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.

15 Fascinating Facts About Victoria

Courtesy of ©ITVStudios2017 for MASTERPIECE
Courtesy of ©ITVStudios2017 for MASTERPIECE

While The Crown may nab the bigger headlines, Victoria—the Masterpiece series that similarly follows a young-and-not-quite-ready royal’s ascension to England’s throne—beat Netflix’s pricey TV series to the air by more than two months. Though it was originally intended as a one-off miniseries, the show—about the early days of Queen Victoria’s reign—just kicked off its third season. To celebrate, we've gathered up some behind-the-scenes facts about the gorgeous, Buckingham Palace-set period piece.

1. Jenna Coleman left Doctor Who to take the lead in Victoria.

In 2015, Jenna Coleman surprised Whovians everywhere when she announced that she was leaving Doctor Who after three years on the series, where she served as a companion to both the Eleventh (Matt Smith) and Twelfth (Peter Capaldi) Doctors. Almost as soon as her departure from Doctor Who was confirmed, her casting as the lead in Victoria was announced. Not long after Coleman made her debut as Queen Victoria, her former Doctor Who co-star, Matt Smith, began his two-year stint as Prince Philip on The Crown.

2. Game of Thrones’s Emilia Clarke was among the actresses rumored to be vying for the lead role.

Victoria was originally meant to air as a single eight-part miniseries (its popularity is what led to a second season … and then a third). Because the time commitment wasn’t so intense, a number of well-known actors’ names were being tossed around as potential stars for the project. Among them? Game of Thrones’s Emilia Clarke and Downton Abbey’s Lily James.

3. Coleman was given access to Queen Victoria’s personal diaries.

Jenna Coleman as Queen Victoria in 'Victoria'
Courtesy of © ITV plc (ITV Global Entertainment Ltd)

In order to better help her get into the mindset of her character, Coleman was given access to Victoria’s private diaries. “I’ve read so many biographies, but I’m always looking for certain details which give me access to her character and her psychology,” Coleman told Vulture in 2017. “Her diaries are so methodological in a lot of ways. You can find out what she ate for breakfast and what time she did this and what time she rose and what time she did everything. The detail is crazy.”

4. Queen Victoria was an avid sketcher, which was enormously helpful to Coleman.

In addition to writing down even the most mundane details of her day, Victoria was an avid sketcher. Gaining access to the Queen's doodles gave Coleman an even deeper insight into Victoria's mind. “She sketched and had done watercolors since she was about five or six years old,” Coleman told Vulture. “You can see what she used to draw and what interested her from a really young age, and that probably gave me the best sense of her psyche. It’s been totally untouched. Nobody has been able to distort her views with her own eyes and her hands. It’s unfiltered in every way so they’re really, really interesting.” (You can see some of those sketches for yourself here.)

5. Queen Victoria and Lord Melbourne's relationship was complicated.

Rufus Sewell as Lord Melbourne in 'Victoria'
Courtesy of ITV Plc for MASTERPIECE

Victoria’s relationship with Lord Melbourne (played by Rufus Sewell) is one of the series’ most dynamic and touching. And while it plays out as somewhat of one-sided love affair in season one, the truth wasn’t quite as romantic. Though she was sometimes referred to as “Mrs. Melbourne” in a mocking manner because of the prime minister's influence over the young queen, their relationship was more like a parental one.

“What’s so wonderful about Lord M and Victoria’s relationship is that it was the prime minister and the queen. It was dear friends,” Coleman told Vulture. “She was 18; he was technically 56 at the time. They made each other laugh. They were like father and daughter in many, many ways. You really can’t quite put a label on it, other than it’s two people who really connect and charm each other through mutual likes and interests. They had a really profound love, but what that love technically was is unclear … I think he was the first person who didn’t try to manipulate her and didn’t try to control her. He really gave her a voice so the trust between them was genuine and two-way. They went through a lot together. He was the person who guided her and shaped her and trained her for the first couple of years on the throne."

