Medicine

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Victorian tonics: Cure-alls or cure-naughts?

If you’ve ever wondered why we need federal regulatory agencies like the Food and Drug Bottle of Huxley’s ‘Ner-Vigor’, England, 1892-1943Administration, you need look no further than the Victorian period, in which there were no such things and everyday patent medicines could contain anything whatsoever.

Dangerous cure-naughts

J. Worth Estes notes, “Congress passed the 1906 Food and Drugs Act in the wake of repeated observations that many over-the-counter remedies were ineffective as cures or even dangerous.” The previous century had seen a boom in the production and use of such remedies. Gone were the simple herbs prepared at home or by the local apothecary from time-honored recipes. In came the elaborate concoctions in dark-colored bottles with attractive labels, guaranteed on the basis of nothing to cure absolutely everything that might ail you.

Huxley’s Ner-Vigor was sold as a strengthening tonic for the nerves and to improve digestion. Made by the Anglo-American Pharmaceutical Co Ltd, based in Croydon, the tonic was prescribed for clinical depression, neurasthenia, anemia, rickets, and sciatica. It was suggested that a teaspoonful should be added to half a wine glass of water and drunk three times a day after meals. Like some other medical products of the period, it contains a very small measure of the highly dangerous poison strychnine. Courtesy of the Wellcome Library

Tone your system

Tonics tone. They strengthen and invigorate blood, nerves, and muscles. These systems operated browns-household-panaceathroughout the body, so if you strengthened them, you would strengthen everything.

Victorian doctors didn’t use the humoral system, but they continued to believe that each kind of personality was prone to its own maladies. They continued to use the humoral temperaments to characterize these types and added the neurotic type – highly responsive to changes in nerve force.

[There are four humoral temperaments: “sanguine (enthusiastic, active, and social), choleric (short-tempered, fast, or irritable), melancholic (analytical, wise, and quiet), and phlegmatic (relaxed and peaceful.)” From Wikipedia.]

These convenient personality catchalls persisted in the public mind long past their day (centuries) in medical science. Tonic makers capitalized on the notion that many ailments were linked by a common underlying cause, such as weak nerves or thin blood.

“Both physicians and patients visualized the body as a dynamic system in which every part of the body interacted with every other part and with its environment.”

Estes quotes a label from the 1880s for Pond’s Extract listing all the things it could cure: “Catarrh, Chafing, Soreness, Sunburn, Influenza, Lameness, Chilblains, Hoarseness, Cuts, Sore Throat, Piles, Inflamed Eyes, Boils, Insect Stings, Burns, Rheumatism, Bruises, Female Complaints, Woulds, Chapped Hands, Sprains, Mosquito Bites, All Inflammations and Hemorrhages.”

In short, anything that burned or itched. Sounds like an excess of choler to me.

Value what goes in by what goes out

Estes notes, “The state of one’s health was interpreted as reflecting a balance – or imbalance – between input and output, between nutriments and excrements. The doctor’s primary weapon against disease was his ability to use drugs to ‘regulate his patients’ secretions’ – feces, urine, sweat, and menstrual flow.”

This belief goes a long way back — all the way back, I think, but you could consult Roy Porter’s short history of medicine, Blood and Guts. Or read my post about it. Illnesses are substances lurking inside the body that have to be flushed out or imbalances, which have to be corrected by reducing the excessive element.

Four categories of medicine

Like the humors, by the late nineteenth century, it was actually four plus one.brainsalt

First we have the Tonics, for strengthening the body and its fibers (nerves, muscles, and veins.) These became increasingly popular as urban populations boomed, because people believed that city life sapped the body of its vital forces.

“The classical time-honored tonic was Peruvian bark.” Aka quinine, often supplemented by another popular import from the Andes, cocaine.

Second category are the Blood Purifiers, said to remove toxic materials from the blood so it could do its job more effectively. This idea is still current and if you scour your local natural food store’s “nutritional supplement” aisles, you’ll find lots of choices.

