⁰

Rusby’s two-year expedition was fired by prospects of commercial opportunity and scientific inquest, and the “publicity possibilities of such an accomplishment.” ⁸¹ His South American odyssey netted 45,000 botanical specimens, shared with herbariums worldwide. It also positioned Rusby as a cultural translator for tropical plant therapies, as exhibited on a whirlwind speaking tour across the northeastern United States sponsored by Parke, Davis to promote coca, cinchona, and guaraná. ⁸² In 1887, standing before faculty and students at the Philadelphia College of Pharmacy, Rusby described encounters with guaraná along the Madeira River, displayed to the audience on a large accompanying map. He described a forest infested with “prowling jaguars” and “enormous anacondas” as “a region which is more like a region of death,” but reported that, fortunately, such was the environment of wild guaraná with which “we have nothing to do.” Rusby detailed the orderly cultivation of guaraná, the transformation of its seeds into smoked sticks for storage, the drug’s unassailable purity, and regional consumption in the form of a cold beverage. Parke, Davis likewise stood by its medicament: “contrary to the general belief, no adulteration or substitution of any kind is resorted to, these Indians vying with one another in the manufacture of the best product.” ⁸³ Parke, Davis’s tribute to guaraná’s Indigenous Amazonian origins underscores how pharmaceutical companies’ marketing showcased the “traditional” and the “exotic” alongside the “modern” and “scientific.” ⁸⁴ Regarding guaraná’s therapeutic value, Rusby opined: “Its effects are very refreshing, but its excessive use is deleterious. It contains two or three times the quantity of caffeine that coffee does, producing a happy effect on the nervous system, but if used in excess bringing on trembling and a palsied condition of the limbs.” ⁸⁵

In a competitive marketplace, Parke, Davis was also among the first firms to standardize dosages for alkaloidal drugs and their fluid extracts. Drug manufacturers had traditionally preferred weak formulas to avert toxicity, with physicians themselves often compounding drugs or referring to a reputable pharmacist. By 1883, Parke, Davis produced twenty chemically assayed, plant-based fluid extracts, including guaraná. Other firms, like Lilly and G.D. Searle, soon adhered to standardization. ⁸⁶

In promoting guaraná, Parke, Davis employed the terminology of nineteenth-century science to shore up consumer confidence. The label stated:

Guaraná

Paullinia sorbilis, Mart; synonyms Brazilian cocoa, pasta guaraná P.G.; part employed, a preparation made from the seeds; natural order, Sapindaceae; habitat, Brazil

Preparation – Fluid extract of a preparation of the seeds, U.S.P.; dose, 5 to 30 minims (0.3 to 2 C. c)

Properties – The physiological effects of Paullinia are chiefly due to its alkaloid; and, as this is identical with caffeine, the therapeutic indications for the remedy are the same as those for caffeine. The special use of paullinia is in the treatment of sick headache or migraine. It is adapted to the so-called nervous form of sick headache, and is less efficient when the attacks are due to stomachal troubles. As it possesses, directly or indirectly restorative powers, it may be employed to promote constructive metamorphosis. Administered with this view, it may be given with advantage in the convalescence from acute maladies, incipient phthisis, and in wasting diseases generally. From its astringency the remedy is useful also in chronic diarrheas, particularly in the diarrhea of phthisis. Literature supplied upon application. ⁸⁷

From a historical perspective, an Indigenous Brazilian plant had been recategorized by scientific nomenclature, chemical make-up and compound class, and standardized usage; a “droga do sertão,” or “backland drug,” as Amazonian therapeutic botanicals were colloquially known, had been rebranded as a “modern” medicine. A stimulant popularized in South America in the form of a chilled beverage had been indicated by medical professionals for the “nervous form of sick headache,” a condition they insisted was restricted to the overtaxed psyches of more “advanced” populations. And although Parke, Davis’s product derived from the long-standing botanico-medical knowledge of Indigenous peoples, it was hailed as “new to science,” with one of the drug’s promoters, Henry Hurd Rusby, impugning Indigenous healers elsewhere as “evil of [the] ignorance of faulty appliance, and want of experience, judgment and skill which was inseparable from an art so grossly unspecialized.” ⁸⁸ Through such narratives marked by epistemological violence, Indigenous understandings and uses of guaraná were downplayed or erased. More broadly, such accounts cemented the myth of science or ‘progress’ as originating in the Western core and diffusing to the global periphery, rather than a circulation of specialized knowledges and practices produced through multidirectional flows and exchanges.

