Transcript Victorian Pharmacy Presentation.

Victorian Pharmacy
The role of the Nineteenth Century Chemist
In Public Health:
from Laudanum to custard,
Introduction
• Charley Downey
• Herbalist and aromatherapist
• Bimble Natural health and wellbeing
• Steampunk and social history
Introduction
• The NHS & Universal Healthcare
• Chemists, Druggists & Pharmacists: Physicians for the Poor
• Famous Pharmacists
• The Chemist’s Inventions
• A One-Stop Shop
• Hair-Raising ‘Remedies’
• Tragic Mishaps
• Questionable Hygiene
Introduction
• Embarrassing Problems and Embarrassing Solutions
• Clever Ideas and Lifesavers
• The Modern Era
• Victorian Remedies & Recipes
• Questions & Answers
• Testing
The NHS and Health for All
• NHS created by Aneurin "Nye" Bevan, Minister for Health
1945 – 1951.
• Formed in 1948 to provide healthcare for all which was ‘Free
at the point of use’.
• Before then, limited healthcare was provided through LloydGeorge’s National Insurance, which helped the working poor
get healthcare subsidised by the Government and employers.
• ‘Panel Doctors’
• Charity 'Free’ hospitals
• Local government-run ‘cottage’ hospitals
• Trades Unions and Friendly Societies
• ‘Endowed’ Beds – a philanthropic legacy
• ‘Pay as you go’ private doctors
• Home remedies and chemists
The cost of good health
• In the late 1920s/early 1930s, a visit to the
doctor would cost you 5 shillings – 15% of a
typical basic weekly salary and half a weekly
widow’s pension.
• Lloyd-George’s ‘National Insurance’ system did
not provide for dependents.
• Free hospitals had limited beds and resources,
and demand outstripped supply.
• Housewives cared for children with home
remedies.
• Only other recourse - the local pharmacist.
Your friendly local chemist
• Dispensing Chemists
• Health Advisors
• Grocers
• Inventors
• Innovators
• Manufacturers
• Entrepreneurs
Apothecaries chemists,
druggists and pharmacists
• From 16th Century, apothecaries separated from
the Guild of Grocers as a separate profession.
No qualifications were required.
• Chemists (traders in chemicals) and Druggists
(traders of drugs) combined as a profession by
1790. Apothecaries joined the trade in the 19th
century. Again, most training was ‘on the job’ via
an apprenticeship.
• 1814 – Royal Pharmaceutical Society formed.
• 1852 – First Register of Pharmacists Created.
Entrance examination required.
Apothecaries chemists,
druggists and pharmacists
• 1868 Pharmacy Act separated the betterqualified pharmaceutical chemists from
chemists and druggists. Both professions
required registration.
• By comparison; in modern times, pharmacists
need to pass a 4-year full time degree course in
pharmacology and maintain registration with
the Royal Pharmaceutical Society.
Famous pharmacists
• Pharmacists in the 19th and early 20th century
sold pre-packaged products, but most of their
healthcare wares were either unbranded
ingredients by weight, like borax or soapflakes,
or made on the premises.
• Pharmacists were also businessmen, so many
promoted their own remedies and mixes as
brands in their own right.
• Some of these products went on to be
household names, and some still are to this
day!
Every mum’s favourite!
• Custard used to be made with eggs, milk, sugar
and vanilla. It was time-consuming and tricky.
• Alfred Bird was a Victorian pharmacist. He
created the first ‘eggless custard mix’ at his
shop in Birmingham, and it’s still a bestseller
today!
Every mum’s favourite!
• Shipping beef to feed the troops in the Crimean
War proved problematic, until chemist John
Lawson Johnston invented 'Johnston's Fluid
Beef‘.
• This product revolutionised care for the infirm
– it was marketed as an ‘instant beef tea’.
• After the 1st World War, it was renamed the
more catchy title ‘Bovril’.
Everyone’s favourite!