Third come the Cathartics, used to cleanse the bowels. We must keep those bowels clean! Fiber does that for us, but if you live on highly processed foods, increasingly possible in Victorian times, you don’t get that effect. Many patent medicines were cathartics – very popular stuff. Unhealthy diets aside, as Estes has observed, people like medicine that makes something happen — the more dramatic, the better. We see lots of cathartics in the diet-trickery aisles at drug stores today.

Fourth are the Oxygenators, which increase the body’s oxygen supply. I can’t find any examples of this in my search of many seconds on the Internet. Getting up and doing yoga for ten minutes will increase the oxygen supply to your brain, but I don’t suppose it does anything for seasickness. Brain Troubles is too broad a category to contemplate.

Last come the Nerve Stimulants, quite the money-spinners in their day. Nerves were everything, what with all the crowds and noise and press of business. Life was more complicated and full of stressors that drained the body of its vital force. A dollop of Ner-Vigor or perhaps a small glass of Coca Wine would recharge those batteries in a trice.

A peek under the label

I studied the ingredients of these patent medicines with great attention while doing my research for Moriarty Takes His Medicine. I was hoping to find undetectable methods of committing murder. I didn’t calomelhave to look far. Those little brown or blue bottles were chock-full of deadly chemicals. With the exception of arsenic, none could be detected after death with any reliability. People had a great fear of being murdered by such means and with good reason!

Mercury, aka quicksilver, has long been used as a medicine. One of its common ores is called cinnabar, which sounds delicious. Mercurious chloride, better known as calomel, was the active ingredient in the omnipresent blue pill, a powerful purgative used to treat syphilis and fevers, as well as indigestion. Everyone had a box or bottle of blue pill in their medicine cabinet.

But John Emsley, my trusty guide to murder by metals, says, “A person’s reaction to mercury is unpredictable.” Some can tolerate large amounts, others are so sensitive they die within seconds of injecting a mercury-based drug. Mercury poisoning is characterized by symptoms such as timidity alternating with aggression and anger, lack of concentration, loss of memory, depression, insomnia, listlessness, and irritability. Just so you know.

Arsenic, of course, is an old favorite, both for medicine and murder. Small doses act as a stimulant, perking people up. Also horses — cheaters would dose their horses before a race. Lots of famous mineral springs, including Ojo Caliente near Taos, New Mexico and Vichy, in France, contain trace amounts of arsenic.

Several patent cosmetics included arsenic, such as Dr. Simms Arsenic Complexion Wafers, which180px-Vin_mariani_publicite156 was said to produce “a beautiful transparency,” remove wrinkles, brighten the eyes, and raise the spirits. If you could get a drug that did all those things through the FDA today, you’d make a fortune.

Arsenic was regarded as a cure-all throughout the century. It was prescribed for neuralgia, syphilis, lumbago, epilepsy, and skin disorders. Take 12 drops 3 times a day for 1 week. Total arsenic, 120 mg. Add the drops to water or wine.

The Marsh test, developed by James Marsh and published in 1836, was the first reliable test for the presence of arsenic in the body, finally giving people a fighting chance against their murderous relatives and household servants. Even so, someone would have to suspect murder and insist that the death be investigated. If you chose your victim wisely and were judicious with your timing, you could still get away with it.

Besides, in those days, juries were very skeptical about so-called scientific evidence. They wanted witnesses and confessions, not a bunch of mumbo-jumbo about chemistry. A good defense attorney could get you off by casting doubts and aspersions on any forensic evidence.

cocaine_tooth_dropsAntimony, aka tartar emetic, was another heavy metal commonly employed in patent medicines, also falling into the cathartic category. In small doses, tartar emetic acts as a diaphoretic: it promotes sweating, lowering the body temperature. In larger doses it acts as an emetic. Vomiting begins within fifteen minutes. “Thus the poison acts as its own antidote to a certain extent.”

