The
1868 Act was testimony to the influence which professional
consolidation could have on the availability of narcotics. In one
important respect, however, it was incomplete. Although the inclusion
of patent medicines within poisons legislation had been one aim of both
medical and pharmaceutical professions since the 1850s, such products
were excluded from the Pharmacy Act.1 The‘ Parliamentary Bills
Committee of the British Medical Association had lobbied for
restrictions on patent medicines to be added, but Section 16 of the Act
specifically excluded any `making or dealing‘ in patent remedies. The
question of patent medicines, in particular those based on opium,
became a central concern of the continuing professional campaign
regarding availability.
The first medicine Stamp Acts under which
the government collected its licensing revenue had been passed in the
eighteenth century. Duties on medicines were in fact first imposed in
1783; but the law as established throughout the nineteenth and early
twentieth centuries and which required a licence to sell, or imposed a
duty on the medicine sold, dated from three acts of 1802, 1804 and 18
12. Few patent medicines which paid duty under the Acts actually
deserved the name. Only in the seventeenth and eighteenth centuries had
owners of medical formulae actually gone to the length of patenting
them. After 1 800, medicinal compounds were only rarely patented. Those
which paid the government stamp were proprietary, rather than patented
medicines. Revenue was nevertheless considerable. Around £200,000
annually was reckoned to be derived from medicine stamps in the early
1890s.2
Many
contained opium in some form and some had a lengthy ancestry. Dover’s
Powder not only became a staple of popular consumption but was used
also in medical practice. Daffy’s Elixir, invented by the rector of
Redmile in Leicestershire, was even older. It first came to public
notice between 1660 and 1680.3 As Chapter 9 has shown, the children’s
opiates, Godfrey’s Cordial in particular, were mostly
long-established.‘ There was no clear dividing line in the first half
of the century between strictly ‚medical‘ remedies and those used in
self-medication, so patent medicines were often used in medical
practice, or medical men made their own semi-patent remedies. Dover’s
Powder was widely used in hospital practice. Pharmacists made their own
versions of Godfrey’s and Atkinson’s. Some patent preparations,
Battley’s Sedative Solution for instance, were incorporated within the
Pharmacopoeia; its official name was liquor opii sedativus. Others were
made by pharmacists aspiring to professional status. Peter Squire of
Oxford Street produced Squire’s Elixir (containing opium, camphor,
cochineal, fennel-seeds, spirits of aniseed and tincture of snake-root)
and later his own chlorodyne in competition with Collis Browne’s.5 The
dividing line between `medical‘ and ’nonmedical‘ remedies was even less
clear when medical men themselves were often involved in-commercial
activity.
The exclusion of patent medicines from control in 1868 was
increasingly resented as establishing an area where doctors and
pharmacists had little influence. The early public health legislation
in the area of food and drugs continued this tendency. The 1875 Sale of
Food and Drugs Act, for instance, specifically excluded proprietary or
patent medicines from Section 27 of the Act, which made it an offence
to sell an article falsely labelled .6 Yet patent medicines appear to
have been enjoying a vogue at the end of the century. To some extent
this was a natural result of the provisions of the 1868 Act, which had
made ordinary opium preparations that much more difficult to obtain.
There was also a practical reason. In 1875, an Act had reduced the
medicine licence duty and the number of vendors increased. Over twelve
thousand licences were taken out in 1874; twenty thousand in 1895.7
There
began in the 1 880s a new professional campaign against open sale, this
time concentrating on the issue of patent medicines. Press publicity
was given to cases of chlorodyne addiction as early as 188o; the views
of the developing anti-opium movement were also displayed in this
direction.“ Discussions took place between the Home Office, the Privy
Council Office and interested bodies like the Pharmaceutical Society
and the Institute of Chemistry in 1881 and 1882. It was hoped at this
stage to establish that patent remedies did in fact come within the Act
and that further legislation was therefore unnecessary. But a test case
involving a solution of chloral sold without a poison label, and
brought before a Hammersmith magistrate at this period, left the
situation unclear. The professional bodies, both medical and
pharmaceutical, were unanimous in demanding further restrictions on the
sale of patent medicines, and they had the press and the government on
their side.“ A Patent Medicine Bill was introduced in 1884 which would
have brought opiate-based patent medicines under the control of the
1868 Act, for any patent medicines containing a scheduled poison were
to be sold only by a registered pharmacist. Pressure from the Society
of Chemists and Druggists had ensured an added degree of freedom for
the pharmaceutical profession. A pharmacist who sold a patent medicine
unlawfully was not to be held responsible if he was unaware that it
contained a scheduled poison.l0
The chlorodyne issue
The
1884 Bill was unsuccessful, and patent medicines remained
unrestricted.“ In the next decade, the bulk of medical and
pharmaceutical hostility was directed at one particular patent
preparation. This was chlorodyne, most commonly associated with the
name of Dr John Collis Browne. Collis Browne, a physician, had first
used the preparation in 1848, while serving with the army in India. In
1854, while on leave in England, Collis Browne was asked to go to the
village of Trimdon in County Durham to fight an outbreak of cholera.