• In the USA in 1886, a pharmacist named John
Pemberton created a drink as a ‘brain and
nerve tonic’. He named it Coca-Cola and sold it
in the pharmacy for 3 cents a glass.
• It sold in pharmacies all over the USA, and
these days it’s probably the most recognisable
trademark in history.
• It did originally contain coca leaf extract (a
small amount of cocaine), but has never
contained any kola nut extracts.
• The main flavourings were lime, vanilla,
cinnamon, orange, lemon and nutmeg.
Jesse boot!
• Possibly the most famous British Victorian
Pharmacist.
• Never heard of him?
How about now?
Boots The Chemist!
• Originally a herbal shop, established in Nottingham in 1849 by chemist John Boot
• 10 Year Old Jesse Boot worked behind the counter after his father’s death
• Jesse advertised widely, cut prices heavily and boasted a range of ‘over 2000
articles’
• Now a huge multinational corporation
• Britain’s biggest chemist, with over 3000 stores across the UK and Ireland
Reforms and improvements
• Jesse Boot supported better education in the pharmacy trade.
He took on many apprentices and trained them in-house
• He was a talented entrepreneur, noting the profits to be made
from the new proprietary medicines with trademarks
• Jesse produced his own proprietary medicines in a factory–
bronchial lozenges, lobelia pills (a herbal purgative) and many
more
• Jesse pioneered the discounted one-stop shop, which was
vastly cheaper and relied on a high volume turnover – over 100
years before the supermarket was invented!
A true one-stop shop!
• Herbs and spices by the ounce (medicinal &
culinary use);
• Herbal tobaccos;
• Exotic proprietary medicines and ‘cure alls’;
• Poisons and pest control – arsenic, fly papers,
mousetraps
• House remedies – medicines, ointments,
tinctures and tablets made on the premises
• Live leeches
• Drugs – laudanum, cocaine, opium, cannabis
(these were not made illegal until early 20th
century;
• First aid supplies;
• Soap and toiletries;
• Cold creams, perfumes and
make-up;
• Food products (custard powder,
Worcestershire sauce,
blancmange, soft drinks);
• Hardware – baby feeding bottles,
steam inhalers, lancets, ear
trumpets;
• Veterinary supplies;
• Fireworks
1nineteeth century public health
• Health in the 19th century was generally poor
• Mistrust of doctors – ‘cures’ worse than disease
• Lack of public health provision
• Little medical advances since Roman times
• Medicines often toxic or addictive
• Blood-letting, purging, enemas, blistering plasters
Blistering plasters
Black Pitch (400 grammes)
Yellow Resin (400 grammes)
Yellow Wax (300 grammes)
Olive Oil (1000 grammes)
Powdered Euphorbium (200 grammes)
Powdered Cantharides (600 grammes)
Mix the ingredients in a vessel over a gentle
heat, stirring constantly, strain through cloth,
leave to cool. Apply on lint as a plaster.
1nineteeth century public health
• Mass urbanisation in the early 19th century caused huge public health issues
• Unregulated urban development & slums made breeding grounds for infectious
disease
• Lack of refuse collection and manure from horses led to rats and filth
• Primitive sewage management fuelled disease and spoiled drinking water
• Cholera and typhoid fever widespread
• Environmental pollution – airborne smog caused by coal fires: ‘pea soupers’ or
‘The London Peculiars’
• Caused respiratory diseases
• Carried on until 1952, when the Great London Fog lasted 4 days and killed
around 4000 people
• Pollution also caused rickets – lack of sunlight
1nineteeth century public health
• Malnutrition widespread cause of early death
• Live expectancy of a Londoner at birth in 1841 was 37 years – 26 years in
Liverpool!