Historians of medicine underscore that the biomedical appropriation of therapeutic plants has entailed elaborate experimental analysis, documentation, and description. As Abena Osseo-Asare notes, whereas Indigenous science depended on oral transmission, harvests from gardens and forests, metaphysical explanations, and experiments on people and animals, scientific appropriation through the laboratory entailed “written documentation of medicinal plants, testing of plants with isolated chemicals, esoteric language to explain experiments, expensive techniques for turning plants into pharmaceuticals, and strict control over plant harvests.” ⁸⁹ Yet as Jonathan Liebenau contends, the early development and production of new drugs in the United States did not entail innovations in scientific research, but rather a rearrangement of conventional therapies. Most nineteenth-century drugs were made by crushing, drying, extraction, and distillation: pills were powdered by hand in large mortars and rolled out and dried prior to sale, tinctures by soaking and squeezing, and crude drugs treated with chemicals (often alcohol) to extract soluble products. Even pharmaceutical firms with established laboratories did not rush to roll out drugs based on germ theory, since many physicians and patients grappled with accepting that diseases resulted from discrete pathogens. Instead, they concentrated on standardizing existing drugs. Medical science offered ethical firms a “veneer” to promote their pharmaceuticals while relying on established methods of drug production. ⁹⁰ In interethnic pharmaceutical transfers, the imprimatur of science served further to devalue Indigenous knowledge systems. Until today, notwithstanding their foundational phytotherapeutic knowledge, Indigenous peoples are likely to be deemed ‘informants’ rather than co-partners to Western pharmacological researchers, unworthy of equivalent intellectual property rights. ⁹¹

The reinvention of guaraná in nineteenth-century biomedicine

As iterations of contingent medical knowledge and understandings of physiology, and of relationships between patients and caregivers, therapeutics are social constructions particular to historical and cultural context. ⁹² In 1874, Illinois physician Finley B. Pugh praised Parke, Davis’s guaraná medication for combating headaches and ”stomach derangements,” based on its capacity “to arrest the waste of the tissues of the body.” He claimed the drug reduced the excretion of phosphoric acid and urea from the kidneys, thereby enabling “the less energetic powers of digestion still to supply as much as needed to repair the wear and tear of the solid tissues.” Likewise, Dr. O. C. Joslyn of Michigan indicated Parke, Davis’s guaraná extract not only to “confine sick headache in its premonitory stage” but also to remedy gastrointestinal distress. ⁹³ An evaluation of the precision of nineteenth-century medical science’s assessment of guaraná is not my objective here, since the relevant historical interlocutors approached therapeutics through epistemic practices distinct to their era. Rather, the objective is to analyze how varied social groups in the Northern Hemisphere adapted guaraná to established understandings of biomedical knowledge for specific ends. ⁹⁴ The embrace and subsequent erasure of guaraná in nineteenth-century North Atlantic pharmaceutical markets reflect the contested and shifting claims attributed to medical science, against a backdrop of racist and colonialist ideologies. ⁹⁵

Charles Rosenberg points out that early nineteenth-century Americans situated health and disease in the interrelationship between the individual’s constitutional make-up and the environment. In this holistic framework, the restoration of bodily equilibrium was essential to good health. Therapies that regulated secretions by inducing perspiration, salivation, diarrhea, or vomit seemingly validated a drug’s potency. Early nineteenth-century physicians thus employed different medications to remedy the same condition, since efficacy was seemingly validated by physiological response. ⁹⁶ Orthodox physicians, of course, never enjoyed a monopoly on healthcare, vying with “sectarians” and alternative caregivers. ⁹⁷ These included “Indian doctors,” whites practicing “medicine according to Indian theory” and popularized by notions of Native peoples’ vigor due to intimate contact with nature and botanical knowledge. ⁹⁸ Patients might also self-medicate, ride out an illness, or merely appeal to the Almighty. ⁹⁹

