Alcohol: A Dangerous and Unnecessary Medicine, How and Why by Martha Meir Allen (warren buffett book recommendations txt) 📕

“When the Temperance Hospital was first opened, it became a question of practical importance, what should be done with regard to the alcohol so largely employed as a vehicle and drug excipient. Not that the principle of the treatment of disease without the ordinary administration of alcoholic beverages precludes the employment of alcoholic tinctures, but it was felt that in such a test case as this it was important to obviate the objection that while withholding alcohol as a beverage, it was given in the medicine. As a matter of fact, it is surprising, when one looks into it, how much alcohol is often given merely as a vehicle for other drugs, and without the special action of alcohol being required or desired. In prescriptions which are to be seen in many text-books, it is not uncommon to find from one to two or three, or even four drachms of rectified spirit in the form of tinctures or spirits. This is very undesirable. If alcohol is needed it should be given in proper measured dose. But if it is not indicated, then it is not well to administer it in this indirect manner.

“Experiments were therefore made, partly at the hospital and specially by Messrs. Southall Bros. & Barclay, of Birmingham, with the result that new non-alcoholic tinctures were made replacing the following alcoholic tinctures and wines:—

Tinct. Aloes.
  "         Arnicæ.
  "         Aurantii.
  "         Belladonnæ.
  "         Buchu.
  "         Calumbæ.
  "         Camph. Co.
  "         Capsici.
  "         Cascarillæ.
  "         Catechu.
  "         Chiratæ.
  "         Cinchonæ Co.
  "           "         Flav.
  "         Cinnamomæ.
  "         Colchici Sem.
  "         Conii.
  "         Digitalis.
  "         Ferri Acet.
  "         Ferri Perchlor.
  "         Gentiani Co.
  "         Hyosciami.
  "         Kino.
  "         Krameriæ.
  "         Limonis.
  "         Lobeliæ.
  "         Nucis Vomicæ.
  "         Opii.
  "         Quassiæ.
  "         Rhei.
  "         Scillæ.
  "         Serpentariæ.
  "         Stramonii.
  "         Valerianæ.
  "           "         Ammon.
Vin. Aloes.
  "         Colchici Rad.
  "           "         Sim.
  "         Ipecac.
  "         Opii.
  "         Rhei.

“These were made by extracting the principles of the drugs in the usual way except that instead of alcohol a mixture of glycerine and water was used in the proportion of one-fourth to one-third part of glycerine, and about five per cent. of acetic acid. These made very elegant preparations, and in the majority of cases appeared to have just the same, and just as great physiological action. Subsequently the ordinary tinctures were distilled, and the extracts thus obtained dissolved in the above menstruum, as far as was possible, in most cases the residuum being found to be inert.

“Gum resins and essential oils were found to be insoluble in this menstruum, and hence such drugs have been given in the form of pill, powder or mixture. Such tinctures are those of assafœtida, benzoin, cannabis indica, cantharides, castor, cubebs, lavender, myrrh, pyrethrum, sumbul, tolu and ginger. Out of 62 tinctures it was found that 46 made good preparations, and 16 did not.

“These were employed for several years. But for some time past, somewhat more reliable preparations have been made for us which contain all the constituents of the alcoholic tinctures without the alcohol. They are for the most part made by taking standardized tinctures, mixing with them sugar of milk, and distilling off the alcohol. The alcoholic extract remains behind in a finely divided condition mingled with sugar of milk. This is broken up, pulverized and compressed into tabloids of a definite dose, which can be taken either in that form or rubbed up and dissolved or suspended in gum water.

“The following have been made up in this form: aconite, belladonna, camph. co., cannabis indica, capsicum, cinchon. co., and cinchon. simpl., digitalis, gelseminum, hyosciamus, nux vomica, opium, strophanthus, ginger and Warburg. Other tinctures will be gradually added to this list.

“As external liniments those commonly used are the linimentum terebinthinæ and the linimentum terebinthinæ aceticum, which do not contain alcohol. A strong solution of iodine is made with iodide of potassium.

“The spiritus ammoniæ aromaticus is made without the spirit, the aromatic oils being emulsionized by means of rubbing up with fine sand, but most of these subsequently rise to the surface. The spiritus etheris nitrosi is impossible without alcohol, but nitrite of amyl, and nitrites of potash or soda can be substituted. The spiritus chloroformi is replaced by aqua chloroformi, or as a sweetening agent by solution of saccharin. Thus a favorite expectorant mixture contains carbonate of ammonia five grains, acetum ipecac, ten minims, and solution of saccharin in each dose.

“As a special stimulant a subcutaneous injection of a drachm of pure ether has been given in a few cases; in others digitalis, or caffeine or ammonia in some form, such as the carbonate dissolved in a cup of hot coffee; or hot solution of Liebig’s extract, or rectal injections of hot water.”

It may be objected by some that glycerine belongs to the family of alcohols, hence hospitals using glycerine tinctures are not, strictly speaking, non-alcoholic. To this the answer is, that while glycerine certainly is classed in the family of alcohols, it is of a very different nature from ethyl alcohol, which is used for beverage purposes. Ethyl alcohol, the alcohol in all intoxicating beverages in common use, and the alcohol generally used in medicine, creates a fatal craving for itself, and is injurious to the body. Glycerine does not create any craving for itself, and has not been demonstrated to have injurious properties, and is not used for beverage purposes.

At the annual meeting of the New York State Medical Society, held in New York City, in October, 1898, a discussion was held upon the use of alcohol as medicine. Dr. E. R. Squibb, a leading pharmacist of Brooklyn, stated that during the last two or three years much had been accomplished in retiring alcohol as a menstruum for exhausting drugs. Of the other menstrua experimented with up to the present time, that which had given the best results was acetic acid, in various strengths. It had been discovered that a ten per cent. solution of acetic acid was almost universal in its exhausting powers. There were now in use in veterinary practice, and in some hospitals, extracts made with acetic acid. They were made according to the requirements of the pharmacopœia, except that acetic acid was substituted for alcohol. Acetic acid, when used with alkaloids gives the physician some advantages in prescribing, owing to there being fewer incompatibles. In small doses, the percentage of acetic acid in the extract is so small as to be hardly appreciable, and when larger doses are required, the acetic acid can be neutralized by the addition of potash or soda.

Dr. Noble said, in article to London Times before referred to:—