• Infant mortality rates at the end of the 19th century were around 20%
• Rotten meat – storage issues
• Contaminated water
• Lack of fresh food in quickly expanding cities
• Adulterated food – manufacturers competing to provide the cheapest food
• 35% of London’s population in 1889 lived in abject poverty
• Typical working class woman or child’s diet consisted solely of tea with sugar,
bread and margarine, with little or no fruit or vegetables
Diy healthcare
Mrs Beeton’s Book of Household Management (published 1859) recommends that
housewives kept the following first aid items at home:
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Antimonial wine
Antimonial Powder
Blistering Compound
Blue Pills
Calomel
Powdered Opium
Carbonate of Potash
Compound Iron Pills
Spirits of Nitre (Nitric Acid)
Oil of Turpentine
Curved Needles
Forceps
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Laudenum
Sal-Ammoniac
Senna Leaves
Soap Liniment
Turner’s Cerate
Common Adhesive Plaster
Isinglass Plaster
Lint
Scales & Weights
Lancet
Probe
Diy healthcare
Housewives who could read and write kept ‘receipt books’, a handwritten
notebook filled with recipes, where the recipe for a pie would sit next to one for
cough syrup. Recipes were shared with neighbours and passed down through
families.
Fortunate housewives might also have Mrs Beeton’s book and/or a ‘herbal’ – a
book containing information on the use of herbs for medicinal purposes.
Risks – Treatment vs Disease
• Without modern safety controls, regulation and scientific
understanding; many medicines were quite toxic, and the side
effects were often worse than the symptoms themselves.
• Doctors were university educated, but had no training in
pharmacology, and so knew little about the drugs they
prescribed.
• While traditional apothecaries served long apprenticeships with
oral exams, chemists and druggists had no such training or
licencing – anyone could set up a practice, selling anything, for
any purpose, until 1842. There was no legal requirement for the
treatment to work!
typhus
• A fever spread by rats and human lice.
• 10-20% mortality rate, and no cure at
the time.
• Only treatment ‘Fenning’s Fever Cure’
– a liquid made from nitric acid,
peppermint oil and a few herbal
extracts, including a tiny amount of
opium.
• This had no therapeutic benefit.
• Now easily treated with antibiotics.
Typhoid fever
• A fever spread by contaminated water
and person-to-person.
• 12-30% mortality rate, and no cure at
the time.
• Treatments were blood letting and
purging, alongside beef tea and
convalescence.
• If anything, the purging and blood
letting made things worse.
• Now easily treated with antibiotics.
cholera
• A highly infectious disease spread through
poor sanitation. Progression is swift,
causing vomiting and dysentery, which
can kill in less than 24 hours.
• 4 major outbreaks in the UK in the 19th
century, which killed a total of over
140,000 people.
• There was no cure, but doctors and
pharmacists prescribed a range of
treatments, which ranged from the
ineffectual to the downright dangerous.
• Now easily treated with oral or IV
electrolytes.
Cholera treatments
• Blue Pills
• Emetics
• Calomel
• Blood transfusion
• Liquid ammonia injections
• ‘Cholera Drops’
• Cheroots (a type of small
cigar) were recommended
as a preventative measure!
toxic treatments
• Clarke’s Blood Mixture – marketed as a
‘guaranteed cure for all blood diseases –
including Scrofula, Scurvy, Glandular
Swellings, Cancerous Ulcers, Syphilis, Bad
Legs, Gout, Rheumatism, Dropsy, Piles,
Blackheads and Pimples’.
• Made from water, burnt sugar, potassium
iodide, sal volatile (ammonium carbonate),
chloroform, and syrup sweetener.
toxic treatments
• Dr James’ Fever Powders were marketed as
a cure for fevers such as Typhoid. It ‘worked’
by inducing sweating and vomiting to help
‘sweat out’ the fever.
• It is hardly surprising that patients sweated
and vomited, as the ‘medicine’ was highly
toxic, being made from Antimony mixed with
Calcium Phosphate.
toxic treatments
• Fowler’s Solution was marketed as a
treatment for everything from asthma and
typhus to syphilis.
• The ‘medicine’ was a solution of Potassium
Arsenite or, more commonly, Arsenic.
