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.

6 Explosive Fart Controversies

iStock/MaryValery
iStock/MaryValery

Last week, the world of professional darts became embroiled in controversy after a player competing in the quarter finals of a major tournament partly blamed his loss on his opponent’s noxious flatulence. The loser, Wesley Harms, told the Dutch television station RTL7, "It’ll take me two nights to lose this smell from my nose." (Harms’s rival Gary Anderson denied being the fart’s founder, saying, "It was bad. It was a stink. It thought it was him, and he started playing better, I went, 'He must needed to get some wind out.'") Now that the niche world of competitive darts is clouded in Fartgate, it seems like an appropriate time to step outside and dutifully reminisce on a few other gassy controversies.

1. German police fine man over $1000 for letting it rip

In 2016, police in Berlin detained a man at a party and asked for his ID. Instead of offering his name, the man gave the police a whiff of his unique perfume, sending two rocketing farts in the direction of the officers. The police summarily fined the offender €900 (just over $1000) for disrespecting law enforcement. The ensuing "Crazy Toot Trial" would involve 23 officials and prompt a public outcry over wasteful public spending.

2. Fart sparks regime-change in Ancient Egypt

Around 570 BCE, the Egyptian Pharaoh King Apries had a problem: Invaders had slaughtered some of his soldiers and people's morale was low. So Apries sent his best general, Amasis, to quell the troops' discontent. Instead, the troops rallied around Amasis and declared him their personal king. When King Apries sent a messenger to accost Amasis, Amasis let out a fart and effectively said, "You can send that message back to the king!" Hearing this, King Apries unwisely decided to punish his messenger. That decision made King Apries even more unpopular and gave the gassy Amasis a chance to stage a revolt and successfully oust his old boss.

3. Cargo plane makes emergency stop because of reported goat gas

In 2015, a Singapore Airlines cargo flight was forced to make an emergency stop in Bali after more than 2000 goats reportedly filled the cargo hold with too many toots, setting off the fire alarm. "The smoke indication was identified to be the result of exhaust gases and manure produced by the sheep," The Aviation Herald reported. Despite this initial report, Singapore Airlines refused to acknowledge that the cause of the stopover was fart-related.

4. Fart fuels mid-flight fight

On a 2018 flight from Dubai to Amsterdam, a Transavia Airlines plane had to make an unscheduled stop in Vienna after an elderly man refused to stop cutting the cheese—even after receiving instructions from the pilot to cease firing. The man's stinkers fueled so much consternation among the surrounding passengers that a fight broke out, prompting police to remove four people from the flight.

5. Canada's Parliament debates the appropriateness of saying "fart"

In November 2016, Canada’s parliament began to spontaneously debate whether it was appropriate for members to use the word fart on the chamber floor. The discussion rose after Conservative MP Michelle Rempel asked, “Why does the government treat Alberta like a fart in the room that nobody wants to talk about or acknowledge?” Eventually, the rules regarding “unparliamentary language” had to be read aloud and the offense was taken under advisement. (You can read a transcript of the exchange here.)

6. Secret Service takes the blame for Presidential retarade

The Secret Service will not only take a bullet for the president, they’ll also take the blame for the Commander-in-Chief’s errant cheek squeaks: Gerald Ford, the 38th President of the United States, would often fart and blame it on his Secret Service agents, loudly saying, "Jesus, was that you? Show some class." (This must have come as a shock to Lyndon B. Johnson, who once said, “Jerry Ford is so dumb he can’t fart and chew gum at the same time.")

Every New Movie, Series, Documentary, and Special That's Coming to Netflix in December

Alfonso Cuarón directs Roma (2018)
Alfonso Cuarón directs Roma (2018)
Carlos Somonte, Netflix

Netflix has made no secret of its desire to bring top-tier entertainment to streaming devices around the world. After successfully testing the waters with a range of critically acclaimed series, from Stranger Things to The Crown, the streaming giant is now making a major push into the feature film market—which we’ll see play out in December with the release of Alfonso Cuarón’s Roma and Susanne Bier’s Bird Box.

Much has already been made about how these films, along with the Coen Brothers’ recently-recently The Ballad of Buster Scruggs, are disrupting the line between streaming and cinemas. How will it all play out come Oscar time? We’ll just have to wait to see.

In the meantime, here’s every new movie, television series, documentary, and comedy special making its way to Netflix in December.

DECEMBER 1

8 Mile
Astro Boy
Battle
Bride of Chucky
Christine
Cloudy with a Chance of Meatballs
Crossroads: One Two Jaga
Friday
Friday After Next
Hellboy
Man vs Wild with Sunny Leone: Season 1
Meet Joe Black
Memories of the Alhambra
My Bloody Valentine
Next Friday
Reindeer Games
Seven Pounds
Shaun of the Dead
Terminator Salvation
The Big Lebowski
The Last Dragon
The Man Who Knew Too Little

DECEMBER 2

The Lobster

DECEMBER 3

Blue Planet II: Season 1
Hero Mask
The Sound of Your Heart: Reboot Season 2

DECEMBER 4

District 9

DECEMBER 6

Happy!: Season 1

DECEMBER 7

5 Star Christmas
Bad Blood
Dogs of Berlin
Dumplin'
Free Rein: The Twelve Neighs of Christmas
Mowgli: Legend of the Jungle
Nailed It! Holiday!
Pine Gap
ReMastered: Who Killed Jam Master Jay?
Super Monsters and the Wish Star
The American Meme
The Hook Up Plan (Plan Coeur)
The Ranch: Part 6

DECEMBER 9

Sin senos sí hay paraíso: Season 3

DECEMBER 10

Michael Jackson's This Is It

DECEMBER 11

Vir Das: Losing It

DECEMBER 12

Back Street Girls: Gokudols
Out of Many, One

DECEMBER 13

Wanted: Season 3

DECEMBER 14

Chilling Adventures of Sabrina: "A Midwinter's Tale"
Cuckoo: Season 4
Dance & Sing with True: Songs
Fuller House: Season 4
Inside the Real Narcos: Series 1
Inside the World’s Toughest Prisons: Season 3
Prince of Peoria: A Christmas Moose Miracle
Roma
Sunderland Til I Die
The Fix
The Innocent Man
The Protector
Tidelands
Travelers: Season 3
Voltron: Legendary Defender: Season 8

DECEMBER 16

Baby Mama
Kill the Messenger
One Day
Springsteen on Broadway
The Theory of Everything

DECEMBER 18

Baki
Ellen DeGeneres: Relatable
Terrace House: Opening New Doors: Part 5

DECEMBER 21

3Below: Tales of Arcadia
7 Days Out
Back With the Ex
Bad Seeds
Bird Box
Wolf (Boru)
Derry Girls
Diablero
Greenleaf: Season 3
Last Hope: Part 2
Perfume
Sirius the Jaeger
Struggle: The Life and Lost Art of Szukalski
Tales by Light: Season 3
The Casketeers

DECEMBER 24

Hi Score Girl
The Magicians: Season 3

DECEMBER 25

Watership Down: Limited Series
Anthony Bourdain: Parts Unknown: Season 11
Marvel Studios' Avengers: Infinity War

DECEMBER 26

Alexa & Katie: Season 2
You

DECEMBER 28

Instant Hotel
La noche de 12 anos
Selection Day
When Angels Sleep
Yummy Mummies

DECEMBER 30

The Autopsy of Jane Doe

DECEMBER 31

The Bill Murray Stories: Life Lessons Learned From a Mythical Man

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