While biomedical understanding of disease specificity evolved significantly over the nineteenth century, propelled by European clinical research and professional specialization in higher education and teaching hospitals, many orthodox U.S. physicians clung to the belief in the holistic, constitutional, or humoral origins of disease. ¹⁰⁰ Physiology was poorly represented in the U.S. medical curriculum until the 1880s, while laboratory research might threaten physicians’ clinical competence. ¹⁰¹ Prioritizing the restoration of the body’s equilibrium and “vital power,” they continued to ply diuretics and cathartics, and increasingly endorsed stimulants between the 1850s and 1870s. ¹⁰² Despite transformations in nineteenth-century medical science, many physicians retained their commitment to traditional therapeutics, motivated by established practice, patients’ expectations, and professional competition. ¹⁰³

A headache sufferer, therefore, might weather innumerable treatments, as physicians targeted the ailment’s starting point rather than the pain itself. ¹⁰⁴ As historian Jan McTavish notes, headaches viewed as originating in the gastrointestinal system, particularly constipation, might elicit recourse to cathartics or emetics to regulate digestion; headaches deriving from an unbalanced nervous system might demand bloodletting, stimulants in the form of caffeine, or sedatives such as bromides or cannabis. ¹⁰⁵ Additional remedies included leeches, blistering lotions, champagne, nasal jets of hot air, and glass-stoppered bottles laced with bisulphide of carbon applied to the temples. ¹⁰⁶ For headaches caused by “nervous exhaustion,” practitioners of electrotherapeutics might employ battery-operated belts, rings, or brushes. ¹⁰⁷ Thus, a certain M.N., a 34-year old woman tormented life-long by “sick-headache” with vomiting, probably endured a range of therapies, until guaraná appeared “to act like a charm,” and left her “like another woman.” ¹⁰⁸ And which therapies had Dr. John Stewart of Maine, another sufferer of chronic “sick headaches,” experienced before repeated teaspoons of Parke, Davis guaraná medication “cured” his condition? ¹⁰⁹

In the annals of the history of medicine, the feats of professional healthcare providers famously overshadow patients’ experiences. ¹¹⁰ Indeed, these patients’ testimonials were only documented in print because they were supplied to Parke, Davis by orthodox physicians whom the firm utilized for product promotion. ¹¹¹ Parke, Davis also dispatched company representatives and drug samples to physicians, feted them at corporate headquarters, and distributed in-house publications featuring their endorsements. ¹¹² While most nineteenth-century drugs, including those of ethical firms, could be obtained without a prescription, the approach of Parke, Davis (like that of other such companies) upheld the physician’s authority in therapeutic care. ¹¹³ In this commercial context, one physician attributed a particularly remarkable patient recovery to guaraná. In 1892, army doctor J. Frazer reported the case of a soldier who had been laid up for months with a condition of “dysenteric character” impervious to vegetable and mineral astringents. After Frazer administered one powder of Parke, Davis guaraná twice daily for several days (later reduced, due to shortage), and stopped other medicines, the patient improved quickly, becoming “perfectly well and getting stout.” ¹¹⁴