His ‚chlorodyne‘ (the name he gave the preparation the following year)
produced encouraging results. But it was not until Collis Browne left
the army in 1856 and went into partnership with J. T. Davenport, a
chemist practising in Great Russell Street, to whom he assigned the
sole right to manufacture and market the compound, that Collis Browne’s
became widely known on the domestic market (Figure 5).12
Collis
Browne’s early presented an impressive list of conditions which
chlorodyne was claimed to cure. `Practical Instructions‘ were issued
for the treatment of cholera and diarrhoea by the preparation; it was
also recommended for `coughs, colds, influenza, diarrhoea, stomach
chills, colic, flatulence, bronchitis, croup, whooping-cough, neuralgia
and rheumatism‘ .13 Its commercial success was demonstrated by numerous
attempts to find its exact formula; and to market rival chlorodynes.
Chloroform and morphia were the main ingredients ; the name chlorodyne
was in fact made from the words `chloroform‘ and ‚anodyne‘. 14 Rivals
were soon on sale, since Collis Browne had not patented his
preparation. Mr A. P. Towle communicated the formula of another
chlorodyne to the Chemist and Druggist in 1859 and Towle’s chlorodyne
was commercially marketed. The advent of Freeman’s chlorodyne (Figure
6) in the early 1860s was the occasion of an unsuccessful law suit
brought by Collis Browne; and the ubiquitous Squire, too, was busy
publicizing his own version.15
Collis Browne’s was certainly
suffering the penalties of success. The exact dimensions of its
popularity are difficult to analyse. Its sales were large and
advertising expenditure was high. In 1871, for instance, sales amounted
to over £28,o00 and advertising to over £4,000. But large sums expended
on advertisements were a normal feature of the nineteenth-century
patent medicine business – Holloway at the same period was spending
£40,000£50,000 a year in advertising his pills and taking a similar sum
in profit-16 Collis Browne’s clearly had a long way to go before it
joined the giants in the patent medicine world. Sales were, however,
increasing – they brought in over C3 i,00o in 1891 (a modest 10-11 per
cent increase in twenty years). Many of the earlier patent medicines –
the soothing syrups in particular – had been developed in the north.
Collis Browne’s, as a relatively late arrival on the scene, gained the
bulk of its sales from London and the southern part of England. More
than half its sales came from this part of the country. 17
There
is no reason to suppose that all chlorodyne users were working-class,
but the continuing cultural traditions of self-medication ensured that
such patent medicines had considerable popular usage. In some
instances, consumption was aided by the generosity of those further up
the social scale. The Rev. W. R. Dawes, a country parson in
Buckinghamshire, who treated with medicine `his numerous gratuitous
patients‘, wrote to Davenport in 1858 asking for fresh supplies: `The
trying weather lately having caused a large demand for this medicine,
my stock is suddenly exhausted and I shall be particularly obliged by
your sending me a pint and half of the Chlorodyne safely packed in a
box by the Oxford coach …“18 Sarah Williams, the wife of an
engine-room artificer at Portsmouth, who after her death in 1889 was
reported to have been buying at least three bottles of chlorodyne a
week from her local branch of Timothy Whites, was one instance of a
poor consumer who took too much.19
Chlorodyne use and addiction was
the central core of the medical campaign against patent medicines at
this time. Unlike morphine, however, the use of the preparation was not
consistently seen from a `disease‘ point of view. It was largely
outside the medical sphere of control. Chlorodyne use was seen more as
a matter of availability and limitation of sale, and less as one of
disease and treatment. E0 Medical men continued to be uneasy about the
availability of patent medicines, chlorodyne in particular, after the
failure of the 1884 Bill. Chlorodyne poisoning cases multiplied in the
medical journals; and following the circulation of a memorandum asking
for further legal controls on opium and morphine preparations by the
chairman of the Parliamentary Bills Committee of the British Medical
Association, „to the Pharmaceutical and Apothecaries Societies and the
President of the General Medical Council in 189o, the attack on patent
medicines and chlorodyne intensified.21 Ernest Hart was editor of the
British Medical Journal at this time, and it was his campaigning in
