CHAPTER II.

COUGH MEDICINES

There are probably few, if any, ailments more frequently treated by the sufferer or his friends, without recourse to medical advice, than coughs and colds. The remedies employed in such domestic practice include preparations like “linseed tea” and others made at home, but these no doubt are supplemented in very many instances by some proprietary preparation, either one of those so largely advertised, or the speciality of some local compounder. It might be contended that here, if anywhere, is a legitimate field for the maker of nostrums, and it is therefore of some interest to ascertain what is being supplied in such nostrums. The particulars as to composition and claims made which are given below show that they well illustrate the evils which inevitably creep into the dealing in secret remedies, and the downward steps which lead to purely swindling nostrums. One of the articles now described bears on the label the unusual recommendation, “For serious cases seek medical aid”; this preparation is recommended as a “valuable aid” in various complaints, and the fact that it contains morphine is stated clearly on the label, but information is not given as to the amount of morphine present. Less modest claims are made for competing articles, until we eventually reach such statements as “all that is necessary is to take one dose of the lung tonic in warm water on retiring to rest, and the cold will have disappeared in the morning ... cure is quite certain,” and “If it fails no other medicine will ever succeed.” Again, while the presence of morphine in one of the medicines is plainly declared, as we have stated, this is not so in other instances. In one of those in which on analysis morphine was found to be present the advertisement begins with a “guarantee” that the medicinal remedies contained in the lozenges cannot injure the most delicate constitution, and includes the statement that they may be safely administered to very young children; in another case the specific declaration is made that “the cough pills do not contain opium,” which would certainly be regarded by most people as meaning that they do not contain the active principle of opium—morphine; and yet this was found to be present. The uncertainty as to what the composition of a secret medicine may be at any particular time is illustrated by another of the articles described, which has in past years been the subject of legal proceedings in the course of which the presence of morphine was proved, but which is now found not to contain any.

The number of advertised proprietary medicines for the cure of coughs is very large, and the number of those but little advertised and having principally a local sale is still larger; the latter, as a rule, have a good deal of resemblance to the advertised preparations. A selected few of the most widely advertised of this class have been examined.

The information which chemical analysis can give as to the composition of proprietary medicines is necessarily limited to the recognition of those ingredients which possess more or less definite chemical properties. The makers, of course, can make use of any one or more of a long series of vegetable extracts which very much resemble each other, and of various sweetening and flavouring materials sold for the purpose. In the case of many secret preparations analysis can afford complete and positive information as to their composition; but this is not so in every case, owing to many preparations commonly used in pharmacy being devoid of definite active principles that can be identified, and possessing no characters distinguishing them from others of the same class. Many such preparations are likely to be employed in cough mixtures; and, as these medicines usually contain a large proportion of treacle, honey, extract of liquorice, decoction of linseed, or some other old-fashioned complex preparations as basis, the identification of small proportions of many substances which are likely to be present becomes practically impossible. Many of the drugs in recognised use for coughs, such as senega, Virginian prune, etc., as well as domestic remedies like horehound and coltsfoot, are practically safe from certain identification by chemical analysis for such reasons, and in some of the preparations described below such substances may perhaps be present in addition to the ingredients named. The receipts given are not put forward as necessarily representing the whole of the ingredients in the articles in question, but they probably include all those which are of any importance or possess any known curative action.

The chief interest in the composition of such medicines, however, centres in the presence or absence of more potent remedies, such as preparations of opium, ipecacuanha, etc.; and here the analyst is on surer ground. The extraction of minute quantities of alkaloids from complex mixtures containing large quantities of saccharine and “extractive” matters is, however, a matter of much difficulty, and their identification is complicated by the great similarity in the behaviour of morphine and the alkaloids of ipecacuanha towards the various reagents used in their recognition. In this connection it may be pointed out that one or two of the nostrums here dealt with have been the subject of fairly frequent legal proceedings in consequence of their having been sold without proper observance of the poisons regulations, and the evidence given in such cases has shown wide differences in the results obtained by different analysts of high standing, both as to the quantity of morphine present, and even as to the fact of its presence or absence. In making the analyses here recorded, great pains have been taken to obtain accurate results, and they have been confirmed by the employment of alternative methods, etc.; but the results can only be given subject to the caution just expressed.