Did guaraná cure this patient’s troubling condition? Or did his recuperation owe to the passage of time? Did Frazer or Parke, Davis fabricate a story to boost their reputation? Or did the patient’s symptoms recur and remain unreported? Given the absence of current standards for clinical drug trials, the answer is uncertain. The episode’s greater relevance may lie in underscoring another dimension of pharmaceutical firms’ remaking of guaraná through particular practitioners, objects, and rituals. ¹¹⁵ As medical anthropologists highlight regarding the importance of authority, trust, and concern involved in taking medicine, a physician’s consoling words, reinforced through the writing of a prescription (in abbreviated Latin in the nineteenth century), reassures patients in light of medical science’s inability to eliminate fully the uncertainty about sickness and health. ¹¹⁶ As Therapeutic Gazette, Parke, Davis’s in-house publication, noted in 1880 of the firm’s “new remedies,” since patients’ illnesses were often self-limiting, with drugs merely mitigating discomfort and recovery time, the doctors’ “hope and joyful anticipation served to stimulate healthful activity, while sadness and despondency depress the vital energies.” ¹¹⁷ In fact, a 1989 study among 141 U.S. physicians revealed that almost half listed patient demand as their primary reason for prescribing medicine, with 24% tying their decision to intentional recourse to the placebo effect. ¹¹⁸ Contemporary studies indicate that prescriber concern enhances a patient’s receptivity to medication and possibility of recovery, similar to the shaman’s “healing hand” or “good word.” ¹¹⁹ The Greek term pharmakon – meaning remedy, poison, and magical charm – captures the multivalence of a drug. ¹²⁰ This is not to say that guaraná has no physiological effects; it certainly does. Rather, there always has been – and continues to be – a psychosocial aspect to patient perceptions of efficacy in therapeutics.

Anglo-American biomedical detachment from guaraná

New drugs also engender skepticism. Parke, Davis lamented that some physicians stubbornly refused to abandon “old-fashioned remedies.” ¹²¹ Others cast aspersions on guaraná’s Indigenous origins. Perhaps due to rivalry with Parke, Davis, one prominent detractor was naval surgeon Edward Robinson Squibb, who headed the eponymous New York-based drug firm. He slammed guaraná as “at best a crude preparation of uncertain composition; the secret of its manufacture is jealously guarded by the half-savage Guaranis [sic],” thus undeserving of inclusion in the USP of 1880. ¹²² Squibb endorsed coffee and tea as safer and cheaper caffeine sources, which he claimed was equivalent to guaraná. ¹²³

Georgia pharmacist John Pemberton was another critic. In “Essay on Guaraná, Caffeine, and Coca,” an 1887 paper describing guaraná’s confection by an “Indian tribe by the name of the Guaraeves [sic], whence its name,” Pemberton, too, impugned the drug’s purity and efficacy. “Thanks to the science of chemistry,” he argued, guaraná had been “superseded by the use of Caffeine,” whose finest source could be found in kola nuts. (Pemberton also praised coca for enhancing physical and mental competence.) ¹²⁴ Traded for centuries in West Africa, kola nuts gained greater ground in global markets in the latter part of the nineteenth century with the demise of the Atlantic slave trade and the diversification of commercial exports. ¹²⁵ Due to labor and transport restrictions, and internal consumption in Brazil, guaraná could not compete globally with kola. Pemberton’s repudiation of guaraná also reflected significant self-interest. A year earlier, he had rolled out his patent medicine, Coca-Cola. ¹²⁶ Thus, kola nuts, rather than guaraná, would feature in the soda’s (early) formula, ultimately achieving worldwide brand name recognition.

In the United States, guaraná struggled to compete with more established and cost-efficient caffeine options. ¹²⁷ Addressing the American Pharmaceutical Association (APA) in 1920, Emory University professor A. Richard Bliss, Jr. proposed removing guaraná and nearly three dozen botanical drugs from the USP due to “minor importance, questionable utility and doubtful reliability,” as reflected in a questionnaire distributed to Atlanta-based practicing physicians. ¹²⁸ Guaraná’s elimination from the USP that year did not ban pharmaceutical use; as the convention’s vice president noted, removed substances could still feature in the National Formulary issued by the APA for practitioners. Yet the USP omission of guaraná due to the inability to combine “both worth and extensive employment” signaled its diminished presence in U.S. therapeutics. ¹²⁹

