Monday, August 22, 2011

Cough supressants - 19th Century style!

With the influenza season in full swing here in the southern hemisphere, the problem of how to treat those ticklish coughs is with us again. Go back a hundred years and you would have been offered a cough medicine containing .... Heroin (and made by the pharmaceutical giant Bayer, which is still alive and well 100 years later: after a sometimes chequered history!) However, science has caught up with Heroin, a very powerful narcotic that still has a focused place in medicine, for the treatment of severe intractable pain in situations such as Palliative care. It's weakened cousin Codeine was still used as a cough linctus  into the late 20th century, but it too does have a number of problems when used as a cough syrup: problems such as drowsiness, hallucinations, constipation; and when it falls into less ethical hands, then it can result in dependence and addiction!

Heroin nevertheless, is a fantastic cough suppressant: and these days we have nothing that matches its effectiveness to get rid of those persistent paroxysms of coughing. I would hazard a guess to say that nothing that you buy "over the counter" at the pharmacy will make one iota of a difference to you, should you succumb to a viral cough. They may soothe for the short time as they pass through your mouth and throat, and they might help dry up a post nasal drip that leads to your cough: but as a true cough suppressant, they just lack the clout to deal with it.

Should you have a dry tickle that is causing you to loose sleep, then sometimes one of the inhalers that are used to treat Asthma may be of benefit; but these are prescription medications and you will have to attend your treating Doctor for an assessment. The good news is that the vast majority of viral coughs are self limiting and need no special treatment. For those with a productive cough, the last thing you need is a "suppressant", as it is important to expectorate the mucous, otherwise it could become a site for secondary infection if it stays "down in the lungs".

But back in the 19th century, they did seemed rather fond of using heroin, or morphine, at the drop of a hat! One soothing syrup for infants troubled with teething, was Mrs. Winslow's Soothing Syrup, and contained over 20 mg of pure morphine in each 20mls - which would tend to render most infants senseless, rather than soothe them ! But at that time, narcotics were still deemed "legal" and were part of the fabric of society with their opium dens and the fashionable use of laudanum! Thank God for progress!

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