that role and as Chairman of the British Medical Association’s
Parliamentary Bills Committee which brought action. Parliamentary
questioning on the subject in 1891 evoked a non-committal response .22
In
the same year, it was this Parliamentary Bills Committee which
communicated with the Treasury Solicitor to ask him to institute
prosecutions against chlorodyne and its manufacturer. The Treasury
prosecution of J. T. Davenport in 1892 was successful in extending the
1868 Act to chlorodyne in particular and opiatebased patent medicines
in general. Davenport was summoned before Mr Lushington at Bow Street
Police Court to answer the charge that he had sold retail a mixture
(chlorodyne) containing opium and chloroform without indicating the
poisonous nature of the contents on the bottle. Davenport’s defence was
that the preparation was a patent one and hence exempt under Section 16
of the 1868 Act. Mr Lushington, however, took a stricter view of the
term: a patent medicine he defined as one actually issued with a
government patent rather than a remedy paying the medicine duty. The
charge was held to be proved; and Davenport fined £5 with costs.23 As a
result chlorodyne and other patent medicines containing scheduled
poisons had to be sold by a registered pharmacist and labelled
`poison‘. The new policy was vigorously prosecuted and the council of
the Pharmaceutical Society took action against offending dealers-“
It
is difficult to estimate how far the professional `scare‘ about
expanding chlorodyne use was indeed justified. Chlorodyne was
responsible for an increased number of deaths in the 1890s, even though
actual death rates were steady. Collis Browne’s sales, as its figures
show, were not expanding rapidly; and the statistics of chlorodyne
mortality may have to some extent mirrored public concern. For the
highest mortality figures came after, not before, restriction .25
Medical men to this extent magnified the `problem‘ ofchlorodyne use to
justify their own control. Yet the 1892 decision certainly had a marked
effect on the sale of chlorodyne. Collis Browne’s sales figures were
down by £6,200 in 1899 (around 20 per cent) from the 1891 level ; and,
at £25,000, were £3,000 lower than the total in 1871.26 The campaign
against patent medicines in general did not cease. Publications such as
Health News’s Exposures of Quackery (1895-6) devoted whole sections to
`chlorodyne, and other opiates and anodynes‘ and to the `widespread
system of home-drugging‘ which had resulted from the easy availability
of opiate patent medicines .Y7
In America at the same time, the
revelations of Samuel Hopkins Adams in Collier’s Magazine were
instrumental in the passage of a Federal Pure Food and Drugs Act in
1906.28 But when the British Medical Association published its own
famous investigations into the composition and profitability of patent
medicines — Secret Remedies and More Secret Remedies in 1909 and 1912
– the talk was all of remedies once containing morphine or opium, but
which had now dropped it from their formulae .2′ The investigations of
the Privy Council Committee which considered the poisons schedule and
reported in 1903 found just the same. Most of the children’s soothing
syrups no longer contained opium. Some cough mixtures – Kay’s Linseed
Compound, for instance, and Keatings‘ Cough Lozenges – still used it.
30 Others which had once included the drug now found commercial benefit
in declaring that it was not present. Owbridge’s Lung Tonic was one
such; and Beecham’s Cough Pills also declared that they did not contain
opium.Liqufruita Medica guaranteed itself to be `free of poison,
laudanum, copper solution, cocaine, morphia, opium, chloral, calomel,
paregoric, narcotics or preservatives…‘; it was basically a sugar
solution. The frequency with which this type of claim was made on the
wrapper was in itself testimony to the increasing alienation of the
drug from popular, as much as from medical, usage.
References
1.
For `professional‘ opposition to patent medicines, see `Petition from
Royal College of Physicians, Edinburgh to House of Commons …‘,
Lancet, r (1859), P. 294.
2. `Patent and secret narcotic
preparations‘, British Medical journal, 2 (1890), p. 639; Health News,
Exposures of Quackery (London, The Savoy Press, 1895), vol. 1, pp.
24-6; L. G. Matthews, History of Pharmacy in Britain (Edinburgh and
London, E. and S. Livingstone, 1962), p. 366; P.P. 1914, I X: Report
from the Select Committee on Patent Medicines, p.v.
3. A. C. Wootton, op. cit., pp. 172-3.
4. `Quack medicines‘, The Doctor, 6 (1876), p. 37.
