I was an asthmatic child in the 1980s, and although there was the advantage of being able to get out of PE sometimes, my asthma could be difficult to manage. Most potentially fun occasions ended up with me wheezing away in a corner, and frequent chest infections left me either in hospital or lying on the sofa at home watching Pebble Mill at One. I can imagine how disabling the condition must have been before modern drugs like salbutamol and beclometasone. Anything that claimed to relieve asthma must have been worth trying – but Dr Tucker’s remedy carried with it the danger of addiction.
This advert for Tucker’s Asthma Specific is fairly unassuming compared with the big pictorial ads in fashion at the time, but it was well-positioned on the front page of London’s Pall Mall Gazette. The product originated in Mount Gilead, Ohio, where Dr Nathan Tucker started The Asthma Specific Company in 1889. (The title ‘Dr’ was genuine.)
Early 20th-century analyses had varying results, but most agreed that the Specific contained cocaine and atropine. While the company emphasised that the amount of cocaine in each inhalation was tiny, the Journal of the American Medical Association didn’t approve:
When one considers the prevalence of the cocain habit and demoralizing and brutalizing effect that this habit has on its victims, the viciousness of the indiscriminate sale of a preparation of this sort becomes evident.
They were particularly concerned about the method of taking the medicine – it was vaporised and inhaled into the nose:
It is only necessary to call attention to those cocain habitués, known as “coke-sniffers” to realise the enormous harm that can be done by the taking of cocain in this way.
An inhaler plus an initial supply of the liquid cost $12.50 in the US and 3 guineas in Britain and you can see Nathan Tucker demonstrating the inhaler below. The company operated by mail order – punters had to fill in a questionnaire and would receive a diagnosis and prescription by post. This was a marginally better bet for American patients than British ones – at least Nathan Tucker and his nephew William Briscoe Robinson were qualified doctors. In the UK, the business was run by Tucker’s brother, Augustus Quackenbush Tucker, who had no medical qualifications and later claimed he didn’t even know what was in the medicine.
There were thousands of happy customers, but for some the outcome wasn’t much fun.
In 1908 the Specific was implicated in the death of a British patient – 36-year-old Margaret Weston from Slough. She had been using the inhaler for two years and the doctor who attended just before her death noted symptoms of cocaine poisoning. The American Medical Association, in Nostrums and Quackery, implied that the Specific killed her, but in their quack-busting enthusiasm, didn’t mention that the inquest found she had also had a cocaine injection for dental work. At about the same time, Augustus Tucker was fined £5 plus £5 5s costs for selling the preparation without marking it ‘Poison’, and for not including an address on the packaging.
Nathan Tucker retired in 1910 and William Robinson took over the business, but got into trouble five years later when a court ruled that under the Harrison Narcotic Act, it was illegal for the company to prescribe its product by mail. Robinson somehow managed to get round this and continued the mail-order system, with his son Dr Gerard Briscoe Robinson later joining him. Tucker’s Asthma Specific was around until 1959, when G B Robinson died in a plane crash and the company’s assets were sold off.
Would it have worked in any way do you think or did it just make them feel *different*?
x
I’m not sure to what extent it would have worked – maybe some of my medical readers might come along and venture an opinion. Though some doctors at the time considered it quackery, others were prepared to let patients give it a try, so they must have thought there was something in it.
Not that I’d condone it obviously but in a spirit of curiosity I’d love to know!
Cocaine relieves the symptoms of asthma, which are largely due to bronchoconstriction (narrowing of the airways).
My biochemistry is several decades old, but I do remember enough to decode the Wikipedia entry on cocaine.
Cocaine is a “serotonin–norepinephrine–dopamine reuptake inhibitor”. Norepinephrine is American for adrenaline. “Reuptake inhibitor” means that it inhibits the metabolism (and prolongs the effects) of the body’s natural supply of adrenaline. Adrenaline’s effects include bronchodilation, which means that it (adrenaline) relieves asthma.
Cocaine’s effects therefore probably include bronchodilation, which would probably be greater for inhaled cocaine.
Adrenaline is not used to treat asthma because it has loads of other effects — some nasty — and the bronchodilator wear off quite rapidly.
I can only guess at how rapidly cocaine’s bronchodilator effects would last — perhaps an hour or two — and I have no idea how potent it would be.
By the way, coffee and tea (and I guess cocoa/chocolate) are not just stimulants; they are also mild bronchodilators. This would be useful information if you are stuck on a remote desert island with an asthmatic and a ready supply of coffee.
