Warburg's tincture was a

pharmaceutical A medication (also called medicament, medicine, pharmaceutical drug, medicinal drug or simply drug) is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy (pharmacotherapy) is an important part of the medical field an ...

drug, now obsolete. It was invented in 1834 by Dr. Carl Warburg. Warburg's

tincture A tincture is typically an extract of plant or animal material dissolved in ethanol (ethyl alcohol). Solvent concentrations of 25–60% are common, but may run as high as 90%.Groot Handboek Geneeskrachtige Planten by Geert Verhelst In chemistr ...

was well known in the

Victorian era In the history of the United Kingdom and the British Empire, the Victorian era was the period of Queen Victoria's reign, from 20 June 1837 until her death on 22 January 1901. The era followed the Georgian period and preceded the Edwardia ...

as a medicine for

fevers Fever, also referred to as pyrexia, is defined as having a temperature above the normal range due to an increase in the body's temperature set point. There is not a single agreed-upon upper limit for normal temperature with sources using val ...

, especially tropical fevers, including malaria. It was considered, by some, to be superior to

quinine Quinine is a medication used to treat malaria and babesiosis. This includes the treatment of malaria due to '' Plasmodium falciparum'' that is resistant to chloroquine when artesunate is not available. While sometimes used for nocturnal le ...

. Warburg's Tincture was a secret, proprietary remedy. The formula was not published until 1875. Later, it was included in the first edition of '' Martindale: The Extra Pharmacopoeia''. Warburg's Tincture included an array of ingredients, including quinine.Warburg, Carl (1870, London), ''Warburg Tincture: Statement proving by numerous official documents its remarkable curative powers in fevers...''''The Lancet'', edition 1875-11-13, 'Professor Maclean, C.B., on the true composition and therapeutic value of Warburg's Tincture', pp. 716–718.

Synonyms

List of alternative names by which Warburg's Tincture was known or referred to: * 'Warburg Tincture' * 'The Warburg Tincture' * 'Warburg's Fever Tincture' * 'Warburg's Fever Tincture and Tonic Medicine' * 'Warburg Fever Tincture and Tonic Medicine' * 'Warburg's Vegetable Fever Tincture' * 'Dr Warburg's Vegetable Fever Drops' Warburg, Carl (1839, London), ''Specific for fever, now first introduced into Europe'', pamphlet * 'Warburg's Vegetable Fever Drops' * 'Dr Warburg's Tincture' * 'Dr Warburg's Fever Tincture' * 'Warburg Drops' * 'Warburg's Drops' * 'Warburg's Fever Drops' * 'Dr Warburg's Fever Drops' * 'Dr Warburg's Drops' * 'Tinctura Warburgi' * 'Tinctura Warburgii' * 'Tinctura antifebrilis Warburgi' * 'Tinctura antifebrilis Warburgii' * 'Tinctura Antiperiodica' * 'Antiperiodica Tincture' * 'Warburg' (informal)

Appearance and format

As its name implies, Warburg's Tincture was originally available only in liquid form. It was deep brown to golden yellow in colour; its taste was bitter and not very palatable. It was sold in small bottles of unique design, containing about one ounce. The label affixed to each bottle bore the registered trademark, which depicted an image of the bottle accompanied by a facsimile of Carl Warburg's signature. By 1888 the drug was available in tablet form.''The British Medical Journal'', edition 1888-12-01, p. 1232

History

Warburg's Tincture was invented by Dr Carl Warburg in 1834, in British Guiana (now Guyana). It was introduced into Europe in 1839.''The medico-chirurgical review and journal of medical science'', Volume 34, p. 658, 1839 Warburg's Tincture received medical trials in British Guiana in the 1830s, and then elsewhere around the world in the 1840s and 1850s. In 1846, Warburg's Tincture was extensively trialled in Austria and, the following year, it was adopted as an official medicine by the

Austrian Empire The Austrian Empire (german: link=no, Kaiserthum Oesterreich, modern spelling , ) was a Central-Eastern European multinational great power from 1804 to 1867, created by proclamation out of the realms of the Habsburgs. During its existence ...

