10 Dubious Victorian Cures From the First Merck Manual of Diagnosis and Therapy

Wellcome Images // CC BY 4.0 (cropped)
Wellcome Images // CC BY 4.0 (cropped)

In his work Of the Epidemics, the Greek physician Hippocrates encouraged doctors to “have two special objects in view with regard to disease, namely, to do good or to do no harm.” Yet the history of medicine has been an exercise in trial and error, with remedies sometimes proving more dangerous than the disease.

Examples of such dubious and sometimes potentially deadly cures abound in the first edition of The Merck Manual of Diagnosis and Therapy, the oldest continuously published English-language medical textbook. First published by the American drug manufacturer Merck & Co in 1899, the manual’s original edition suggests remedies such as hot baths for heat exhaustion, coffee for insomnia, nitroglycerin for headaches, and opium for constipation.

“What’s most fascinating to me are drugs that have an immediate dangerous effect,” says Robert S. Porter, M.D., editor-in-chief of the manual’s 20th edition, which was published earlier this year. “Cocaine for angina? Cocaine is a vasoconstrictor that causes heart attack. Give it to someone with angina and they might die. The bulk of the book is things that simply don't work—that are useless or odd—but these ones really raise questions as to how people could recommend them.”

Here's a selection of puzzling remedies from the first edition, some of which went on to be recommended for decades.

1. ARSENIC FOR ANEMIA

A page from the Merck Manual about anemia
Merck's 1899 Manual of the Materia Medica, Internet Archive // Public Domain

Arsenic was one of the top remedies the manual recommended for anemia. Though arsenic had been known as a poison since ancient times, medicines containing small doses of the substance were long used for conditions ranging from anthrax to syphilis to anemia. By the 19th century, arsenic was being inhaled as vapors, ingested, injected, and given in enemas for a variety of ailments. In fact, so many people suffered symptoms—such as rashes, stomach distress, and headaches—from taking arsenic remedies during the Victorian era that their ailments are now sometimes referred to as “Fowler’s disease," after the popular remedy Fowler’s Solution, which contained potassium arsenite.

2. LAXATIVES FOR CHICKENPOX

A page from the Merck Manual about chickenpox
Merck's 1899 Manual of the Materia Medica, Internet Archive // Public Domain

Before chickenpox vaccinations became available in the U.S. in 1995, an average of 4 million people each year suffered through itchy outbreaks. When the Merck Manual was first published, part of the comprehensive treatment plan for an "eruptive fever"—whether it was chickenpox, smallpox, or scarlet fever—was laxatives, ideally a dose of castor oil. The idea was to purge the body of the infectious disease, but such treatment usually just compounded the misery and forced the patient to stay close to the toilet.

3. STRYCHNINE FOR CONSTIPATION

A page from the Merck Manual about constipation
Merck's 1899 Manual of the Materia Medica, Internet Archive // Public Domain

Even a tiny dose of strychnine can cause convulsions. Yet the Merck Manual, following the medical practice of the day, recommended small amounts as a treatment for acute constipation. Commonly derived from the plant Strychnos nux-vomica, strychnine was thought to improve gastric function. (Strychnine injections were also recommended for both flatulence and ulcers.) Opium and turpentine were also recommended, but patients probably derived more relief from the less dramatic manual-recommended regimens, such as eating apples and figs or drinking coffee.

4. CHLOROFORM FOR HICCUPS

A page from the Merck Manual about hiccups
Merck's 1899 Manual of the Materia Medica, Internet Archive // Public Domain

Bad case of the hiccups? Today, you might be told to hold your breath or drink water. But in 1899, your doctor might recommend inhaling chloroform. An organic compound that also a popular anesthetic in the 19th and early 20th century, chloroform eventually fell out of favor because of its potential to damage the nervous system, liver, and kidneys. Other hiccup remedies listed in the Merck manual included nitroglycerin and the slightly less toxic sugar and vinegar.

5. INHALING SMOKE FOR ASTHMA

A page from the Merck Manual about asthma
Merck's 1899 Manual of the Materia Medica, Internet Archive // Public Domain

As counterintuitive as it seems today, the manual noted that "smoking is sometimes beneficial" for asthma, adding that “cannabis indica can be used in chronic cases.” The manual was far from alone in recommending the practice; throughout the late 19th and early 20th centuries, inhaling the fumes of tobacco and cannabis, as well as stramonium (a hallucination-inducing nightshade) and lobelia (a flowering plant known for its sedative properties) were popular treatments for asthmatics. There were even special anti-asthma cigarettes. We now know that inhaling any kind of smoke has been shown to damage and eventually reduce the number of cilia—the fine lung filaments which, when healthy, help transport mucus in the lungs—which only leads to a worsening of asthma symptoms.

