Laudanum
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Laudanum is an alcoholic tincture of opium. Laudanum is also known as tincture of opium, opium tincture, or tinctura opii. There are several varieties of opium tinctures, including wine of opium (vinum opii or Sydenham's Laudanum), which contains sugar, white wine, cinnamon, and cloves; saffronized tincture of opium, also known as tinctura opii crocata, containing saffron; deodorized tincture of opium (discussed below); and camphorated tincture of opium (tinctura opii camphorata or paregoric), containing camphor. Each variety of opium tincture, including laudanum, contains a different amount of opium and inactive ingredients. The term "Laudanum" should be applied only to a specific tincture of opium containing approximately 10 milligrams of morphine per milliliter.
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History
Paracelsus, born Phillippus Aureolus Theophrastus Bombastus von Hohenheim (1493–1541) in Salzburg, Austria, a 16th century Swiss-German alchemist, discovered that the alkaloids in opium are far more soluble in alcohol than water. Having experimented with various opium concoctions, Paracelsus came across a specific tincture of opium that was of considerable use in reducing pain. He called this preparation laudanum, derived from the Latin verb laudare, to praise. Initially, the term "laudanum" referred to any combination of opium and alcohol. Indeed, Paracelsus' laudanum was strikingly different from the standard laudanum of the 17th century and beyond. His preparation contained opium, crushed pearls, musk, amber, and other substances. One researcher has documented that "Laudanum, as listed in the London Pharmacoepoeia (1618), was a pill made from opium, saffron, castor, ambergris, musk and nutmeg."
Laudanum remained largely unknown until the 1660s when an English physician named Thomas Sydenham (1624–1689) compounded a proprietary opium tincture that he also named laudanum, although it differed substantially from the laudanum of Paracelsus. In 1676 Sydenham published a seminal work, Medical Observations Concerning the History and Cure of Acute Diseases, in which he promoted his brand of opium tincture, and advocated its use for a range of medical conditions. By the 18th century, the medicinal properties of opium and laudanum were well-known. Several physicians, including John Jones, John Brown, and George Young, the latter of whom published a comprehensive medical text entitled Treatise on Opium extolled the virtues of laudanum and recommended the drug for practically every ailment. "Opium, and after 1820, morphine, was mixed with everything imaginable: mercury, hashish, cayenne pepper, ether, chloroform, belladonna, whiskey, wine and brandy."
As one researcher has noted: "To understand the popularity of a medicine that eased--even if only temporarily--coughing, diarrhoea and pain, one only has to consider the living conditions at the time." In the 1850s, "cholera and dysentery regularly ripped through communities, its victims often dying from debilitating diarrhoea," and dropsy, consumption, ague and rheumatism were all too common.
By the 19th century, laudanum was used in many patent medicines to "relieve pain... to produce sleep... to allay irritation... to check excessive secretions... to support the system... [and] as a soporific". The limited pharmacopoeia of the day meant that opium derivatives were among the most efficacious of available treatments, so laudanum was widely prescribed for ailments from colds to meningitis to cardiac diseases, in both adults and children. Laudanum was used during the yellow fever epidemic. Innumerable Victorian women were prescribed the drug for relief of menstrual cramps and vague aches. Nurses also spoon-fed laudanum to infants. The Romantic and Victorian eras were marked by the widespread use of laudanum in Europe and the United States. Mary Todd Lincoln, for example, the wife of President Abraham Lincoln, was a laudanum addict, as was the English poet Samuel Taylor Coleridge, who was famously interrupted in the middle of an opium-induced writing session of Kubla Khan by a "person from Porlock." Initially a working class drug, laudanum was cheaper than a bottle of gin or wine, because it was treated as a medication for legal purposes and not taxed as an alcoholic beverage.
Laudanum was used in home remedies and prescriptions, as well as a single medication. For example, a 1901 medical book published for home health use gave the following two "Simple Remedy Formulas" for DYSENTERRY [sic]: (1) Thin boiled starch, 2 ounces; Laudanum, 20 drops; "Use as an injection every six to twelve hours"; (2) Tincture rhubarb, 1 ounce; Laudanum 4 drachms; "Dose: One teaspoonful every three hours." In a section entitled "Professional Prescriptions" is a formula for DIARRHOEA (ACUTE): Tincture opium, deodorized, 15 drops; Subnitrate of bismuth, 2 drachms; Simple syrup, 1/2 ounce; Chalk mixture, 1½ ounces, "A teaspoonful every two or three hours to a child one year old." DIARRHOEA (CHRONIC): Aqueous extract of ergot, 20 grains; Extract of nux vomica, 5 grains; Extract of Opium, 10 grains, "Make 20 pills. Take one pill every three or four hours."