, by imperial order.''Medical Times'', edition, 1851-1-4, pp. 700–702, letter from Carl Warburg Warburg's Tincture was sold as a secret, proprietary medicine for over forty years, and was marketed and manufactured by Carl Warburg for many decades. He wanted the British Government to procure the formula of Warburg's Tincture from him, but such an arrangement never came to fruition. Nevertheless, the British Government was a significant client, procuring Warburg's Tincture for military forces serving overseas in

India India, officially the Republic of India (Hindi: ), is a country in South Asia. It is the seventh-largest country by area, the second-most populous country, and the most populous democracy in the world. Bounded by the Indian Ocean on the so ...

and Ceylon (now Sri Lanka); in Africa, in

Gold Coast Gold Coast may refer to: Places Africa * Gold Coast (region), in West Africa, which was made up of the following colonies, before being established as the independent nation of Ghana: ** Portuguese Gold Coast (Portuguese, 1482–1642) ** Dutch G ...

(now

Ghana Ghana (; tw, Gaana, ee, Gana), officially the Republic of Ghana, is a country in West Africa. It abuts the Gulf of Guinea and the Atlantic Ocean to the south, sharing borders with Ivory Coast in the west, Burkina Faso in the north, and To ...

), Gambia and

Sierra Leone Sierra Leone,)]. officially the Republic of Sierra Leone, is a country on the southwest coast of West Africa. It is bordered by Liberia to the southeast and Guinea surrounds the northern half of the nation. Covering a total area of , Sierr ...

; in the

West Indies The West Indies is a subregion of North America, surrounded by the North Atlantic Ocean and the Caribbean Sea that includes 13 independent island countries and 18 dependencies and other territories in three major archipelagos: the Greater A ...

; and in

Cyprus Cyprus ; tr, Kıbrıs (), officially the Republic of Cyprus,, , lit: Republic of Cyprus is an island country located south of the Anatolian Peninsula in the eastern Mediterranean Sea. Its continental position is disputed; while it is geo ...

Corfu Corfu (, ) or Kerkyra ( el, Κέρκυρα, Kérkyra, , ; ; la, Corcyra.) is a Greek island in the Ionian Sea, of the Ionian Islands, and, including its small satellite islands, forms the margin of the northwestern frontier of Greece. The isl ...

Mauritius Mauritius ( ; french: Maurice, link=no ; mfe, label=Mauritian Creole, Moris ), officially the Republic of Mauritius, is an island nation in the Indian Ocean about off the southeast coast of the African continent, east of Madagascar. It incl ...

and

China China, officially the People's Republic of China (PRC), is a country in East Asia. It is the world's most populous country, with a population exceeding 1.4 billion, slightly ahead of India. China spans the equivalent of five time zones and ...

. In 1867, in the

House of Commons of the United Kingdom The House of Commons is the lower house of the Parliament of the United Kingdom. Like the upper house, the House of Lords, it meets in the Palace of Westminster in London, England. The House of Commons is an elected body consisting of 650 me ...

Sir Robert Anstruther, 5th Baronet Sir Robert Anstruther, 5th Baronet (28 August 1834 – 21 July 1886) was a Scottish Liberal Party politician who sat in the House of Commons between 1864 and 1886. Life and career Anstruther was the son of Sir Ralph Anstruther, 4th Baronet and ...

asked the Secretary of War why Warburg's Tincture was not being supplied in larger quantities to troops in India. Writing in 1870, Carl Warburg lamented that his

eponymous An eponym is a person, a place, or a thing after whom or which someone or something is, or is believed to be, named. The adjectives which are derived from the word eponym include ''eponymous'' and ''eponymic''. Usage of the word The term ''epon ...

drug was "comparatively unknown". The formula was disclosed by him in November 1875 when it was published on his behalf in ''

The Lancet ''The Lancet'' is a weekly peer-reviewed general medical journal and one of the oldest of its kind. It is also the world's highest-impact academic journal. It was founded in England in 1823. The journal publishes original research articles, ...