Antimony was prescribed for depression (melancholia.) It was used by women to suppress the sexual demands of partner and was a patent cure for alcoholism. Then again, heroin was used for a short time as a cure for alcoholism.

Cocaine is not a metal, but a plant-derived alkaloid. It’s properties as a local anesthetic were discovered in 1884, although its virtues as a stimulant had been known for some time, having been observed by Europeans in Peru. Cocaine was an excellent source of vigor and strength. “[I]t vitalizes and enriches the blood, tones up the system, makes the weak strong, builds up the broken-down body, invigorates the brain, and, as a result, cures many conditions including dyspepsia, nervous diseases, paralysis, chronic diarrhea, and generalized debility.” (Estes, p. 13.) Until it wears off and you feel twice as bad as you did before. Oh, well — better take another dose!

These medicines weren’t employed only by the gullible or the uneducated. Charles Darwin took arsenic regularly to treat a tremor in his hands. Thomas Henry Huxley periodically took strychnine and quinine, whenever he felt anxious about his health or suffering from the melancholy that plagued him all his adult life.

References

Emsley, John. 2005. The Elements of Murder. Oxford University Press.

Estes, J. Worth. 1988. “The Pharmacology of Nineteenth-Century Patent Medicines,” Pharmacy in History, Vol. 30, No. 1 (1988), pp. 3-18.

Electro-therapy

The idea of electro-therapy inspired me to set Moriarty Takes His Medicine in the world of private electro_therapy2hospitals. Books often start as titles in my mind and I really loved this one: Moriarty Gets a Shock. Think of the possibilities for double-entendre!

I studied it intensively, trying to figure out ways to use that quintessentially Victorian treatment for nefarious purposes. To my growing alarm, I could not find any way to hurt even a fly with the devices of that day. I was in despair until I realized I could just change the title. And now I’m getting a blog post out of all that research.

STEM for novelists

Part of the reason it took me so long to understand the issues is that I allowed myself to learn precious little about math and science as a young person. Sheer mental laziness and entirely my fault, although a slice of blame goes to teachers who let girls slide in math class and schools whose curriculum was so skimpy I could make As without actually learning anything.

voltsIn college, I managed to get away with Self-Paced Astronomy for my science credits. There must have something else… but if there was, I’ve forgotten it. Granted, that was back when I could pay my tuition myself, in cash, out of my tips from the restaurant. What can you expect for $300 a semester?

I had to look up basic facts like, what’s an ohm when it’s at home? My notes have many entries like this: “At 120 volts, the most common household current in the United States, a 100-watt light bulb draws 0.83 amps. To calculate the amperage of a light bulb, one must divide the number of watts by the volts powering the circuit. So a 10-watt bulb would draw 0.083 amps.”

Ten watts is about right for a Victorian light bulb. But is it lethal? Apparently not.

“Amps would be the volume of water flowing through the pipe. The water pressure would be the voltage. Watts would be the power (volts x amps) the water could provide (think back to the old days when water was used to power mills).” (newelectric.com) That’s a great explanation. Thank you!

Then I realized that my devices would be powered by batteries. How dangerous is a battery? Well, a standard C battery has 1.5 volts and 7.5 amps. Cellphones charged from a USB cord have a supply voltage of about 5 volts, not enough to severely harm a person. Curses!

It turns out that electro-therapeutic devices measure current in milli-Amperes (mA.) That sounds very small and indeed it is. One ampere is equal to 1000 milliamperes or 1 volt/watt. You can’t electrocute anyone with a cellphone, much less one-fifth of a cellphone. Foiled again!

electro_therapy3

The Victorian devices are vividly funny, stimulating the imagination as well as the nerves, but electro-therapy turns out to be a valid medical treatment nowadays. In fact, there are increasing studies demonstrating its effectiveness in treating chronic conditions like pain, depression, and PTSD. More power to that effort, say I.