The early 20th century brought increased regulation of all manner of narcotics, including laudanum, as the addictive properties of opium became more widely understood, and "patent medicines came under fire largely because of their mysterious compositions." (In the Arms of Morpheus: The Tragic History of Laudanum, Morphine, and Patent Medicines," by Barbara Hodgson) In the United States, the Pure Food and Drug Act of 1906 required that certain specified drugs, including alcohol, cocaine, heroin, morphine, and cannabis, be accurately labeled with contents and dosage. Previously many drugs had been sold as patent medicines with secret ingredients or misleading labels. Cocaine, heroin, cannabis, and other such drugs continued to be legally available without prescription as long as they were labeled. It is estimated that sale of patent medicines containing opiates decreased by 33% after labeling was mandated. In 1906 in Britain and in 1908 in Canada "laws requiring disclosure of ingredients and limitation of narcotic content were instituted." (ibid)
The Harrison Narcotics Tax Act of 1914 restricted the manufacture and distribution of opiates, including laudanum, and coca derivatives in the United States; this was followed by France's Loi des stupefiants in 1916, and Britain's Dangerous Drugs Act in 1920.
Laudanum was supplied to druggists and physicians in regular and concentrated versions. For example, in 1915, Frank S. Betz Co., a medical supply company in Hammond, Indiana, advertised Tincture of Opium, U.S.P., for $2.90 per lb., Tincture of Opium Camphorated, U.S.P, for 85 cents per lb., and Tincture of Opium Deodorized, for $2.85 per lb. Four versions of opium as a fluid extract were also offered: (1) Opium, Concentrated (assayed) "For making Tincture Opii (Laudanum) U.S.P. Four times the strength of the regular U.S.P." tincture, for $9.35 per pint; (2) Opium, Camphorated Conc. "1 oz. making 8 ozs. Tr. Opii Camphorated U.S.P (Paregoric)" for $2.00 per pint; (3) Opium, Concentrated (Deodorized and Denarcotized) "Four times the strength of tincture, Used when Tinct. Opii U.S.P. is contraindicated" for $9.50 per pint, and (4) Opium (Aqueous), U.S.P., 1890, "Tr. (assayed) Papayer Somniferum" for $2.25 per pint.
In 1929-30, Parke, Davis & Co., a major United States drug manufacturer based in Detroit, Michigan, sold "Opium, U.S.P. (Laudanum)" as Tincture No. 23 for $10.80 per pint (16 fluid ounces), and "Opium Camphorated, U.S.P. (Paregoric)" as Tincture No. 20, for $2.20 per pint. Concentrated versions were available. "Opium Camphorated, for U.S.P. Tincture: Liquid No. 338" was "exactly 8 times the strength of Tincture Opium Camphorated (Paregoric) [italics in original], U.S.P., "designed for preparing the tincture by direct dilution," and cost $7 per pint. Similarly, at a cost of $36 per pint, "Opium Concentrated, for U.S.P. Tincture: Liquid No. 336," was "four times the strength of the official tincture," and "designed for the extemporaneous preparation of the tincture." The catalog also noted: "For quarter-pint bottles add 80c. per pint to the price given for pints."
Toward the middle 20th century, the use of opiates was generally limited to the treatment of pain, and opium was no longer a medically-accepted "cure-all". Further, the pharmaceutical industry began synthesizing various opioids, such as propoxyphene, oxymorphone and oxycodone. These synthetic opioids, along with codeine and morphine were preferable to laudanum since a single opioid could be prescribed for different types of pain rather than the "cocktail" of laudanum, which contains nearly all of the opium alkaloids. Consequently, laudanum became mostly obsolete as an analgesic, since its principal ingredient is morphine, which can be prescribed by itself to treat pain. There is no medical evidence that laudanum is superior to treating pain over morphine alone.
In 1970, the U.S. adopted the Uniform Controlled Substances Act, which regulated opium tincture (Laudanum) as a Schedule II substance (currently DEA #9630), placing even tighter controls on the drug.
By the late 20th century, laudanum's use was almost exclusively confined to treating severe diarrhea. The current prescribing information for laudanum in the U.S. states that opium tincture's sole indication is as an antidiarrheal, although the drug is occasionally prescribed off-label for treating pain and neonatal withdrawal syndrome.