'' and ''The Medical Times''. In 1855, it retailed at 6s/6d a bottle.

Famous users

Famous

Victorians In the history of the United Kingdom and the British Empire, the Victorian era was the period of Queen Victoria's reign, from 20 June 1837 until her death on 22 January 1901. The era followed the Georgian period and preceded the Edwardian ...

who are documented to have used Warburg's Tincture include: * Captain

Sir Richard Francis Burton Sir Richard Francis Burton (; 19 March 1821 – 20 October 1890) was a British explorer, writer, orientalist scholar,and soldier. He was famed for his travels and explorations in Asia, Africa, and the Americas, as well as his extraordinary kn ...

- explorer and diplomat * General

Charles George Gordon Major-general (United Kingdom), Major-General Charles George Gordon Companion of the Order of the Bath, CB (28 January 1833 – 26 January 1885), also known as Chinese Gordon, Gordon Pasha, and Gordon of Khartoum, was a British Army officer and ...

of Khartoum - senior army officer and colonial administrator * Dr

David Livingstone David Livingstone (; 19 March 1813 – 1 May 1873) was a Scottish physician, Congregationalist, and pioneer Christian missionary with the London Missionary Society, an explorer in Africa, and one of the most popular British heroes of t ...

- missionary and explorer *

Dante Gabriel Rossetti Gabriel Charles Dante Rossetti (12 May 1828 – 9 April 1882), generally known as Dante Gabriel Rossetti (), was an English poet, illustrator, painter, translator and member of the Rossetti family. He founded the Pre-Raphaelite Brotherhoo ...

Pre-Raphaelite The Pre-Raphaelite Brotherhood (later known as the Pre-Raphaelites) was a group of English painters, poets, and art critics, founded in 1848 by William Holman Hunt, John Everett Millais, Dante Gabriel Rossetti, William Michael Rossetti, James ...

artist.letter from Rossetti to Frederic Shields, dated 1869-8-27 - ''The life and letters of Frederic Shields'

*

Frederic Shields Frederic James Shields (14 March 1833 – 26 February 1911) was a British artist, illustrator, and designer closely associated with the Pre-Raphaelites through Dante Gabriel Rossetti and Ford Madox Brown. Early years Frederic James Shields ...

- artist and illustrator.

Medicinal uses

Medicinal claims

Warburg's Tincture was promoted by its inventor, Dr Carl Warburg, as a medicine suitable for treating all types of

, but especially tropical fevers, including

malaria Malaria is a mosquito-borne infectious disease that affects humans and other animals. Malaria causes symptoms that typically include fever, tiredness, vomiting, and headaches. In severe cases, it can cause jaundice, seizures, coma, or death. S ...

and

yellow fever Yellow fever is a viral disease of typically short duration. In most cases, symptoms include fever, chills, loss of appetite, nausea, muscle pains – particularly in the back – and headaches. Symptoms typically improve within five days. In ...

; and that it could also be used as a tonic in debility and convalescence. He claimed that his

tincture was superior to any other

antipyretic An antipyretic (, from ''anti-'' 'against' and ' 'feverish') is a substance that reduces fever. Antipyretics cause the hypothalamus to override a prostaglandin-induced increase in temperature. The body then works to lower the temperature, which r ...

, including

. "I assert that for perfect safety, for efficacy, rapidity of action, and for economy, my tincture has no rival, nor any approach to it". He also stated that quinine only "relieves", whereas Warburg's Tincture "cures". He advocated that Warburg's Tincture could be employed at all stages of fever, as well as a

prophylactic Preventive healthcare, or prophylaxis, consists of measures taken for the purposes of disease prevention.Hugh R. Leavell and E. Gurney Clark as "the science and art of preventing disease, prolonging life, and promoting physical and mental hea ...

