{"id":8303,"date":"2019-06-22T12:55:57","date_gmt":"2019-06-22T17:55:57","guid":{"rendered":"http:\/\/richard.rathe.org\/?p=8303"},"modified":"2019-08-25T14:02:11","modified_gmt":"2019-08-25T19:02:11","slug":"patent-medicines-before-scientific-pharmaceuticals","status":"publish","type":"post","link":"https:\/\/redmangrove.org\/rathe.org\/richard\/2019\/patent-medicines-before-scientific-pharmaceuticals","title":{"rendered":"Patent Medicines in the Age Before Scientific Pharmaceuticals"},"content":{"rendered":"\n

My Wife’s Grandfather worked as a chemist for The Tilden Company<\/strong> in Upstate New York during the early 1900s. As a result we came into possession of his “Recipe Book<\/strong>” for the plethora of nostrums and remedies he helped create. Some of the ingredients are still sold today under various brand names. Some are humorous, others are forgotten, while still others are downright dangerous. The following installments are my exploration of this unique window into the medical past. [Note: We donated the actual book to the historical section of the National Library of Medicine<\/strong>.]<\/p>\n\n\n\n

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The Tilden Company (circa 1930) source: NLHS<\/figcaption><\/figure>\n\n\n\n

The book is mostly a unordered compilation of the labels that appeared on the various products they sold. There are a limited number of handwritten notes as well. Here is the full first page.<\/p>\n\n\n\n

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The words “Poison”, “Opium” and “Strychnine” sort of jump off the page. Let’s look a bit closer a the bottom\/center item.<\/p>\n\n\n\n

Good for What Ails You<\/h4>\n\n\n\n
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Note the alcohol component of 12-17%. This would presumably “fortify” the patient. Alcohol was a common primary ingredient or base for many daily tonics. I wonder why? <\/p>\n\n\n\n

Let’s start with Maltopepsine<\/strong>. This appears to be a Tilden brand concoction of digestive enzymes and acids. A search yielded nothing current about it, but plenty of very old medical journals mention it. Here is a full page ad from the 1895 Journal of Materia Medica<\/em>.<\/p>\n\n\n\n

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source:google books<\/figcaption><\/figure>\n\n\n\n

The rationalization for it being a “very perfect substitute” for missing (?) body fluids and relying on “the indubitable testimony” of a few “reliable” physicians is quaint but hardly evidence-based as they claim.<\/p>\n\n\n\n

Moving on to the other ingredients, supplemental Iron<\/strong> (in alcohol of course!) may still be used as a tonic in some quarters. No big surprise there but it does have GI effects, mostly constipation.<\/p>\n\n\n\n

Quinine<\/strong> (of gin & tonic fame) is next. During my early career it was given to patients with leg cramps. Apparently it helped because there was a hue and cry when it was taken off the market in the 2000s because it’s also known to cause bleeding and arrhythmias. It is still used to prevent and even treat malaria.<\/a> <\/p>\n\n\n\n

Finally there’s Strychnine<\/strong>!! Extracted from the plant Strychnos nux-vomica<\/em> it is a central nervous stimulant, anti-emetic, and at higher doses a deadly poison. According to the ad the elixir was used by pregnant women and infants. Yikes!<\/p>\n\n\n\n

Most of these patent medicines had multiple active ingredients (the “shotgun approach<\/strong>“) and were used to treat broad groups of symptoms<\/strong> and\/or diseases. From the physician’s standpoint this made diagnosis and therapeutic decisions rather simple.<\/p>\n\n\n\n

“Cerebral Sedative”<\/h4>\n\n\n\n

Now let’s consider the two labels marked “Poison” near the top. I’ll note here that these are the only oral medication labels in the collection thus marked.<\/p>\n\n\n\n

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Of course we start off with Alcohol<\/strong> 20%. Add a little Opium<\/strong> resin and you have a Tincture<\/strong> (one or more substances dissolved in alcohol). This is better known as Laudanum<\/strong> of novel and movie fame. The “40 M” may refer to molar concentration (?), but I can’t pin this down.<\/em><\/p>\n\n\n\n

Chloral Hydrate<\/strong> is a potent sedative that was in common use until the past few decades. It may be the original date rape drug referred to as “slipping someone a Mickey<\/strong>” (a frequent plot element in old movies). It was commonly used to treat psychiatric patients and children. It is no longer available in the US.<\/p>\n\n\n\n

Potassium Bromide<\/strong> is a sedative and anticonvulsant that is no longer used in human medicine. Gelsemium<\/strong> is a native plant containing alkaloids related to strychnine.<\/p>\n\n\n\n

Units of Measure<\/h4>\n\n\n\n

The labels make reference to units of measure that are mostly gone, and in some cases obscure:<\/p>\n\n\n\n