“Cocaine raises blood epinephrine (adrenaline) levels, and epinephrine-like drugs are a recognised treatment for asthma…” [from A Brief History of Cocaine by Stephen B Karch] It’s easy to forget that today’s bad drugs were yesterday’s good drugs, even if it turned out their long term effects outweighed their benefits. Heroin was an effective cough suppresant, I believe. I bet it made you feel better quicker than Benylin…
Michael, that’s even more interesting. Cocaine is like a super charged SSRI, then? As well as an effective asthma treatment. We should be keeping this stuff quiet… ;>
Hope this all helps. I’m only an Emergency Medical Technician. *prods brain*
Atropine
Does have the effect of decreasing bronchial secretions which *may* have helped some patients who would have looked like they were wheezing asthmatics but in reality actually had a heavy mucus cold. It can also slow the heartbeat (and therefore breathing will be slowed as well, which in someone who is panicking (fast heart rate, fast breathing) would appear to make them feel better.
I have serious doubts about atropine being effective in genuine asthmatic emergencies (I’m willing to be corrected). Some of the possible side effects are very nasty: distinctly fatal heart rhythms, make you nauseous, blurred vision, loss of balance and make you dizzy, extremely bad confusion, severe hallucinations.
Cocaine
Cocaine is a stimulant so patients may have seemed to those around that they are improving due to this alone. It can also raise the heart rate to dangerously high levels so the combination of cocaine and atropine would have easily had potentially fatal results.
Of course there’s nothing to stop Doctor Tucker giving a verdict that the medicine wasn’t given in time and the poor patient died of their Asthma.
As a side note in late 2004/2005 there was a number of deaths in Holland from Cocaine that was laced with Atropine.
Thank you all very much for these highly informative answers – much appreciated.
Oh, I could bore you for hours on this one…
This combination of cocaine and atropine would have been probably the best treatment available at the time. If only it was inhaled into the lungs, instead of depositing mainly (and uselessly) in the nose.
If inhaled, the ‘bronchodilatation’ produced by cocaine was probably mediated by it’s constrictor effect on the blood vessels in the airway lining. This would reduce the inflammatory swelling of the airway lining and hence improve airflow. Cocaine was used for the same effect on the blood vessels in the nose in hayfever sufferers (I’ve always wondered if this is how the snorting habit arose.). Twenty years later, the less addictive drug ephedrine would surpass cocaine for both diseases (roughly the same mechanism of action).
If cocaine rapidly enters the blood stream (as it would if snorted) it increases the levels of adrenalin released by the adrenal gland. Adrenalin is the body’s best bronchodilator, so there would be an associated improvement in airflow. An adrenalin rush works: physicians around this time knew that giving a patient a jolly good fright was more effective than any drug in their bag. In addition to relaxing airway muscle, adrenaline also constricts blood vessels, which would have the same beneficial effect as cocaine itself with respect to the inflammatory swelling of the airway lining.
Atropine (and similar anti-muscarinics) inhibits the nerve supply to both the mucus glands and muscle of the airways. Thus, it would have relaxed the airways (producing bronchodilatation) as well as inhibiting the secretion of mucus. It is not much good stuck up your nose, though. Pharmacists sold herbal cigarettes containing atropine and (similarly-acting drugs) well into the 20th century; these were quite effective. Similar drugs were used in asthma until quite recently, and would still be on the crash trolley in A&E for the treatment of severe asthma attacks (they tend to try everything when things are bad enough). Longer lasting, synthetic equivalents of atropine are still the mainstay for the treatment of chronic obstructive pulmonary disease (COPD).
[Blame my tutee for not turning up on time for that lecture.]
Brilliant – that’s really interesting. Thank you.
This is a great site! Not just the sire itself, but the amazing links. I’ve been looking a blog dedicated to pre-20th centure life and mores, and this does it for me!
A relevant but strangely ignored or not generally known fact about asthma and breathing troubles is that the change between weak (asthmatic) and strong (healthy) breathing is dependent on abdominal muscle tension. Slackening the muscles here causes abysmally weak and asthmatic breathing. Instead of describing an asthma attack as being like breathing through a straw, attempting to breathe vigorously with relaxed abdominal muscles provides a more genuine illustrative example. Training the muscles, for example by “abdominal hollowing” (see Web articles) produces an antiasthmatic effect. Abdominal muscle tension plays a prominent part in Asian martial arts.
So it is fair to assume that there is a natural breathing spectrum with an asthmatic tendency at one end and Ku Fu or Karate breathing at the other end. For a few words on the Japanese version of Asian breathing see http://www.lrz.de/~s3e0101/webserver/webdata/OBT.pdf
I personally tend to breathe asthmatically after an evening meal or in pollen-laden air. Breathing powerfully into my lower abdomen with tensed muscles provides an effective cure for me. But then I’ve always been sceptical about medical wisdom on asthma: such a paradoxical and doctor-baffling increase in the last 40 years with modern, merely symptomatic inhalers. Respectfully, Richard Friedel