19th century

In the Victorian era Warburg's Tincture was principally employed in the treatment of tropical

, including

and

typhus Typhus, also known as typhus fever, is a group of infectious diseases that include epidemic typhus, scrub typhus, and murine typhus. Common symptoms include fever, headache, and a rash. Typically these begin one to two weeks after exposure. ...

. It was therefore an

, and an

antimalarial drug Antimalarial medications or simply antimalarials are a type of antiparasitic chemical agent, often naturally derived, that can be used to treat or to prevent malaria, in the latter case, most often aiming at two susceptible target groups, young c ...

20th century

Warburg's Tincture was vaunted as being superior to quinine in the treatment of malaria by many in the Victorian era. Quinine remained the first-line antimalarial drug of choice until the 1940s, when other drugs replaced it. Until recently

Chloroquine Chloroquine is a medication primarily used to prevent and treat malaria in areas where malaria remains sensitive to its effects. Certain types of malaria, resistant strains, and complicated cases typically require different or additional medi ...

was the most widely used antimalarial drug. Warburg's Tincture was included in Burroughs Wellcome & Company's tabloid medicine cases of the late 19th and early 20th centuries. "There is now no exact equivalent of Warburg's Tincture ....The most similar modern preparation is ammoniated tincture of quinine. This omits aloes and rhubarb, whose function was a laxative to 'purge' the patient's system, an approach to fever treatment now redundant. Ammoniated tincture of quinine last appeared in the ''

British Pharmaceutical Codex The British Pharmaceutical Codex (BPC) was first published in 1907, to supplement the ''British Pharmacopoeia'' which although extensive, did not cover all the medicinal items that a pharmacist might require in daily work. Other books existed, ...

'' of 1963, but still remains an official preparation that could be prepared if necessary....it was popular as an over the counter medicine for colds until c. 1980, but is now rarely used."

Reputation and efficacy

'Warburg's Tincture' was a well-known drug in the Victorian era. It earned itself a well regarded international reputation in certain quarters of the medical profession, many attesting to its efficacy and value.Dr William Henry Broadbent, article, ''The Practitioner'', edition February 1877, pp.196–202. One of the most notable and strongest advocates of Warburg's Tincture was Surgeon-General W. C. Maclean, C.B, (1811–1898), Professor of Military Medicine at the Army Medical School, at Chatham and later at the

Royal Victoria Military Hospital The Royal Victoria Hospital or Netley Hospital was a large military hospital in Netley, near Southampton, Hampshire, England. Construction started in 1856 at the suggestion of Queen Victoria but its design caused some controversy, chiefly from ...

, Netley, from 1860 until 1885. Maclean contributed the chapters on malarial fevers and dysentery in ''A System of Medicine'', edited by

Sir John Russell Reynolds Sir John Russell Reynolds, 1st Baronet (22 May 1828 – 29 May 1896) was a British neurologist and physician. Reynolds was born in Romsey, Hampshire, as son of John Reynolds, an independent minister, and grandson of Dr. Henry Revell Reynolds. ...

(the latter being "an eminent and highly influential physician in the Victorian era who held the Presidencies of the

Royal College of Physicians of London The Royal College of Physicians (RCP) is a British professional membership body dedicated to improving the practice of medicine, chiefly through the accreditation of physicians by examination. Founded by royal charter from King Henry VIII in 1 ...

, and of the

British Medical Association The British Medical Association (BMA) is a registered trade union for doctors in the United Kingdom. The association does not regulate or certify doctors, a responsibility which lies with the General Medical Council. The association's headquar ...

"). Maclean considered Warburg's Tincture to be the best drug for the treatment of malaria and, in his lectures and writings on tropical diseases, he strongly recommended its use. In addition to Surgeon-General Maclean, Warburg's Tincture was highly praised by many other eminent medical professionals of the Victorian era, including: * Sir

James Johnson James Johnson may refer to: Artists, actors, authors, and musicians *James Austin Johnson (born 1989), American comedian & actor, ''Saturday Night Live'' cast member *James B. Johnson (born 1944), author of science nonfiction novels *James P. John ...