6. Keeping the child actors entertained can be a challenge.

Over the course of their marriage, Victoria and Albert had nine children together. So as the series has gone on, the number of babies and children on set has grown. Writing for Marie Claire, series creator Daisy Goodwin admitted that keeping the youngsters entertained can require some creative solutions:

"One of the tricks we use is to dress their mothers up as nursemaids to keep them right at their side—but sometimes the kids just won’t play ball. In one episode, Victoria comes home after a trip to Scotland and rushes in all excited to see the children, but they didn’t even turn round to look at her. A bag of sweets later, we got them at least to look up when their 'Mother' walked in."

7. Coleman likes playing a pregnant Queen best.

Queen Victoria famously loathed being pregnant, which we witness in the series. She “absolutely hated it,” Coleman told Town & Country. “She called it ‘being caught’ … [E]very time she gave birth to a child, it took her out of being able to be Queen. Each time that happened, she was being more and more and more removed. And she’s an impatient person; she doesn’t like being told to lie down. She just wanted to do her job. She had this exhilaration and love for her independence, I suppose. And she hated breastfeeding; she thought it was for cows, not for humans. So a lot of the things that came with her being a mother, she found pretty vile, I think."

Coleman feels quite differently about Victoria’s pregnancies—or at least about playing a pregnant Queen. “I think I enjoy playing her most when she’s pregnant because one, I don’t have to wear a corset, but then two, I get to kind of waddle around, and I feel like she can just be foul-tempered and rude,” Coleman said. “I relish playing her when she’s like that because she doesn’t really care what anybody thinks, in a way. She does when it comes to the public and her people, but ultimately, you get free reign to play Victoria irritable and in a bad mood, and I really love playing her when she’s like that."

8. The child actors have “no respect” for Victoria, according to Coleman.

JENNA COLEMAN as Victoria and TOM HUGHES as Albert in 'Victoria'
GARETH GATTRELL/ITV Plc for MASTERPIECE

When asked about what it’s like working with a handful of kids on a regular basis, Coleman described it as both “absolutely crazy” and “hilarious.” Especially because the children are too young to understand what it means to stay in character. “Imagine toddlers, and you put them on set, and you kind of just have to get what you can,” Coleman said of shooting with her onscreen kids. “It's unpredictable, and incredibly funny because kids do say the funniest things, and they say the funniest things during takes. They ask Queen Victoria for some Doritos. It just becomes chaos, and I just absolutely get the giggles. They should release some footage of what really happens when the kids come to set. There’s no respect to Victoria. They completely rule me."

9. Buckingham Palace is actually an old airplane hangar.

Much of the series takes place at Buckingham Palace, and the show’s production team has done an amazing job of recreating the splendor of the property and what it would have looked like during Victoria’s reign. The location of their set, however, is not quite so glamorous. “The set where we film the Buckingham Palace scenes is in an old aircraft hangar, and is home to all kinds of wildlife,” according to Goodwin. “We had to stop shooting a very tender scene between Victoria and Albert because an owl kept flying through the frame, attracted by the jewels in Victoria’s hair."

10. Lighting all those candles is no easy task.

Victoria ascended to the throne in 1837, at about the same time that candlelight was being replaced with gas light in some of London’s most stately properties. While the switch to gas lighting has its own storyline in the series (there are rats involved), there were still a lot of candles to be lit on the set—about 300 in total. According to Goodwin, the process of lighting all those candles took an hour each time they shot.

11. The dog that plays Dash is no stranger to playing Dash.

Dash, Queen Victoria's prized dog, in 'Victoria'
Courtesy of ©ITVStudios2017 for MASTERPIECE

The adorable Cavalier King Charles Spaniel that plays the Queen’s most trusted BFF Dash has some experience with the role. “The dog who played Dash is actually called Tory, and she made her screen debut playing the same role in the film Young Victoria starring Emily Blunt,” Goodwin wrote for Marie Claire.