Increasingly, headache sufferers opted for synthetic analgesics. Advances in turn-of-the-century pharmaceutical chemistry enabled the introduction of aspirin by Bayer in 1899. Pitched as antirheumatics and febrifuges, the synthetic drug’s unforeseen efficacy as painkillers garnered popular appeal and were easily accessible at local drugstores. In the 1920s, the discovery that migraines could be alleviated with ergot, a fungus with vasoconstricting properties, converted ergotamine tartrate into a go-to treatment. ¹³⁰

As synthetics overtook the Anglo-American pharmaceutical market, scientific specialization also became more pronounced, with chemistry applied to laboratory-produced compounds, and pharmacognosy for the study of botanical drugs. The latter discipline suffered disapprobation from researchers focused on a plant’s morphology and taxonomy rather than its biochemistry, pharmacology, and therapeutics. ¹³¹ The pharmaceutical industries, of course, continue to rely on plant-sourced medicines. At the end of the twentieth century, one-quarter of prescription drugs derived from plants, while most major synthetic medicines originated from prototypes of natural origin. Moreover, sales of herbal supplements in the United States (classified by the Food and Drug Administration as dietary aids rather than drugs), exceeded $1.5 billion. ¹³² Over 3.5 billion people in the developing world turn to plants for their primary health care. ¹³³

Many botanicals, however, never regained their status in Anglo-American pharmacy. Guaraná is one. The plant faded into relative pharmaceutical oblivion in the Northern Hemisphere, strangled by “the tentacles of progress” of industrial science and the research and development agendas of pharmaceutical industries. ¹³⁴ The latter, eyeing profit and risk, have concentrated on single-activity drugs targeting one biochemical node, with the majority of late twentieth-century U.S. pharmaceutical research dedicated to treatments for cardiovascular disease, cancer, neurological disorders, and microbial disease. Indigenous plant-based therapeutics, conversely, tend to target gastrointestinal, dermatological, and gynecological conditions due to their more noticeable impact, and lifestyles or life expectancies with lesser proclivity to be impaired by chronic disease. ¹³⁵ Google Ngram Viewer corroborates the decrease in English-language print references to guaraná: peaking between 1872 and 1886, their level had dropped to less than one-third between 1920 and 1940 and for most of the century’s remainder. ¹³⁶

Conclusion

Long before spices and herbs moved to the grocery or health food store, pharmacists dispensing pills, tinctures, and other forms of medication were well acquainted with the plant materials that they crushed or folded into powdered form, or featured in the liquid extracts supplied by drug companies. ¹³⁷ Guaraná took its place in North American pharmaceutical markets alongside coca, cinchona, pichi, boldo, ipecac, matico, pareira brava, krameria, sarsaparilla, quassia, simaruba, and quebracho from South America. ¹³⁸ Thus, in 1891, when Henry Hurd Rusby, then serving as Professor of Botany and Materia Medica at the Columbia University College of Pharmacy, was appointed curator of the New York Botanical Garden’s Museum of Economic Botany, he assembled nearly 10,000 specimens from around the world, including guaraná, displayed according to use and “correct nomenclature.” ¹³⁹ As one of many phytotherapies that anchored nineteenth-century medicine, however, guaraná’s pharmaceutical usage was subsequently buried and forgotten, along with its deeper history. And like guaraná, the “social life” of countless medicinal plants involves stories of Indigenous science, colonial entanglements, multilateral knowledge flows, therapeutic adaptations, and pharmaceutical commodification that have been eclipsed or obfuscated by triumphalist accounts of biomedicine.

In highlighting Indigenous and biomedical knowledge production, marketing strategies, and adaptations intrinsic to the cross-cultural transfer of guaraná, this essay has not only traced a caffeine-rich plant’s trajectory in the history of medicine. It has also underscored biomedicine’s historical disparagement of forms of know-how and self-expression by marginalized populations, the uncompensated acquisition of Indigenous and subaltern knowledge, and the structural unevenness of scientific exchanges as originators of modernity’s multiple forms.