6. BLOODLETTING FOR NAUSEA

A page from the Merck Manual about nausea
Merck's 1899 Manual of the Materia Medica, Internet Archive // Public Domain

Bloodletting—with leeches or other means—has been used to treat various ailments, including excessive bleeding, for thousands of years. The Ancient Greek physicians thought that it was sometimes necessary to balance blood and other bodily fluids, known as humors. The practice remained a standard treatment for many ailments, including nausea and morning sickness during pregnancy, well into the 19th century. It was thought to regulate the pulse, alleviate fever, and calm pain. While bloodletting can actually help with a few conditions, such as hemochromatosis (a genetic disorder leading to abnormal iron accumulation in the liver), doctors eventually realized that bleeding could also weaken patients and that frequent cutting could lead to infections.

As well as this traditional remedy, the manual’s first edition also recommended cocaine, the wonder drug of the day, to treat all kinds of nausea. Better and less stomach-turning effects could have been achieved with another recommended remedy: cinnamon.

7. COLD DOUCHES FOR INSOMNIA

A page from the Merck Manual about insomnia
Merck's 1899 Manual of the Materia Medica, Internet Archive // Public Domain

Alcohol, cannabis indica, and “cold douches” were effective remedies for insomnia, according to the Merck Manual. Cold douches—being blasted with cold water—might not seem sleep-inducing, yet in the late 19th and early 20th century this form of hydrotherapy was recommended as a way to improve circulation, fight infection, and treat headaches as well as insomnia. “By this means, the brain is enabled to resume a healthier mode of action, and sleep follows as a matter of course,” wrote Dr. Henry M. Lyman in his 1885 book Insomnia and Other Disorders of Sleep. Other remedies the manual recommended for insomnia included coffee, alcohol, and putting hot water bags on your feet while applying cold ones to your head.

8. BELLADONNA FOR COLIC

A page from the Merck Manual about colic
Merck's 1899 Manual of the Materia Medica, Internet Archive // Public Domain

Misguided medical notions were also applied to easing colic—the severe bouts of stomach pain often suffered by very young babies. The Merck Manual recommended ammonia, turpentine, and belladonna—a poisonous plant in the deadly nightshade family—for relief from colic spasms. Belladonna is still used modern medicines for adults (it's the main ingredient in the drops your eye doctor uses to dilate your eyes), but according to the FDA, “there is no known safe dose or toxic dose of belladonna in children.” In 2010, the FDA warned against its use in homeopathic teething tablets.

9. LEECHES FOR EARACHES

A page from the Merck Manual about leeches for earaches
Merck's 1899 Manual of the Materia Medica, Internet Archive // Public Domain

Using leeches for an ear infection might sound disgusting at best, but there was some medical justification for the manual's recommendation. Once leeches are firmly attached to their host, they can numb pain, while peptides and proteins in their saliva prevent blood clotting, so they can help drain an infection. Modern medicine has recently taken another look at leeches: In 2004, the FDA decided the creatures met the definition of a live medical device, since their tiny jaws (and anticoagulants) keep blood flowing, which helps wounds to heal. They can also be used to break up blood clots, treat varicose veins, and improve other circulatory disorders.

10. COCAINE FOR ALCOHOLISM

A page from the Merck Manual about alcoholism
Merck's 1899 Manual of the Materia Medica, Internet Archive // Public Domain

In the 1880s, Sigmund Freud helped popularize the idea of using cocaine to treat alcoholism, calling it a “magical drug.” In its heyday, cocaine was also promoted as a cure for morphine addiction, depression, anxiety, fatigue, and migraines. It was available over the counter in tonics, powders, wines, and soft drinks. Patients likely felt energized by regular cocaine infusions, but they soon became habituated. (Freud experimented on himself for a few years until the mounting evidence of cocaine’s addictive nature proved too much to ignore; the drug was made illegal in the U.S. in 1914.) The 1899 manual also offered simpler, less dangerous—but also likely ineffective—ways to battle alcohol cravings, including slowly sucking an orange or drinking water hot ("one pint drunk as hot as possible an hour before meals will remove craving"), or cold in small sips.

