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: • • • • • • • • • • • • 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 • • • • • • • • • • • 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 ! ! 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? ! Thanks for coming and merry www.bimble.co Christmas!?