• Arsenic is highly poisonous. The solution
contained about 1% potassium arsenite by
volume, so 100ml would easily contain a
fatal dose.
• Arsenic is retained by the body, so
cumulative doses lead to chronic toxicity.
• Prescribed for morning sickness!
toxic treatments
Dr Collis Brown's ‘Chlorodyne’ was a very
popular medicine which actually granted
some relief of symptoms.
It was used for everything from coughs
and colds to cholera and dysentery, and
became popular as a cough syrup for
infants as well as adults.
Chlorodyne Recipe
4 Drachms Chloroform
1 ½ Drachms Ether
8 Drachms Oil of Peppermint
16 Grains Cannabis Resin
2 Grains Capsicum (pepper)
3 Grains Morphine Hydrochloride
Drug abuse
• Opium
• Laudanum
• Morphine
• Cocaine
• Chloroform
• Cannabis
Poison
A significant proportion of a chemist’s
stock was poisonous.
• Arsenic
• Belladonna
• Opium
• Laudanum
• Antimony
• Oxalic Acid
• Mercury
arsenic
• Colourless and odourless
• Tasteless in food or drink
• Poisoning resembled stomach flu until
skin lesions show (when too late)
• Nondescript off-white powdered
appearance
• Unrestricted sale until 1851
• Popular murder weapon
• Regular accidental poisonings
Humbug Billy
• Adulteration common practice
• Literacy levels low
• Pharmacists worked long hours (12
hour days Mon-Fri & 15 Hours on
Saturday) and had little rest
• Verdict at York Crown Court – Not
guilty
• Assessed as a ‘tragic accident’
• Public more angry about adulteration
than the poison risk!
• Horsemeat – have things changed all
that much?
Questionable hygiene
• Infection routes poorly understood
• Cross-contamination equally caused
problems
• Issues raised by re-use of equipment to
make different products without
modern cleaning techniques such as
autoclaves.
• Issues raised by the need to make
hundreds of different products in a
small space
Embarrassing ailments
• ‘Victorian Values’ made talking about
‘personal’ problems, even in a medical
setting, somewhat difficult.
• ‘Victorian Values’ weren’t as regularly
practiced as discussed.
• London known as the ‘Whore Shop of
the World’ – prostitution known as ‘the
great evil’.
• 1 prostitute to every 12 adult males in
London in the 1850s.
• 15% of the population of Europe
infected with Syphilis.
Victorian values
• Victorian prudery sometimes went so
far as to consider it improper to say
"leg" in mixed company!
• Words such as ‘devil’ and ‘damned’
were blanked out in books.
• Women wore clothing in the bath
• This gave rise to a rich vocabulary of
euphemisms
Guess the euphemism
• Fruitful Garden
• Wife in Watercolours
• Green Gown
• Wasp
• Margery
• Convenient
• French Gout
Embarrassing ailments
• Syphilis affected all walks of life, including many fampus figures
• Transmitted in utero
• No cure until antibiotics became widespread in the 1940s
• Embarrassment made treatment difficult
• Treatment indiscreet – mercury-based treatment caused hair loss,
tooth loss, skin discolouration and excessive saliva (up to 4-6lb a day!)
• Mercury-laced chocolates
• Confusion with ‘gout’
Every mother’s helper
• Blancmange powder – a sago and cornflour blend flavoured with lemon,
cassia and nutmeg.
• Tonics and drinks – like Dandelion & Burdock and Sarsaparilla
• Soda Siphons
• Dried soft drinks – lemon kali – tartaric acid, sodium bicarbonate, sugar
& lemon oil. Halve the lemon oil and add ginger, and you have ginger
beer mix.
• Chemists also brewed herb beers, lemonade and ginger ale.
• Carbolic soap, Jeye’s Disinfectant, Sulphur candles, borax, silvering
paste, ‘dolly blue’.
Every mother’s helper – and everyone
else!
