Opium tincture

Laudanum is a tincture of opium containing approximately 10% powdered opium by weight (the equivalent of 1% morphine). Laudanum is a tincture of opium containing approximately 10% powdered opium by weight (the equivalent of 1% morphine). Reddish-brown and extremely bitter, laudanum contains almost all of the 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 Uniform Controlled Substances Act, for one example, lists it on Schedule II. Laudanum is known as a 'whole opium' preparation since it historically contained all the opium alkaloids. 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 anti-propulsive 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 and theoretically in the United Kingdom, although today the drug's therapeutic indications are generally confined to controlling diarrhea, alleviating pain, and easing withdrawal symptoms in infants born to mothers addicted to heroin or other opioids. Recent enforcement action by the U.S. Food and Drug Administration (FDA) against manufacturers of paregoric and opium tincture suggests that opium tincture's availability in the U.S. may be in jeopardy. The terms laudanum and tincture of opium are generally interchangeable, but in contemporary medical practice the latter is used almost exclusively. Paracelsus, a 16th-century Swiss-German 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 or may not 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. 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'. Laudanum remained largely unknown until the 1660s when English physician 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, and the term 'laudanum' came to refer to any combination of opium and alcohol. 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 ... as 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.