12. A bird played an unanticipated role in Victoria and Albert’s proposal scene.

Much like Victoria herself, some viewers were surprised to learn that when a Queen decides it’s time to tie the knot, she must be the one who proposes. Making the scene in which Victoria proposes to Albert even more awkward and difficult was the fact that an uninvited bird kept interrupting the production.

"The proposal, on paper it looked like a great scene but to film it was a nightmare,” Tom Hughes, who plays Prince Albert, admitted at a screening of the episode. “[It took] about 50 [takes] because there was a stray bird upstairs in the roof. Every time I got to the point where I say, ‘I have to kiss you first’, [the bird] thought that it was the most hilarious line it had ever heard. It was making a variety of all different noises, so that was the tough scene to film."

13. Prince Albert could be the next James Bond.

At this point, there are a handful of actors who have been rumored to be “the next James Bond,” and Hughes is one of them. The actor reportedly caught the attention of James Bond producer Barbara Broccoli after playing an MI5 operative in 2014 BBC miniseries The Game. When asked about his thoughts on taking on the iconic 007 role, Hughes responded: “Would I like to be James Bond? There’s not many people who wouldn’t want to be James Bond.” Though he made it clear that he had not been approached about the role, he stated that “I’d love them to ask."

14. The Duchess of Buccleuch was not so outspoken in real life.

In season two, the legendary Diana Rigg (who played Emma Peel in The Avengers TV series back in the day, and Game of Thrones’s Olenna Tyrell more recently) joined the cast of Victoria as the Duchess of Buccleuch, one of the Queen’s ladies-in-waiting. Though audiences love the character for her outspokenness, the real-life Duchess—who served as the Queen’s Mistress of the Robes from 1841 to 1846—was not quite so frank. “The real Duchess of Buccleuch was younger and not quite as cantankerous as Diana Rigg’s portrayal,” Goodwin said. “[But] when you’ve got Diana Rigg, you go with that!"

15. Albert’s imminent death is coming, and it’s a bit of dark cloud.

Jenna Coleman and Tom Hughes in 'Victoria'
Courtesy of Gareth Gatrell/ITV Plc for MASTERPIECE

Prince Albert died in 1861 at the age of 42. While the official cause of death was typhoid fever, modern scholars believe that he may have been suffering from Crohn’s disease or abdominal cancer. Knowing that Victoria and Albert’s time is limited is a fact that the cast can’t ignore. When asked whether knowing how this story ends ever affects her performance or how she approaches the character, Coleman admitted that it does. “I think everyone knows it’s coming, and it’s really interesting because Tom [Hughes] and I look a bit older in this series, and we’re so many children in,” she told Town & Country. "You kind of have that creeping feeling, but we still have an amazing part of the story to tell."

7 Ways to Take Advantage of the Bullet Journal Method

iStock.com/Neustockimages
iStock.com/Neustockimages

If you haven't heard of the bullet journal, it's the productivity method du jour—one that combines the features of a planner, calendar, to-do list, diary, and more. It's not a specific product (although the founder of the method, Ryder Carroll, has created a special notebook for it) as much as a way of creating a journaling system that works for you.

Proponents say the method helps you focus your time and your goals, in part through periodic "migration" sessions that force you to review how you've been spending your days. And yes, it's popular on Instagram—because many bullet journalers have filled their notebooks with colorful flair. (But that part is entirely optional.)

While core components of the bullet journal system like monthly spreads and daily logs are great, many bullet journalers like to add other features that fit their own life. After all, the beauty of the method is the customization and flexibility. We've rounded up a few ideas for new and not-so-new bullet journalers alike to try.

1. Track—and fuel—your creative projects.

Let's say that, like most people, you have a day job. But at night, you're writing the next Great American Novel—or at least some short stories. You might get an idea related to one of those projects on your morning commute or while taking a walk in the park at lunch. There's no time to pull out the manuscript, and if you email yourself the idea it might get lost in a jumble of newsletters and other alerts.