• Pesticides & fly papers
• Fireworks – made from charcoal,
saltpetre & brimstone –
sometimes sulphur.
• Arsenic sheep dip, horse drops &
poultry spice
• Cosmetics & toiletries
!
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recipes
Ginger Cordial
1 Litre Water
300g Fresh Grated Root Ginger
100ml Honey
25g Chamomile (or 10 chamomile tea bags)
3ml Lemon Oil
150ml Lemon Juice
100ml Cider Vinegar
100ml Glycerine
400g Brown Sugar
Stew the chamomile & ginger in water for ½ hour, then strain.
Add all other ingredients, bring to the boil, simmer 20 minutes and bottle.
Cough Syrup (Surprisingly Delicious!)
500ml Water
50ml brandy
4 liquorice juice sticks (or 100g liquorice sweets)
100ml Honey
25g Marshmallow Root
50g Liquorice Root
100ml Black Treacle
3ml Lemon Oil
50ml Lemon Juice
100ml White Wine Vinegar
100ml Glycerine
Dissolve the liquorice sticks In brandy overnight. Stew the herbs in water for ½ hour, then
strain. Add all other ingredients, bring to the boil, simmer 20 minutes and bottle.
Comfrey Wound Healer
50ml Water
50ml Witch Hazel
100ml Comfrey Tincture
50ml St John’s Wort Tincture
5ml Lavender Oil
1ml Thyme Oil
2ml Goldenseal Extract
5ml Potassium Sorbate
6ml Polysorbate
Mix the oils with the Polysorbate and add the potassium Sorbate. Mix in the witch
hazel and tinctures, then add the water and bottle.
Cooling Liniment
50ml Distilled Water
300ml Rubbing or Grain Alcohol
10ml Peppermint Oil
5ml Camphor Oil
5g Menthol Crystals
Dissolve the menthol in the alcohol overnight. Shake well and add the oils, followed
by the water and bottle.
The Black Dose – Liquid Black Jacks to Keep You Regular!
600ml Water
50ml brandy
4 liquorice juice sticks (or 100g liquorice sweets)
25g Senna Leaves
10g Caraway Seeds
20g Ginger Root
5g Cloves
30g Liquorice Root
200g Black Treacle
200g Brown Sugar
100ml Glycerine
Dissolve the liquorice sticks In brandy overnight. Stew the herbs & SPices in water for ½
hour, then strain. Add all other ingredients, bring to the boil, simmer 20 minutes and bottle.
Rosehip Syrup Tonic
600ml Water
250g Rosehip Shells
10g Cinnamon Sticks
30g Dried Ginseng
100ml Honey
25g Chamomile (or 10 chamomile tea bags)
150ml Lemon Juice
300g Brown Sugar
Stew the herbs and rosehips in water for ½ hour, then strain.
Add all other ingredients, bring to the boil, simmer 20 minutes and bottle.
Sore Throat Gargle
120ml Water
100ml Honey
100ml Myrrh Tincture
10ml Clove Tincture
5ml Goldenseal Extract
120ml Lemon Juice
3ml Lemon Oil
1ml Marjoram Oil
2ml Lime Oil
6ml Potassium Sorbate
6ml Polysorbate
Mix the oils with the Polysorbate and add the potassium Sorbate. Mix in the
tinctures, then add the water and bottle.
Blemish & Pimple Elixir
10ml Aloe Juice
60ml Lemon Juice
5ml Lemon Oil
5ml Tea Tree Oil
5ml Lavender Oil
240ml Witch Hazel
6ml Polysorbate
Mix the oils with the Polysorbate and add the witch hazel. Mix in the other
ingredients and bottle.
Moth Balls
Lavender
Cloves
Dried Ginseng
Thyme
Rosemary
Mix equal quantities of the above herbs and tie into muslin bags. Hang in wardrobes
and put in clothes drawers and case. Refresh with cedarwood and lavender oils.
!
Making tinctures
!
Any Questions?
!
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