Depictions in fiction
Literature
- In C.S. Forrester's book Lieutenant Hornblower, part of the Horatio Hornblower series, Captain James Sawyer is declared unfit for duty and kept bound in his cabin. His overthrowers give him laudanum to keep him quiet.
- In William Faulkner's 1935 novel Pylon, the reporter tries to buy absinthe, but is given gin with laudanum in it.
- In Thomas Harris's 2006 novel Hannibal Rising, Hannibal Lecter is asked by a condemned prisoner to give him laudanum before facing death by guillotine, in exchange for allowing his body to be used in a Paris medical school. It is later suggested that this was common practice at the time.
- In Patrick O'Brian's Aubrey–Maturin series of novels, the ship's surgeon, Stephen Maturin, both uses the drug professionally and battles his own addiction to it.
- In Alan Moore's The League of Extraordinary Gentlemen, Allan Quatermain, opium-addicted, uses his bottle of laudanum to paralyze Edward Hyde.
- In Joanne Harris's 1993 novel Sleep Pale Sister, Effie was fed laudanum to keep her out of "hysterics" and also so that she could sleep.
- The character of Oscar Hopkins in Peter Carey's novel Oscar and Lucinda (1988) uses laudanum, initially under duress, to dull his hydrophobiaTemplate:Dn during his expedition from Sydney.
- Mary Shelley's character Victor Frankenstein uses laudanum to help him sleep after the death of his friend, Henry Clerval.
- In E.L. Doctorow's Ragtime, Harry K. Thaw is said to have once drank an entire bottle of laudanum.
- In Jack Finney's Time and Again, the main character, Si Morley, wonders if a live baby in an 1882 display case has been "doped up with one of the laudanum preparations I'd seen advertised in Harpers."
- Laudanum is also used as a means to circumvent Speck magic in the Soldier Son Trilogy by Robin Hobb.
- Laudanum is mentioned frequently in William S. Burroughs' Naked Lunch, and The Nova Trilogy, beginning with The Soft Machine.
- In the fourteenth chapter of James Joyce's Ulysses, Haines is depicted drinking laudanum from a phial.
- In Octavia E. Butler's Kindred, Rufus' mother uses laudanum as a medicine to relieve her pain.
- In Wilkie Collins' The Moonstone (1868), a valuable diamond, the Moonstone, is stolen by a character in a laudanum-induced stupor.
- It is mentioned in Sarah Waters' Tipping the Velvet as a way a nanny calmed the child Cyril, and thus an argument for Nancy to stay with that family and watch the child during the day.
- The character Cassy in Uncle Tom's Cabin kills one of her children with laudanum to prevent it from growing up in slavery.
- Hannibal Sefton, a tuberculosis-afflicted violinist in Barbara Hambly's Benjamin January mystery series, is addicted to laudanum, and uses it as a means of self-medication.
- It appears in the hard-boiled detective novels of Dashiell Hammett and Raymond Chandler, including Red Harvest and The Big Sleep, respectively.
- In Charles Dickens' novel The Mystery of Edwin Drood it is the drink of choice for the sinister uncle Jasper.
- In Love in the Time of Cholera by Gabriel Garcia Marquez, laudanum is the drink that America Vicuna uses to kill herself.
- In One Hundred Years of Solitude by Gabriel Garcia Marquez, Amaranta decides to poison her adopted sister Rebeca with laudanum in order to prevent the latter's marriage to Pietro Crespi, whom Amaranta secretly loves. Instead, Amaranta inadvertently poisons her innocent sister-in-law Remedios Mascote.
- In "Kal" by Judy Nunn, the character "Carmelina" is given laudanum by Lewis as a sexual enhancement; (p568)"Just a sip, my darling, just for fun", He'd said the first time he offered her the spoon.....and of course, she'd obeyed.
- In Affinity (novel) by Sarah Waters, protagonist Margaret Prior takes laudanum as advised by her doctor.
- In Cloud Atlas, one of the protagonists Adam Ewing is made to become addicted to laudanum after being fed it as medicine by another passenger without being aware of its nature.
- In Bram Stoker's Dracula several maids are incapacitated by a mixture of laudnum and wine, administered by Count Dracula in the course of his recurring nightly attacks on the weakening Lucy Westenra.
- In Titus Alone, the second book in Mervyn Peake's Gormenghast Trilogy, Sepulchrave - the 76th Earl of Gormenghast - is briefly mentioned to be a laudanum user.
- In Interview with the Vampire (from The Vampire Chronicles series by Anne Rice), Claudia gives a deadly dose of absinthe and laudanum to two orphans whom Lestat is tricked into feeding upon, thus poisoning him.