M.D. - physician extraordinary to

King William IV William IV (William Henry; 21 August 1765 – 20 June 1837) was King of the United Kingdom of Great Britain and Ireland and King of Hanover from 26 June 1830 until his death in 1837. The third son of George III, William succeeded h ...

. *

Sir James Clark Sir James Clark, 1st Baronet, KCB (14 December 1788 – 29 June 1870) was a Scottish physician who was Physician-in-Ordinary to Queen Victoria between 1837 and 1860, and was previously physician to poet John Keats in Rome. Early life and career ...

M.D. - royal physician to

Queen Victoria Victoria (Alexandrina Victoria; 24 May 1819 – 22 January 1901) was Queen of the United Kingdom of Great Britain and Ireland from 20 June 1837 until Death and state funeral of Queen Victoria, her death in 1901. Her reign of 63 years and 21 ...

and Prince Albert. * Sir William Henry Broadbent, 1st Baronet, M.D. -

St Mary's Hospital, London St Mary's Hospital is an NHS hospital in Paddington, in the City of Westminster, London, founded in 1845. Since the UK's first academic health science centre was created in 2008, it has been operated by Imperial College Healthcare NHS Trust, wh ...

and

London Fever Hospital The London Fever Hospital was a voluntary hospital financed from public donations in Liverpool Road in London. It was one of the first fever hospitals in the country. History Originally established with 15 beds in 1802 in Gray's Inn Road, it mov ...

, Physician in Ordinary to

and

King Edward VII Edward VII (Albert Edward; 9 November 1841 – 6 May 1910) was King of the United Kingdom of Great Britain and Ireland and Emperor of India, from 22 January 1901 until his death in 1910. The second child and eldest son of Queen Victoria a ...

. ("Warburg’s Tincture has long held a high reputation in India, as a remedy of undoubted and indeed unequalled power in the treatment of the malignant malarial fevers of that country and of cholera. Testimony to its efficacy has come from men whose capability and opportunities of forming an opinion could not be disputed", 1877) * Dr

Thomas Southwood Smith Thomas Southwood Smith (17881861) was an English physician and sanitary reformer. Early life Smith was born at Martock, Martock, Somerset, into a strict Baptist family, his parents being William Smith and Caroline Southwood. In 1802 he won a sc ...

, and recognised expert on the treatment of fevers. * Dr

Benjamin Guy Babington Benjamin Guy Babington (5 March 1794 – 8 April 1866) was an English physician and epidemiologist. Life He was born on 5 March 1794, the son of the physician and mineralogist William Babington (1756–1833) and his wife, Martha Elizabeth (née ...

Guy's Hospital Guy's Hospital is an NHS hospital in the borough of Southwark in central London. It is part of Guy's and St Thomas' NHS Foundation Trust and one of the institutions that comprise the King's Health Partners, an academic health science centre. ...

("I consider it the most potent anti-intermittent medicine I have ever employed", 1851). * Dr F. C. Skey -

St Bartholomew's Hospital St Bartholomew's Hospital, commonly known as Barts, is a teaching hospital located in the City of London. It was founded in 1123 and is currently run by Barts Health NHS Trust. History Early history Barts was founded in 1123 by Rahere (died ...

, and Professor of Surgery to

Royal College of Surgeons of England The Royal College of Surgeons of England (RCS England) is an independent professional body and registered charity that promotes and advances standards of surgical care for patients, and regulates surgery and dentistry in England and Wales. The ...

