Thursday, January 21, 2021

Jennifer Mittler-Lee's COLUMN

A Company Famous For Selling Aspirin Once Legally Sold Heroin

And other wacky tales from the 19th-century medicine cabinet.

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Cold and flu season is coming. Once again, we will reach for a product to soothe our sore throat and comfort our cough.

It seems unimaginable that not so long ago, those products that people trusted were marketed by companies that did not need to prove that the drug worked or was even safe.

Misadventure abounded, resulting in potions, elixirs, and nostrums whose popular demand resulted in serious effects, overdoses, and sometimes death.

Morphine

National Library of Medicine — History of Medicine, No restrictions, via Wikimedia Commons

Yes. We gave children morphine. Who could imagine that was a bad idea?

One of the more popular morphine-containing remedies was Mrs. Winslow’s Soothing Syrup,“designed to soothe excitable and irritable children.”

A real-life Mrs. Winslow existed

A pediatric nurse, Charlotte Winslow, came up with the formulation in 1849 to soothe colicky babies. The syrup contained 65mg of morphine per fluid ounce plus alcohol. One teaspoon contained around 10 mg of morphine, more than enough to harm a child. So it seems incredible that the recommended dose was one teaspoonful three to four times a day!

At the time, there were no regulations on so-called “patent medicines.” They did not have to be effective or safe. Often the ingredients weren’t even listed on the packaging.

Nevertheless, frazzled mothers administered the popular syrup for teething, fussiness, and colic. The product could also relieve watery diarrhea associated with dysentery because morphine slows the bowel, causing constipation.

One mother wrote to The New York Times claiming its effect on her son was “like magic; he soon went to sleep, and all pain and nervousness disappeared.”

The baby killer

Soon, reports of children dying after receiving the syrup began to appear. No official data exist, but estimates place the death toll at thousands of children, either killed directly from an overdose or complications surrounding the inevitable withdrawal.

New laws regarding safety are always slow to take effect, and with no evidence to directly link the deaths to the syrup, the “baby killer” remained on the market until the 1930s.

Heroin

en:Image:BayerHeroin.png and therefrom: [1], Public domain, via Wikimedia Commons

Aspirin is considered by many to be a wonder drug. Cheap, effective, and generally recognized as safe when used as directed, aspirin seems to occupy the opposite end of the spectrum than heroin. For that reason, it’s unthinkable that the same company, Bayer, once produced both.

Heroin (diacetylmorphine)hit the market in 1898 as a non-addictive cough suppressant for patients with tuberculosis, bronchitis, and other respiratory diseases.

Less than a year later, the first patients began to exhibit signs of tolerance, addiction, and withdrawal.

Doctors also prescribed heroin to treat morphine addiction, a problem common among soldiers. Consequently, morphine and opium addicts discovered the benefit of intravenous heroin abuse — a euphoric high.

By the time legislation was passed in 1914 to regulate narcotics, nearly a quarter of a million residents of New York City alone were addicted to heroin.

However, it took another ten years to ban heroin. And then the production of the drug simply moved underground.

Cocaine

Public Domain, https://commons.wikimedia.org/w/index.php?curid=426824

Long used by tribal people for its stimulant effect, scientists isolated cocaine from coca leaves around 1860. Surprisingly, no one knew what to do with it.

An unlikely source became cocaine’s early champion — Sigmund Freud.

The neurologist became obsessed, devoting the years 1884 to 1887 to his “side interest” and studying all the available literature. He soon promoted cocaine for depression, extreme shyness, and even impotence.

Freud also believed cocaine could be helpful for morphine addicts. He had witnessed the suffering of a close friend who had become addicted to pain killers after losing a thumb to amputation.

“Uber Coca”

After Freud released his findings, the medical community embraced the drug, and addiction rates began to skyrocket.

Surgeon William Halsted, excited about the possibility of cocaine as a topical anesthetic, experimented on himself. History tells the tale of Halsted showing up in the operating room under the influence of the drug, taking one look at the patient, and fleeing the scene.

Fortunately, the surgeon admitted himself for treatment. Unfortunately, medical personnel used morphine to “cure” him, so he emerged from rehab addicted to both drugs.

Arthur Conan Doyle gave his famous detective Sherlock Holmes a cocaine habit, and even Pope Leo XIII was known to carry around a flask of Vin Mariani, a beverage made from Bordeaux wine and cocaine.

Artist not credited.derivative work (restoration): Victorrocha (talk)Cocacola-5cents-1900.jpg: ‘, Public domain, via Wikimedia Commons

Soon more tonics appeared with cocaine in it, including the famous Coca-Cola.

The party came to a halt in 1920 after the long term effects began to appear — disrupted eating and sleeping patterns, delusions and hallucinations, and severe depression upon withdrawal.

The FDA restricted cocaine, and today, the drug’s only accepted use is a topical anesthetic.

Chloroform

Containers & packaging for Wellcome chloroform. Credit: Wellcome CollectionAttribution 4.0 International (CC BY 4.0)

Chloroform was produced in 1831 by combining whiskey with chlorinated lime, and farmers initially used it as a pesticide.

It wasn’t until 1847 that surgeons discovered its anesthetic effect. But even under careful supervision, chloroform was a volatile and dangerous drug. The amount required to put a patient under was unnervingly close to the dose that would paralyze the lungs.

However, its use persisted with such famous people as Queen Victoria requesting chloroform while giving birth to her eighth child.

Soon the quacks got a hold of the “knock ’em out” drug, and capitalizing on its narcotic-like effect, put chloroform into cough syrups, mouthwashes, and ointments.

One of the more popular syrups, Kimball’s White Pine and Tar Cough Syrup, contained chloroform and was marketed to relieve asthma symptoms, wheezing, and cough.

Unsurprisingly, patients began to experience kidney and liver damage. Eventually, chloroform was found to be carcinogenic but still wasn’t banned from human consumption until 1976.

Same story, different century

We have tighter rules and regulations in place now, but things don’t seem much better than the era of the snake oil salesman.

In this age of OxyContin and Fentanyl, it’s easy to think we aren’t much better off than our ancestors.

Maybe one day we’ll get it right.

Until then, we have information at our fingertips. Emergency responders use Narcan to quickly reverse the effects of opioids, and there is a multitude of call centers available to help those with addiction.

If you, or someone you know, struggles with addiction, the SAMHSA National Helpline is available 24/7 at 1–800–662–4357.

PATIENT ADVISORY

Medika Life has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your health care provider(s). We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy is not an endorsement by Medika Life

Jennifer Mittler-Lee B.S. Pharmahttps://medium.com/@jrmittle

I am a pharmacist with over 20 years in the industry. I have worked both retail and hospital and have been known to frequent the nightshift. As a pharmacist, I see how medical jargon confuses people. I like to write healthcare articles in a casual manner in order to connect. Find me on Medium @jrmittle

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Jennifer Mittler-Lee

B.S. Pharma

I am a pharmacist with over 20 years in the industry. I have worked both retail and hospital and have been known to frequent the night shift. As a pharmacist, I see how medical jargon confuses people. I like to write healthcare articles in a casual manner in order to connect.

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