Tincture Of Opium

Laudanum is a tincture of opium containing approximately 10% powdered opium by weight (the equivalent of 1% morphine). Laudanum is prepared by dissolving extracts from the opium poppy (''Papaver somniferum Linnaeus'') in alcohol (ethanol).

Reddish-brown in color and extremely bitter, laudanum contains several opium alkaloids, including morphine and codeine. Laudanum was historically used to treat a variety of conditions, but its principal use was as a pain medication and cough suppressant. Until the early 20th century, laudanum was sold without a prescription and was a constituent of many patent medicines. Today, laudanum is recognized as addictive and is strictly regulated and controlled as such throughout most of the world. The United States Controlled Substances Act, for one example, lists it on Schedule II, the second strictest category.

Laudanum is known as a "whole opium" preparation since it historically contained all the alkaloids found in the opium poppy, which are extracted from the dried latex of ripe seed pods (''Papaver somniferum L., succus siccum''). Today, however, the drug is often processed to remove all or most of the noscapine (also called ''narcotine'') present as this is a strong emetic and does not add appreciably to the analgesic or antipropulsive properties of opium; the resulting solution is called Denarcotized Tincture of Opium or Deodorized Tincture of Opium (DTO).

Laudanum remains available by prescription in the United States (under the generic name "opium tincture") and in the European Union and United Kingdom (under the trade name Dropizol), although today the drug's therapeutic indication is generally limited to controlling diarrhea when other medications have failed.

The terms ''laudanum'' and ''tincture of opium'' are generally interchangeable, but in contemporary medical practice, the latter is used almost exclusively.

History

Paracelsus's laudanum

Paracelsus, a 16th-century Swiss alchemist, experimented with various opium concoctions, and recommended opium for reducing pain. One of his preparations, a pill which he extolled as his "archanum" or "laudanum", may have contained opium. Paracelsus' laudanum was strikingly different from the standard laudanum of the 17th century and beyond, containing crushed pearls, musk, amber, and other substances.

British laudanum

One researcher has documented that "Laudanum, as listed in the ''London Pharmacopoeia'' (1618), was a pill made from opium, saffron, castor, ambergris, musk and nutmeg".

Sydenham's laudanum

In the 1660s English physician Thomas Sydenham (1624–1689) popularized 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.

18th century laudanum

By the 18th century, the medicinal properties of opium and laudanum were well known, and the term "laudanum" came to refer to any combination of opium and alcohol.

In the eighteenth century several physicians published work about it, including John Jones, who wrote ''The Mysteries of Opium Revealed'' (1700), which was described by one commentator as "extraordinary and perfectly unintelligible." The Scottish physician John Brown, creator of the Brunonian system of medicine, recommended opium for what he termed asthenic conditions, but his system was discredited by the time of his death. The most influential work was by George Young, who published a comprehensive medical text entitled ''Treatise on Opium (1753).'' Young, an Edinburgh surgeon and physician, wrote this to counter an essay on opium by his contemporary Charles Alston, professor of botany and materia medica at Edinburgh who had recommended the use of opium for a wide variety of conditions. Young countered this by emphasising the risks '''...that I may prevent such mischief as I can, I here give it as my sincere opinion... that opium is a poison by which great numbers are daily destroyed. Young gives a comprehensive account of the indications for the drug including its complications. He is critical about writers whose knowledge of the drug is based on chemical or animal experiments rather than clinical practice. The treatise is a detailed, balanced and valuable guide to prevailing knowledge and practice. As it gained popularity, opium, and after 1820, morphine, was mixed with a wide variety of agents, drugs and chemicals including 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.

An 1869 article in ''Scientific American'' describes a farmer growing and harvesting poppy in Indian Springs, Georgia, and subsequently selling the raw material to a local pharmacist who prepared laudanum.

19th century laudanum

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 ... ndas a soporific". The limited pharmacopoeia of the day meant that opium derivatives were among the most effective 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 the US 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": (1) Thin boiled starch, 2 ounces; Laudanum, 20 drops; "Use as an injection eaning as an enema">enema.html" ;"title="eaning as an enema">eaning as an enemaevery six to twelve hours"; (2) Tincture rhubarb, 1 ounce; Laudanum 4 Dram (unit)">drachms