Instead, just start a new page for the project in your journal, note it in your index, and scribble away. You can come back to it later, and fill in other, non-sequential pages in the journal as the mood strikes. Your journal probably isn't the best place to write whole stories, but it's perfect if you just had a mini-breakthrough you want to take down, or even as a way to keep track of potential prompts and inspiration.

2. Improve your habits.

Habit trackers are some of the most popular add-ons to the regular bullet journal time-oriented spreads. You can make yours cute—tracking the number of glasses of water you drink a day by coloring in a big glass, say—or more minimalist, perhaps by listing the habits you want to build (yoga, waking up early) on the left next to a chart of days and coloring in the days you manage to do the habit. You can also create a page just to log you often you do one particular thing—drinking alcohol, for example. Some people even use their bullet journals to track food and digestive symptoms, either by creating a section for a food journal or just noting in their daily log when they eat a certain food and how it makes them feel.

3. Save money.

You can create a custom spread for your monthly budget, track all your expenses, or just track your purchases in a particular category (say, eating out) if there's a particular type of spending you're trying to curb. The design can be as crafty as you like—whether you're coloring in bricks that represent each $50 saved toward a house or just filling in columns noting every time you make a purchase. The key is that, as with health habits, writing something down can serve as a powerful motivator and/or deterrent, since you know you'll have to come face-to-face with yourself at the end of the month.

4. Plan your meals.

Nothing combines health and finance goals quite like planning your meals. You can make your meal plan a section of your weekly spread: Carroll, the bullet journal's creator, likes to set up a list of meals on the left page of his notebook and a shopping list of ingredients on the right. Dividing the items by categories (like meat, produce, and pantry staples) can speed things up at the store, too. It's great to do this at home so you can check the fridge and see what you're missing. Then, when you're done shopping, note how much you spent at the bottom of the list. You can track that to develop insights about your grocery budget.

Over time, you can also create lists to help you with meal planning, perhaps "Favorite Weeknight Dinners," "Easy Work Lunches," etc. Some people also like to create a master grocery list of frequently bought items they can consult whenever they're at the store, just in case they forget to write staples down on their weekly shopping list.

5. Remember the good things.

In our flurry of to-do lists, project deadlines, and meal plans, it can be easy to forget about the things that brighten our days, whether it's an especially funny joke from a colleague or a milestone in a child's development. Create a "memories" page (don't forget to log it in your index!) where you record the great stuff that happens, and pull it out to reflect whenever you're having a gray day. Some bullet journalers like to put pages like this toward the back of their journals to separate them out from the time-oriented spreads. A memories page is also a great opportunity to bust out some thematic artwork.

6. Track your reading lists.

Another great way to encourage better habits is through a reading log. Like a memory log, many people like to put this toward the back of their journal, although ultimately the placement is totally up to you. You can keep track of all the books you read this year, perhaps with notes on what you thought of them—a definite resource when you're drawing up those year-end best-of lists to share with other reading pals!

7. Pair it with an app.

While the bullet journal is touted as "the analog method for the digital age," most of us don't want to go full-on analog. There's now an official companion app that will help you organize and search your old bullet journals, help you learn the method, offer prompts, and serve as a log for when you're away from your journal. It's designed as an addition to the journal, not a replacement, so you still need to put in that time with pen (or pencil, or watercolor brush) and paper.

Bullet journals also pair well with apps like Evernote—for example, you can use Evernote on your smartphone to snap photos of text you scrawl down to save digitally for later use. (Maybe those on-the-fly notes on your novel go into an Evernote notebook that you consult when you have a bit more time, for example.) That's a good option for longer-term projects that might span a couple notebooks.

Many people also use both bullet journals and an online calendar, using the latter for fixed events like birthdays and doctors appointments and the former as more of a way to time-block the day and focus on goals. After all, the beauty of the bullet journal is that unlike digital space, the paper in your notebook is finite—which helps you realize that so is your time and energy. That makes it easier to plan accordingly.

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