KAY’S LINSEED COMPOUND.

This compound is sold by an English provincial company in bottles, price, 9½d., 1s. 1½d., 2s. 9d., 4s. 6d., and 11s. per bottle; the 2s. 9d. size contained a little over 5½ fluid ounces.

This preparation is described on the label, wrapper, and in circulars, both as “Linseed Compound,” which is given as the registered trade mark, and as “Kay’s Compound Essence of Linseed, Aniseed, Senega, Squill, Tolu, etc.” On the label it is also stated that it

contains a preparation of chloroform and morphine, and it is, therefore, labelled Poison. It is Demulcent, Expectorant, Tonic, and Soothing for Colds, Coughs, Asthma, Hoarseness, Difficulty of Breathing, Consumption, and Simple Ailments of the Chest, Throat, and Lungs.

In a pamphlet enclosed in the package, this preparation is recommended to be taken for Cold, Influenza, Sore Throat and Quinsey, Pulmonary Catarrh, Bronchitis, Asthma, Consumption of the Lungs, Whooping Cough and Croup. In most of these, however, it is recommended as a “valuable aid” rather than a positive cure; other articles, such as ipecacuanha wine, muriate of ammonia, cod liver oil, and chemical food, as well as “Kay’s Linum Catharticum Pills,” are also recommended; while under Bronchitis we read:

In an acute attack, _i.e._, when the symptoms are inflammatory with much fever, etc., _the family doctor should at once be called in_.

The directions on the label are as follows:

Scale of Doses { To be modified according to the { age or debility of the Patient.

For over 21 years, a teaspoonful in water, at bedtime. ” 12 ” half a teaspoonful ” ” ” 6 ” 15 drops ” ” ” 4 ” 10 ” ” ” ” 2 ” 5 ” ” ”

Half Doses may be taken three or four times a day. It is not intended for Infants. For serious cases seek medical aid.

Analysis showed that 100 parts by measure contained 1·07 parts of chloroform and 4·3 parts of alcohol, both by measure, and 67 parts of solids; about 48 parts of the latter consisted of sugar, partly in the form of invert sugar, and the remaining 19 parts consisted principally of the mucilage of decoction of linseed; oil of aniseed was present, and evidence was obtained of small quantities of preparations of tolu and squill. Tho ipecacuanha alkaloids extracted amounted to 0·007 per cent., and the morphine to 0·021 per cent. If the ipecacuanha were present in the form of wine of the official strength, this represents:

Ipecacuanha wine 42 minims. Morphine ¹/₇ grain. Chloroform 5 minims.

in each fluid ounce.

OWBRIDGE’S LUNG TONIC.

This is sold by another English provincial company, price, 1s. 1½d., 2s. 9d., 4s. 6d., and 11s. a bottle; the 2s. 9d. size contained a little over 6½ fluid ounces.

It is stated on the wrapper that this:

Cures Coughs, Colds, Asthma, Bronchitis, Influenza, and all Affections of the Chest, Throat, and Lungs.

Also,

This Preparation does not contain any Opium, Laudanum, or Morphine, therefore does not require a Poison Label.

A pamphlet was enclosed in the package, from which the following is an extract:

Having once contracted a cold, however slight, it is of the first importance to have it thoroughly and radically removed. To do this it is worse than useless to rely upon a few lozenges, or any of the simple expedients to which many have recourse. Avoid linseed poultices, which are excessively weakening, and highly calculated to make the patient liable to a second, and, perhaps, more severe cold than the first. All that is necessary is to take one dose of the lung tonic in warm water on retiring to rest, and the cold will have disappeared in the morning. The lungs and bronchial tubes will be fortified and invigorated to an extraordinary degree. Should the cough not be quite removed by the first dose, continue according to directions. Cure is quite certain.

The directions on the label were:

Scale of Doses.

Above 14 years one teaspoonful. 6 to 14 years half a teaspoonful. 3 ” 6 ” fifteen drops. 1 ” 3 ” five to seven drops. 6 months to 1 year three to five drops.

Not to be given to a child under Six Months old.

