Health follies

Pharmacy historian Ralph Tapping has been looking into some of the questionable treatments sold in pharmacy in the recent past 

Laudanum and other preparations containing tincture of opium, for example as in Chlorodyne, were able to be sold over-the-counter in pharmacy up until the 1960s—and were very useful remedies. However, they had to be rescheduled because of abuse.

Interestingly, even as late as 1947, the Australian Pharmaceutical Formulary featured a formula for Linctus Diamorph (heroin)!

My old boss, who spent time as an officer pharmacist in the army around the end of the second world war, related how the unit dispensary carried various mixtures ready to dish out by dose to the patients. One in particular was Mist Valerian and Asafetida (labelled No. 9) that was sometimes given to patients at sick parade who were suspected of malingering. The smell and taste of this mixture was so foul that only the most dedicated patient would return to risk being given another dose.

Amphetamines such as dexamphetamine were often prescribed to help people such as long-haul truck drivers remain alert over long periods. During the second world war, amphetamines were used by the military and in civilian factories to keep alert. The abuse of methylamphetamine (ICE) has only recently escalated to being the major problem that exists today.

Lead oxide (used as “red lead” to protect steel from oxidation) and as a white paint pigment, was also used to treat mastitis! The inclusion of “red lead” in Bates Breast Salve for nursing mothers was surely a “folly”.

Advising nursing mothers to use a product containing ‘red lead’ was a definite health folly

Mercurials were commonly used in the treatment of sexually transmitted diseases and rather surprisingly, in some early infant “Teething Powders”, resulting in “Pinks Disease”. Eventually it was realised that both lead and mercury compounds were potentially cumulative poisons and their use was discontinued.
Cascara Sagrada in both tablet and liquid form was a widely used laxative in the early to mid-1960’s. The Parke, Davis & Co “Casevac” was popular, but fell out of favour because of reports of Megacolon occurring through overuse.

Ford Pills were very popular in the 1960s and 1970s. An advertisement in 1972 claimed that “Ford Pills can help make you as attractive as the girls that your husband stares at in the street!” Apparently, even though just a laxative (aloin and phenolphthalein) they were supposed to keep the body trim.

Phenylbutazone (brand name Butazolidine or BTZ) was probably the first of the NSAIDs and was considered to be very effective, but was eventually discovered to cause blood dyscrasias and was discontinued. Similarly, oral chloramphenicol was widely used as an effective early antibiotic until the same problem arose and was dropped in favour of the penicillins and tetracyclines. These days, chloramphenicol is still used as an effective antibiotic eye drop.

The era when benzodiazepines were all the rage presented many difficulties. While they were (and still are) useful drugs when used short term, patients often came to rely on them and with continuous use needed an ever increasing dose to satisfy their habituation. Doctors and pharmacists were both pressured to provide a regular supply to patients, who would often “doctor shop” in order to satisfy their craving. Alprazolam was a particularly troublesome benzodiazepine because of potency and habituation. Mandrax (methaqualone) had to be withdrawn from sale for the same reasons.

From a PDL point-of-view the history of “incidents reported” in the days when prescriptions were hand-written were often as a result of misinterpretation of bad handwriting. The introduction of computer-generated prescriptions eventually eliminated this difficulty, although it is still possible to press the wrong button.

Selection errors were often a problem, more recently overcome by the introduction of the dispensary bar code scanner, which needs to be employed with EVERY dispensing to be effective. Just one of many regular problems over the years was due to mix-ups over methotrexate doses, usually because of patient misunderstandings over frequency of dose or varying strength of tablets prescribed.

This is part of a series of articles that have been provided by Mr Tapping, and published in the AJP magazine. We will be running the series in our newsletter over the coming weeks

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