. * Sir James Gibson, M.D., K.C.B. - Director-General, Army Medical Department, Whitehall, London. * Sir Andrew Halliday, M.D. - Deputy Inspector General of Military Hospitals. * Dr Macgrath - Director-General, Army Medical Department, Madras, India. * Dr Joseph Johann Knolz - head of the civilian medical department of the Austrian Empire. * Dr Rieken - Belgium, physician to

Leopold I of Belgium * nl, Leopold Joris Christiaan Frederik * en, Leopold George Christian Frederick , image = NICAISE Leopold ANV.jpg , caption = Portrait by Nicaise de Keyser, 1856 , reign = 21 July 1831 – , predecessor = Erasme Loui ...

. * Count E Bylandt M.D. - physician to

William II of the Netherlands William II ( nl, Willem Frederik George Lodewijk, anglicized as William Frederick George Louis; 6 December 1792 – 17 March 1849) was King of the Netherlands, Grand Duke of Luxembourg, and Duke of Limburg. William II was the son of William ...

* Dr Salgues - Dijon, France. * Dr Uyttrhoven - Brussels, Belgium.

Detractors, secret remedy

As a consequence of Warburg's Tincture being sold as a secret, proprietary remedy, many in the medical profession, particularly in England, derided, distrusted and dismissed it as a '

patent medicine A patent medicine, sometimes called a proprietary medicine, is an over-the-counter (nonprescription) medicine or medicinal preparation that is typically protected and advertised by a trademark and trade name (and sometimes a patent) and claimed ...

' or 'quack medicine', and disliked it and criticised Carl Warburg on grounds of

professional ethics Professional ethics encompass the personal and corporate standards of behavior expected of professionals. The word professionalism originally applied to vows of a religious order. By no later than the year 1675, the term had seen secular applic ...

Status, entries in pharmacopoeia, formulary and other pharmaceutical compendia

* Warburg's Tincture was adopted by the Austrian empire as an official medicine in 1847; it was added to the Austrian 'Materia Medica' under the name 'Tinctura Warburgi'. * Warburg's Tincture appeared in the first edition of '' Martindale: The Extra Pharmacopoeia'' (now known as '' Martindale: The complete drug reference'') in 1883, and was included until the 19th edition of 1928. * Warburg's Tincture was included in the National Formulary Section of ''The Dispensatory for the United States of America'' in the 20th edition in 1918, listed under the entry for 'Tinctura Antiperiodica'.''United States Dispensatory'' 20th Edition, p. 1834, 1918, Joseph P. Remington et al. * ''The Pocket Formulary, and synopsis of the British & Foreign pharmacopoeias: comprising standard and approved formulae for the preparation and compounds employed in medical practice'' London, by Henry Beasley. Included in various editions, e.g. 1851 (fifth edition), 1856, 1877. * ''Jahresbericht der Pharmazie'', 1910, Munich, Germany. * Warburg's Tincture is now obsolete as a medicinal drug. It last appeared in the Martindale: The Extra Pharmacopoeia in 1928.

Properties / formula

The formula of Warburg's Tincture was disclosed by its inventor in November 1875 when it was published in ''

'' and '' The Medical Times'' on his behalf - see below. Ingredients and directions for preparation Warburg's Tincture therefore contained quinine in addition to various

purgative Laxatives, purgatives, or aperients are substances that loosen stools and increase bowel movements. They are used to treat and prevent constipation. Laxatives vary as to how they work and the side effects they may have. Certain stimulant, lubri ...

aromatics Aromatic compounds, also known as "mono- and polycyclic aromatic hydrocarbons", are organic compounds containing one or more aromatic rings. The parent member of aromatic compounds is benzene. The word "aromatic" originates from the past grouping ...

and

carminative A carminative, also known as carminativum (plural carminativa), is a herb or preparation intended to either prevent formation of gas in the gastrointestinal tract or facilitate the expulsion of said gas, thereby combatting flatulence. Name The wo ...

s. The ingredient Confection Damocratric is a complex preparation which has not been obtainable for over a century; it contained many different aromatic substances. The prepared chalk was used to correct the otherwise extremely acrid taste of the tincture. Dosage A bottle of Warburg's Tincture contained about one ounce of liquid. The drug was to be administered in two equal doses, a few hours apart.