To be repeated 3 or 4 times a day, if necessary. The doses given during the day should be mixed with a little cold water, the one at bedtime in a tablespoonful of warm water.

Analysis showed that 100 parts by measure contained 0·3 part of chloroform and 2 parts of alcohol, both by measure, and 89 parts of solids; about 73 parts of the latter consisted of sugar, rather more than half of which was in the form of invert sugar; it is probable that this had been added in the form of honey, and that the remainder of the solids consisted largely of the non-saccharine portion of the honey. Oils of aniseed and peppermint were present, and evidence was obtained of a very small quantity of a preparation of capsicum. The alkaloids of ipecacuanha were found to the amount of 0·002 per cent.; if these were present in the form of wine of the official strength, this represents:

Ipecacuanha wine 15 minims. Chloroform 2 ”

in each fluid ounce.

POWELL’S BALSAM OF ANISEED.

This fluid, prepared by a London maker, is sold in bottles, price, 1s. 1½d., 2s. 3d., 4s. 6d., and 11s. per bottle; the 2s. 3d. size contained a little over 3 fluid ounces.

In a circular enclosed with the bottle it was stated that:

This old and invaluable Medicine has the extraordinary property of immediately relieving Coughs, Colds, Bronchitis, Hoarseness, Difficulty of Breathing, and Huskiness in the Throat. It operates by dissolving the congealed Phlegm, and thus promotes free expectoration....

In Asthma, Chronic Cough, Influenza, Difficulty of Breathing, etc., no pen can describe the wonders that have been wrought by this deservedly popular preparation.

The directions for use were:

For a Grown Person a teaspoonful two or three times a day. For a child about 8 years old, 20 drops; and 12 years, 40 drops.

N.B.—Grown persons as well as children should take it in a little gruel or warm water; or saturate a lump of sugar with the above quantities is a pleasant way of taking it.

Analysis showed that 100 parts by measure contained 1·8 parts of benzoic acid, about 4·2 parts of extract of liquorice, and 2 parts of sugar, 40 parts by volume of alcohol, and enough oil of aniseed to give a strong aniseed flavour; a very small quantity of an aromatic resin, apparently benzoin, was also found, and 0·012 per cent. of alkaloid. This alkaloid resembled morphine in its behaviour to solvents, by which all the commoner alkaloids were excluded; but other tests showed that it was not morphine, and it is possible that it was a morphine derivative, such as dionine or peronine, but it was not found practicable to establish its exact identity owing to the smallness of the amount. Powell’s Balsam of Aniseed has, in the past, been the subject of legal proceedings on several occasions, and evidence has been brought in those proceedings proving that it contained morphine; so that it would seem that its composition has been changed since then.

DR. KILMER’S INDIAN COUGH CURE.

This preparation, stated to be made in U.S.A., is advertised from an address in London. The price is 1s. 1½d. a bottle, containing 3 fluid ounces.

It was stated on the outside of the package that:

This wonderful preparation contains no opium, morphine, chloral, or other hurtful drugs, and therefore does not dry up a cough. Every ingredient is from Vegetable products which grow within sight of almost every sufferer. It will not only help but cure the most Chronic and Complicated cases.

The directions were:

Dose: ½, 1, or 2 teaspoonfuls every ½, 1, 2, 3, or 4 hours as the case may require. Children—less according to age.

Analysis showed that 100 parts contained 63 parts of solids, of which practically the whole was sugar; there was also present about 2 per cent. of alcohol and about 0·5 per cent. of oil of pumilio pine, with rather less than 0·1 per cent. of a resinous substance agreeing well with the resins from compound tincture of benzoin; a small resinous deposit also remained adhering to the inside of the bottle. A trace of a bitter yellowish substance was present, which may have been the aloes contained in the compound tincture, but did not agree perfectly with it in character; the quantity was too minute for exact identification. No alkaloid was present.

CROSBY’S BALSAMIC COUGH ELIXIR.

This elixir, sold from a provincial English town, and wholesale through a company in London, costs 1s. 1½d., 2s. 9d., and 4s. 6d. per bottle; the 2s. 9d. size contained nearly 4¾ ounces.