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6 Amazing Facts About Sally Ride

U.S. National Archives and Records Administration, Public Domain, Wikimedia Commons
U.S. National Archives and Records Administration, Public Domain, Wikimedia Commons

You know Sally Ride as the first American woman to travel into space. But here are six things you might not know about the groundbreaking astronaut, who was born on May 26, 1951.

1. Sally Ride proved there is such thing as a stupid question.

When Sally Ride made her first space flight in 1983, she was both the first American woman and the youngest American to make the journey to the final frontier. Both of those distinctions show just how qualified and devoted Ride was to her career, but they also opened her up to a slew of absurd questions from the media.

Journalist Michael Ryan recounted some of the sillier questions that had been posed to Ride in a June 1983 profile for People. Among the highlights:

Q: “Will the flight affect your reproductive organs?”
A: “There’s no evidence of that.”

Q: “Do you weep when things go wrong on the job?”
A: “How come nobody ever asks (a male fellow astronaut) those questions?"

Forget going into space; Ride’s most impressive achievement might have been maintaining her composure in the face of such offensive questions.

2. Had she taken Billie Jean King's advice, Sally Ride might have been a professional tennis player.

When Ride was growing up near Los Angeles, she played more than a little tennis, and she was seriously good at it. She was a nationally ranked juniors player, and by the time she turned 18 in 1969, she was ranked 18th in the whole country. Tennis legend Billie Jean King personally encouraged Ride to turn pro, but she went to Swarthmore instead before eventually transferring to Stanford to finish her undergrad work, a master’s, and a PhD in physics.

King didn’t forget about the young tennis prodigy she had encouraged, though. In 1984 an interviewer playfully asked the tennis star who she’d take to the moon with her, to which King replied, “Tom Selleck, my family, and Sally Ride to get us all back.”

3. Home economics was not Sally Ride's best subject.

After retiring from space flight, Ride became a vocal advocate for math and science education, particularly for girls. In 2001 she founded Sally Ride Science, a San Diego-based company that creates fun and interesting opportunities for elementary and middle school students to learn about math and science.

Though Ride was an iconic female scientist who earned her doctorate in physics, just like so many other youngsters, she did hit some academic road bumps when she was growing up. In a 2006 interview with USA Today, Ride revealed her weakest subject in school: a seventh-grade home economics class that all girls had to take. As Ride put it, "Can you imagine having to cook and eat tuna casserole at 8 a.m.?"

4. Sally Ride had a strong tie to the Challenger.

Ride’s two space flights were aboard the doomed shuttle Challenger, and she was eight months deep into her training program for a third flight aboard the shuttle when it tragically exploded in 1986. Ride learned of that disaster at the worst possible time: she was on a plane when the pilot announced the news.

Ride later told AARP the Magazine that when she heard the midflight announcement, she got out her NASA badge and went to the cockpit so she could listen to radio reports about the fallen shuttle. The disaster meant that Ride wouldn’t make it back into space, but the personal toll was tough to swallow, too. Four of the lost members of Challenger’s crew had been in Ride’s astronaut training class.

5. Sally Ride had no interest in cashing in on her worldwide fame.

A 2003 profile in The New York Times called Ride one of the most famous women on Earth after her two space flights, and it was hard to argue with that statement. Ride could easily have cashed in on the slew of endorsements, movie deals, and ghostwritten book offers that came her way, but she passed on most opportunities to turn a quick buck.

Ride later made a few forays into publishing and endorsements, though. She wrote or co-wrote more than a half-dozen children’s books on scientific themes, including To Space and Back, and in 2009 she appeared in a print ad for Louis Vuitton. Even appearing in an ad wasn’t an effort to pad her bank account, though; the ad featured an Annie Leibovitz photo of Ride with fellow astronauts Buzz Aldrin and Jim Lovell gazing at the moon and stars. According to a spokesperson, all three astronauts donated a “significant portion” of their modeling fees to Al Gore’s Climate Project.

6. Sally Ride was the first openly LGBTQ astronaut.

Ride passed away on July 23, 2012, at the age of 61, following a long (and very private) battle with pancreatic cancer. While Ride's brief marriage to fellow astronaut Steve Hawley was widely known to the public (they were married from 1982 to 1987), it wasn't until her death that Ride's longtime relationship with Tam O'Shaughnessy—a childhood friend and science writer—was made public. Which meant that even in death, Ride was still changing the world, as she is the world's first openly LGBTQ astronaut.