And of course we have many uses for mild electrical devices for health and grooming, like toothbrushes, massagers, hair trimmers, heart rate monitors, etc. etc. etc. You can even get an electrical abdominal toning belt! Not to mention all the people romping around with ear buds, which are tiny electrical devices too. Harmless, at low volumes.

1000 Questions

There are lots of old manuals for employing electro-therapeutic devices at Google books. Searching for electro-information prompted me to discover the wealth of period information to be found. How not? The Victorians, like us, published guidebooks, manuals, medical handbooks, and the like annually.

bennett_electro-therapy1_wall-battery
A wall plate

These books are fascinating and yield lots of jolly details, like the fact that doctors would test the current on their own tongues before applying it to their patients. That small fact made it vividly clear to me that the devices were wholly unsuitable as murder methods.

My favorite book was published in 1912, a good twenty-five years after my story takes place. Evidently the faith in the healing power of electricity had not diminished. Homer Clark Bennett’s guidebook was meant as a practical manual for ordinary doctors, so it was accessible and handsomely illustrated.

Bennett presents his information in a series of questions, such as those the country doctor might ask. Here’s an example.

What is a wall plate?

Many physicians want some apparatus for the practice of electro-therapeutics, which will be complete, well made and reliable, compact, ornamental and attractive, at the same time reasonable in price. The plate shown herewith contains the essentials. it is mounted in a handsome well-made oak, imitation rosewood, or white enamel case, to be attached to the wall, with glass front door and sides, and a drawer below for electrodes…” The battery cells can be kept in the next room or in a closet.

Bennett starts with some general advice. “Don’t try experiments on patients. Try them first on yourself and see how it goes.” “Use iodine preparations under negative pole in cataphoresis. Use cocaine and alkaloids under positive pole in anaphoresis.”

Decades before Bennett, doctors were even more optimistic about electricity’s potential value. As earlybennett_electro-therapy4 as 1858 doctors were recommending mild shocks to treat mental illness. The shocks they’re talking about are nothing like modern electro-convulsive therapy which is still used sometimes. The electrical stimulus used in ECT is about 800 mA and has up to several hundred watts and the current flows for between one and 6 seconds. Its side effects may include loss of memory, verbal disfluency, and memory impairment.

Back in the late nineteenth century, no one would attempt such a strong current. I’m not sure they could even produce it with any confidence. They were still debating the relative merits of static electricity, galvanic currents, faradic currents, and magnetism.

Alternated_currentbody_cage
Alternated current body cage. The guy is lying on a wooden table with the current running through the cage around him, surrounding him with healing electricity.

Here’s a description of one of Dr. Wiglesworth’s cases (his real name, stop snickering): “No. 1, married; aged 23. Acute dementia of six months’ duration. Medium size plates used; kathode to forehead, anode to nape of neck. A [galvanic] current strength of 3 milli-amperes was used to begin with, and this was gradually increased to 25, the average being 15 milli-amperes for ten minutes. Usually there was a daily sitting… After 27 applications the patient became brighter, and in another three weeks had improved considerably…”

Voltage depends on resistance, but 25 mA is equivalent to 5-10 volts. According to instructables.com, that old-timey phone line running into your house has a direct current of around 50 volts. I once touched a phone line when I was sitting in my crawl space installing another phone jack. (Quite the handywoman, I am!) It shocked me enough to not want to do it again, but did me no harm whatsoever.

bennett_electro-therapy7
Your ultra-modern, multi-functional, electro-therapy delivery system.

That ten minutes of seven-volt current probably felt like a pleasant, light, buzzing massage. I’ll bet that woman felt better because Doc Wiglesworth was a cutie with a soothing voice and warm hands.

References

Bennett, Homer Clark. 1912. The Electro-Therapeutic Guide or A Thousand Questions Asked and Answered. Lima, OH: The National College of ElectroTherapeutics.

Beveridge, A.W. and E.B. Renvoize. 1988. “Electricity: A history of its use in the treatment of mental illness during the second half of the 19th century,” in British Journal of Psychiatry (1988), Vol. 153, pp 157-162.

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