It was described on the label as:

A safe, speedy, and effectual remedy for Coughs, Colds, Hoarseness, Difficulty of Breathing, Wheezing and Irritation of the Throat, Hooping Cough, Asthma, and Incipient Consumption.

In circulars enclosed with the bottle, its use in these various complaints was more fully described; and it was stated further that:—

It contains no opiates, and is absolutely non-poisonous, and may therefore be taken with safety by the young and aged alike.

The directions given on the label were:

For Children, one month to one year, 5 to 10 drops in a little water. From one to five years, 10 to 20 drops. From five to ten years, 20 to 30 drops. From ten to fifteen years, 30 drops to one teaspoonful. From fifteen years and upwards, one teaspoonful, gradually increased to three teaspoonfuls, in a wineglassful of water.

Analysis showed that 100 parts by measure contained 65 parts of solid matter, about 58 parts of which consisted of invert sugar, 10·6 parts by volume of alcohol, a trace of chloroform, 1·35 parts of sulphuric acid, and 0·3 part of acetic acid; a trace of an aromatic substance probably derived from tolu was present, and a minute trace of alkaloid (much less than 0·001 per cent.); the remainder appeared to consist of extractive and colouring matter, and may have contained the non-saccharine portion of honey if the invert sugar were added in that form. A trace of acetic ether could be detected, and it is probable that the acetic acid found represented acetic ether originally added, which had undergone hydrolysis; in that case the amount of acetic ether originally present would be 2¼ minims in 1 fluid ounce. The sulphuric acid found corresponds to 44 minims of the official dilute sulphuric acid in 1 fluid ounce.

VENO’S LIGHTNING COUGH CURE.

This is prepared by a company in an English manufacturing town. The price charged is 1s. 1½d. a bottle, containing 2¾ fluid ounces.

On the label it was stated that:

If it fails no other medicine will ever succeed. It should be used in all cases of Coughs, Colds, Bronchitis, Pleurisy, Sore Throat, Hoarseness, Asthma, Croup, Whooping Cough, Influenza, and Catarrh.

In most cases it should be used with Veno’s Lightning Fluid.

Dose.—For an Adult, one teaspoonful; for a Child under ten, half teaspoonful; for an Infant, five or ten drops every two or three hours, during the day only.

Analysis showed that 100 parts by measure contained 7·6 parts of glycerine, 1·6 parts by volume of alcohol, a trace of chloroform, 0·23 part of a resin, 0·2 part of alkaline ash, and 1·1 parts of extractive and colouring matter. No alkaloid was present. The resin was not aromatic, and possessed no well-marked characters, but showed some resemblance to the resin of _Grindelia robusta_; the fluid extract of this drug is prepared with the aid of alkali, and the strongly alkaline nature of the ash found would agree with the presence of fluid extract of grindelia, but positive proof of the presence of the latter could not be obtained; the amount of resin found corresponds to about 7 minims of the fluid extract in 1 fluid ounce.

KEATING’S COUGH LOZENGES.

These lozenges are sold from an address in London in boxes, price, 1s. 1½d., 2s. 9d., 4s. 6d., and 11s. per box; the 1s. 1½d. size contained 50 lozenges.

A circular enclosed in the package was headed:

Notice—Guarantee.

The medicinal remedies contained in these lozenges cannot injure the most delicate constitution.

Another extract from the circular stated:

Very many also of the Nobility and Clergy, and of the public generally use them _under the recommendation of some of the most eminent of the Faculty_. Such medical testimony must be convincing of their efficacy as well as conveying the satisfactory assurance of their freedom from any medicine in the slightest degree injurious to the constitution, Medical Men being well aware of the deleterious effects of many preparations, which in Pulmonary Affections do but mask the symptoms for a time, and afford only temporary relief, while perhaps the constitutional disease is aggravated, or at least unsubdued. They may be safely administered to females of the most delicate frame, and to very young children, for they not only allay Cough and Nervous Irritation, but they sustain the constitution, by promoting a healthy state of the Digestive Organs. They have immediate influence over the following cases:—_Asthmatic and Consumptive Complaints, Coughs, Shortness of Breath, Hoarseness, etc., etc._

Directions for Use. One or two, taken at bedtime, will allay the irritation in the Throat, and prevent the Cough from disturbing the patient during the night, _and one also eight or ten times in the day_, when the Cough is troublesome, will afford great relief.