5. `Squire’s Elixir‘, Lancet, r (1823-4), p. 38; Chemist and Druggist, 167 (1957), op. cit., PP. 164-5, 274, 298 and 322.
6. Quoted in P.P. 1914, op. cit., p. vi.
7. Health News, op. cit., p. 34
8.
For example, the correspondence in The Times on 1o January I880, which
dealt in general with the abuse of narcotics, but also brought up the
question of chlorodyne. See also Privy Council Office papers, P. C. 8,
310, 1884, `Notes on the Sale of Poisons Bill‘.
9. Privy Council
Office papers, P.C. 8, 273, 1882, `Memorandum on the Pharmacy Act‘;
P.C. 8, 283, 1883, `Objections to the Pharmacy Bill‘; P.C. 8, 299,
1883, `Pharmacy Bill. Sale of poisons‘, P.C. 8, 364, 1886, `Poisons
Bill‘, and P.C. 8, 310, 1884, op. cit.
10. P.C. 8, 283, 3 March 1883, letter to Home Secretary from Society of Chemists and Druggists.
11.
See details of the Bill and its failure in Pharmaceutical journal, 3rd
ser. 14 (1883-4), PP. 746, 763; British Medical Journal, I (1882), p.
760; Home Office papers, H.O. 45, 9605, 1881-6, `Sale of poisonous
patent medicines …‘; and Hansard, 3rd ser. 286 (1884), col. 8o,,
where its second reading was deferred for six months in the expectation
of a government Bill which never materialized.
12. J. P. Entract,
‚Chlorodyne Browne: Dr John Collis Browne, 181984′, London Hospital
Gazette,5-73, no. 4 (1970), pp. 7-11; and J. Collis Browne, Practical
Instructions for the Treatment and Cure of Cholera and Diarrhoea by
Chlorodyne (London, n.d.), pp. 15-16.
13. See, for example, the advertisement in News of the World, I I May 1862.
14. `Formula for chlorodyne‘, The Doctor, 2 (1872), p. 173; `Composition of chlorodyne‘, Lancet, 1 (187o), p. 72.
15. Correspondence from Squire and Davenport on chlorodyne, Lancet, 2 (1869), PP. 74 and 152.
16. E. S. Turner, The Shocking History of Advertising (London, Michael Joseph, 1952), pp. 66-7.
17. C. D. Wilson, managing director of J. T. Davenport and C0., personal communication, 1975.
18. `Postal services and traffic‘, Pharmaceutical Journal, 210 (1973) P.115.
19.
`Poisoning by chlorodyne‘, Pharmaceutical Journal, 3rd ser. 20
(18899o), p. 1035. See also H.O. 45, 10454, 1893, `Letters on the
question of chlorodyne and the Habitual Drunkards Act, 1879′.
20.
Norman Kerr did, however, recognize `chlorodynomania‘ as a disease
entity, but few other English specialists followed his lead. N. Kerr,
Inebriety, its Etiology, Pathology, Treatment and Juridsprudence
(London, H. K. Lewis, znd edn 1889), p. 115.
21. `Memorandum by the
chairman of the parliamentary bills committee of the B. M. A.‘, British
Medical journal, 2 (1890), pp. 973-5.
22. `The consumption of chlorodyne and other narcotics‘, British Medical Journal, r (1891), p. 817.
23. `Important decision under the Pharmacy Act 1868′, Pharmaceutical Journal, 3rd ser. 22 (1891-2), pp. 928-40.
24. H. H. Bellot, op. cit., p. 36; `The Irregular Sale of Poisons‘, British Medical Journal, r (1892), p. 978.
25.
See V. Berridge and N. Rawson, op. cit. Also Annual Reports of the
Registrar General (London, H.M.S.O., 1889-99). 26. C. D. Wilson, op.
cit.
27. Health News, op. cit., p. 35; also R. Hutchinson, Patent
Foods and Patent Medicines (London, Bale, Sons and Danielsson, 2nd edn
1906).
28. S. H. Holbrook, The Golden Age of Quackery (New York, Macmillan, 1959), P. 26.
29.
British Medical Association, Secret Remedies, What They Cost and What
They Contain (London, B.M.A., 1909), pp. 12-13, 14-18; and More Secret
Remedies, What They Cost and What They Contain (London, B.M.A., 1912),
p. 77, 148.
30. H.O. 45, 10059, 1888-x903, `Departmental Committee
to consider Schedule A of the Pharmacy Act, 1868′, p. 548; R.
Hutchinson, `Patent medicines‘, British Medical Journal, 2 (1903), p.
1654.