# 22243


[MEDICINE; OPIUM] A late nineteenth century manuscript listing a range of preparations for pain relief.

[U.S.A. : s.n., circa 1890]. Manuscript in ink written recto of single quarto sheet of unruled linen paper (250 x 200 mm); old fold lines, but a very well preserved document.

Most likely an apothecary’s handy reference for preparing and dispensing drugs for sedation and pain relief – for both medicinal and recreational use – this manuscript contains fifteen recipes whose main ingredients are morphine, opium, laudanum, and Godfrey’s Cordial. At the foot is a note on the pricing of smoking opium (“20 to 35 grains for 25c = 6 to 10 fooms”).

‘The Civil War helped set off America’s opiate epidemic. The Union Army alone issued nearly 10 million opium pills to its soldiers, plus 2.8 million ounces of opium powders and tinctures. An unknown number of soldiers returned home addicted, or with war wounds that opium relieved. “Even if a disabled soldier survived the war without becoming addicted, there was a good chance he would later meet up with a hypodermic-wielding physician,” [David T.] Courtright [author of Dark Paradise: A History of Opiate Addiction in America] wrote. The hypodermic syringe, introduced to the United States in 1856 and widely used to deliver morphine by the 1870s, played an even greater role, argued Courtwright in Dark Paradise. “Though it could cure little, it could relieve anything,” he wrote. “Doctors and patients alike were tempted to overuse.”

Opiates made up 15 percent of all prescriptions dispensed in Boston in 1888, according to a survey of the city’s drug stores. “In 1890, opiates were sold in an unregulated medical marketplace,” wrote Caroline Jean Acker in her 2002 book, Creating the American Junkie: Addiction Research in the Classic Era of Narcotic Control. “Physicians prescribed them for a wide range of indications, and pharmacists sold them to individuals medicating themselves for physical and mental discomforts.”

Male doctors turned to morphine to relieve many female patients’ menstrual cramps, “diseases of a nervous character,” and even morning sickness. Overuse led to addiction. By the late 1800s, women made up more than 60 percent of opium addicts. “Uterine and ovarian complications cause more ladies to fall into the [opium] habit, than all other diseases combined,” wrote Dr. Frederick Heman Hubbard in his 1881 book, The Opium Habit and Alcoholism.

Throughout the 1870s and 1880s, medical journals filled with warnings about the danger of morphine addiction. But many doctors were slow to heed them, because of inadequate medical education and a shortage of other treatments. “In the 19th century, when a physician decided to recommend or prescribe an opiate for a patient, the physician did not have a lot of alternatives,” said Courtwright in a recent interview. Financial pressures mattered too: demand for morphine from well-off patients, competition from other doctors and pharmacies willing to supply narcotics.

Only around 1895, at the peak of the epidemic, did doctors begin to slow and reverse the overuse of opiates. Advances in medicine and public health played a role: acceptance of the germ theory of disease, vaccines, x-rays, and the debut of new pain relievers, such as aspirin in 1899. Better sanitation meant fewer patients contracting dysentery or other gastrointestinal diseases, then turning to opiates for their constipating and pain-relieving effects….’ (Extract from an article by Erick Trickey. Smithsonian.com January 4 2018)