The average weight of the lozenges was 16½ grains; analysis showed that they contained morphine, alkaloids of ipecacuanha, extract of liquorice, sugar (partly as invert sugar), and gum; some evidence was also obtained of the presence of extract of squill and tolu, but positive proof of the identity of these was not obtainable. The proportions of the various ingredients found corresponded to:

Morphine 0·007 grain. Ipecacuanha 0·07 ” Extract of liquorice 2·1 grains. Sugars 13 ”

in one lozenge.

BEECHAM’S COUGH PILLS.

These cough pills, sold from a town in Lancashire, cost 1s. 1½d. per box, containing 56 pills.

The following extracts are from a circular enclosed with the box:

Persons suffering from Cough and kindred troubles should relieve their minds of the idea that nothing will benefit them unless it be in the form of a lozenge, or taken as liquid. Let them try _Beecham’s Cough Pills_, and they will never regret it.

The _Cough Pills_ do not contain opium; they do not constipate; they do not upset the stomach. On the first symptoms of a Cold or Chill, a timely dose of Beecham’s Cough Pills will invariably ward off all dangerous features. For years many families have used no other Winter Medicine. Householders and travellers should avail themselves of this good, safe, and simple remedy for Coughs in general, Asthma, Bronchial Affections, Hoarseness, Shortness of Breath, Tightness and Oppression of the Chest, Wheezing, etc.

The doses may be from three to six pills morning, noon, and night.

The pills had an average weight of 1·4 grains. In spite of the statement that they “do not contain opium,” analysis showed morphine to be present, together with powdered squill, powdered aniseed, extract of liquorice, and a resinous substance agreeing in character with the resin of ammoniacum. Approximate determination of the proportions of the ingredients is alone possible in such a mixture; the results obtained pointed to the following formula:

Morphine 0·0035 grain. Powdered squill 0·1 ” Powdered aniseed 0·3 ” Ammoniacum 0·3 ” Extract of liquorice 0·4 ”

in one pill.

SOME GERMAN NOSTRUMS.

Dr. F. Zernik, assistant in the Pharmaceutical Institute of the University of Berlin, undertook a short time ago, at the invitation of the Editor of the _Deutsche Medicinische Wochenschrift_, to report on some of the secret remedies which are thrown on the market in such numbers in Germany as well as England. It would appear that for the most part the remedies advertised in Germany are not the same as those most advertised in this country, but it is proposed in this and subsequent chapters to give some abstracts from the articles in which Dr. Zernik has from time to time reported the results of his examinations.

DR. LAUSER’S COUGH DROPS.

Dr. Zernik found on analysis that these Cough Drops did not contain the ingredients alleged; there was for instance only 3·35 per cent. of alcohol, although the advertiser speaks of tinctures of 50 per cent. In addition to this small proportion of alcohol the mixture appeared to consist of a watery solution of liquorice, an infusion of senna root, some ammoniated solution of aniseed and small quantities of ammonium chloride.

REICHEL’S COUGH DROPS.

Reichel’s Cough Drops cost 1 mark for a bottle containing 65 ccm., about 2¼ fluid ounces. The purchaser is supposed to take 15 or 20 drops on sugar or in water four or five times a day. It is an alcoholic fluid, smelling and tasting of arnica, pimpinella, and anise.

TUSSOTHYM.

Tussothym, in spite of the wonderful qualities claimed for it by the firm producing it, proved to be a weak alcoholic distillate of thyme, diluted with water but probably containing another indifferent drug. It is advertised as good for all diseases of the respiratory organs, and especially for whooping cough.

DR. B. ASSMANN’S WHOOPING COUGH REMEDY.

This Whooping Cough Remedy is, according to the vendor, so complicated that it is only made by himself, and cannot be obtained elsewhere. The packet contains forty powders, twenty of which are marked No. 1, and twenty No. 2. The chemical analysis showed that each powder, weighing 2 grams, consisted of milk sugar (lactose). No other constituent was detected.