- In The House of the Scorpion by Nancy Farmer, the protagonist, Matt is accused of killing the dog of his friend, Maria, by adding laudanum to its meat.
- In Alice Munro's short story "Meneseteung", Almeda Roth, an eccentric spinster, is imagined (by the narrator) to have taken laudanum ("Many ladies did", Munro writes.)
- In Libba Bray's novels A Great and Terrible Beauty, Rebel Angels and The Sweet Far Thing, Gemma's father is addicted to laudanum as a result of the death of his wife.
- Samuel Taylor Coleridge wrote the poem fragment Kubla Khan immediately on waking from a laudanum-induced dream.
- In Robery Hicks novel The Widow of the South laudanum is mentioned by Carrie McGavock as a method of controlling grief in women whose husbands and sons had gone to war.
- Also in the novel Freaks: Alive, on the Inside, author Annette Curtis Klause has a character by the name of Ceecee harboring a dangerous secret of laudanum addiction.
- Dirk Gently's Holistic Detective Agency by Douglas Adams references Samuel Taylor Coleridge's use of Laudanum.
- In Asterix, Laudanum is one of the four Roman encampments surrounding the protagonists' village.
- In Secrets and Sacrifices by Diane Wylie, Confederate surgeon Captain Daniel Reid gives injured soldier laudanum to kill their pain.
- in the Bloody Jack series by LA Meyer there are copiuose references to tincture of opium. and its is used numerouse times throughout the series
Film
- In the 2001 movie From Hell laudanum plays an important role: Jack the Ripper is shown using it to numb his victims, while Inspector Frederick Abberline (played by Johnny Depp) uses a laudanum and absinthe mixture to see visions of the future or past.
- In John Wayne's final movie The Shootist, his character J.B. Books is suffering from terminal cancer, and his doctor E.W. Hostetler (played by James Stewart) prescribes laudanum to relieve the pain.
- In Amazing Grace, the William Wilberforce Story, there are numerous scenes of Wilberforce being given laudanum to relieve symptoms of colitis.
- In Cold Mountain the main character Inman gets a drink with laudanum from the old woman who killed her goat to feed him.
- In Master and Commander: The Far Side of the World, the doctor issues laudanum to a boy whose arm is to be amputated.
- In the 1971 movie The Beguiled, Geraldine Page's character used laudanum to sedate Clint Eastwood's character when she amputated his leg.
- In Shadow of the Vampire F.W. Murnau (played by John Malkovich) is discovered using laudanum by his cinematographer.
- In Tombstone, Mattie Blaylock, Wyatt Earp's common law wife, is depicted as a laudanum addict, true to her real-life addiction.
- In the 1995 Ang Lee adaptation of Jane Austen's Sense and Sensibility, Doctor Harris (Oliver Ford Davies) gives Laudanum to a heartbroken Marianne Dashwood (Kate Winslet) to bring down an infectious fever after she ventures out in a storm to see Willoughby's Estate.
- In the movie House of Mirth, Gillian Anderson's character Lily Bart uses laudanum to escape her troubles.
- In the film Interview with the Vampire: The Vampire Chronicles, Claudia poisons two young boys with laudanum to keep their blood warm and fool Lestat into drinking from them.
Television
- Alma Garrett (played by Molly Parker) was addicted to laudanum in Deadwood.
- In the Hornblower television movies "The Mutiny" and "Retribution", Dr. Clive (played by David Rintoul) freely dispensed laudanum to injured or beaten seamen, to the mentally unstable Captain Sawyer (played by David Warner), and to himself.
- In an episode of the Little House on the Prairie television series titled "Blizzard", several children are experiencing pain in their hands and feet as they are warmed up in the schoolhouse after suffering from partial hypothermia and frostbite. To help them with the pain, Dr. Baker issues laudanum, but "just half a teaspoon!".
- In the first episode of the 19th season of The Simpsons, entitled "He Loves To Fly And He D'oh's", Mr. Burns has a shopping list on which "Laudanum" is first on the list. Followed by: "cotton gin", "spats", "cell phone" and "Brooklyn Dodgers."
- In episode seven of the first season of Bramwell, Lady Cora Peters (played by actress Michele Dotrice) suffered acute stomach pains which turned out to be appendicitis inaccurately diagnosed as tifilitis by her doctor who prescribed a small bottle of laudanum to ease her pain.
- In many episodes of the series"Gunsmoke," Doc Adams gives laudanum to his patients.
