AUBERGIER’S SYRUP OF LACTUCARIUM
That clause in the Federal Food and Drugs Act which requires certain potent drugs to be declared on the label of the proprietary mixtures containing them has been responsible for clearing up many mysteries. Physicians have frequently wondered why they were unable to obtain from the syrup of lactucarium, U. S. P., the therapeutic results which they were able to obtain from a proprietary product known as Aubergier’s Syrup of Lactucarium, sold by Fougera & Co. at an exorbitant price and put up in “patent-medicine” style. The milk-juice of lettuce once bore the reputation of being a soporific—a reputation that has been artificially maintained largely through the effects of the Aubergier preparation. With the advent of the Food and Drugs Act the secret of the soporific effect of the Aubergier product was explained—it contains morphin.[124]
The practical difficulties of making a satisfactory syrup of lactucarium are not realized by most physicians. To such the following note, presented at a meeting of the Pennsylvania Pharmaceutical Association by Mr. Louis Emanuel, president of the Pennsylvania Pharmacy Board, will prove enlightening:
“Did you ever make a syrup of lactucarium direct from the crude drug? If you did, shake hands, and let me hail you as a brother, a brother pharmacist in fact worthy of the title. If you did not, I am sorry for you; you have missed something worth knowing.
“The American Journal of Pharmacy tells us that in 1851 ‘Aubergier cultivated lactuca and poppy on a larger scale, in order to obtain lactucarium and opium. Please note the latter for further reference. In lactucarium he found lactucin, mannite, resin, cerin, asparmid, brown coloring-substance and oxalic acid.’ In 1860, in the same publication, Proctor says: ‘The attention of the medical practitioners has of late been turned to the syrup of lactucarium, and the preparation sold usually by apothecaries in this city is that known as Aubergier’s, a French preparation, made by dissolving 30 parts of alcoholic extract of lactucarium in 500 parts of boiling water, straining the liquor and adding 15,000 parts of boiling simple syrup, which is kept boiling, and albuminous water added from time to time until it is clarified.’ In ’66, ’77, ’78, ’82 and ’84 various writers produced elaborate dissertations on the supposed improved methods of making this syrup, but not one has had the temerity of inquiring into the therapeutic value of this preparation, or to examine the French preparation to ascertain whence comes its vaunted superiority.
“The French, it is said, are an impressionable people, but they appear to have a limit; they do not take any chances on plain syrup of lactucarium. Theirs contains the added product, extract of opium. This implies a lack of faith in soporific properties of lactucarium, and displays a recklessness in regard to cost and labor.
“The National Dispensatory, fifth edition, says:
“The utility of retaining lactucarium as an official medicine is very doubtful. It may possibly be desirable as a hypnotic for very impressionable persons, with whom faith in a remedy supplies its want of intrinsic efficiency.”
“The official modus operandi for making this syrup looks laborious, but the innocent-looking task of reducing the drug to a coarse powder is a revelation to the uninitiated.
“It was {a} hot day in July and it took my 175-pound clerk and me all that day to reduce 50 gm. of lactucarium to a satisfactory condition. The stuff looked like old pieces of discarded rubber shoes, and it really appeared to act like rubber. After perspiring all day with the Pharmacopeia and iron mortar, imagine our disgust, if you can, on reading in the National Dispensatory the following:
“This alcoholic preparation of lactucarium is quite as valueless and more objectionable than the syrup of the same drug.”
“Moral: Why pay $6.50 a pound for material that has no medicinal value, and is so hard to manipulate as lactucarium when decrepit rubber shoes are so cheap? You can have just as much fun on a hot summer day in reducing the latter to a coarse powder with clean sand in an iron mortar as you can with the more expensive material.”
One of the advantages claimed for ready-made prescriptions over the made-to-order variety, or even over pharmacopeial preparations, is that they are more elegant in appearance and less offensive to the nostrils and palate. This is the common experience of physicians who, having prescribed some ready-made mixture, wish to change the dose of one of its constituents and write a prescription or ask their pharmacists to prepare a similar preparation. The inability of the pharmacist to prepare a preparation even approaching the original in appearance, color or taste usually leads to increased confidence in the skill of the manufacturer of the proprietary and a correspondingly decreased belief in the pharmacist’s professional attainments. But these conclusions, although natural, are based on false premises. As the proprietary did not have the composition declared on the label, a mixture based on the formula differed more or less widely from the proprietary it was expected to resemble.—(From The Journal A. M. A., Nov. 9, 1912.)
A Protest and a Reply
Three months after publishing the foregoing we received a nine-page communication from Comar & Co. of Paris, the promotors of Aubergier’s Syrup of Lactucarium, in which they took issue with some of the statements in our article. The company claimed that a possible reason for the difficulty experienced by Mr. Louis Emmanuel in trying to make the Syrup of Lactucarium from the crude drug is that he did not use the same variety of Lactucarium that it employs. Furthermore, it said that the presence of morphin in the product was acknowledged before the passage of the Food and Drugs Act. On more careful investigation, we find that this is true—that the presence of “a certain proportion of extract of opium” in the preparation was mentioned even before the federal Food and Drugs Act compelled the morphin content to be published on the label. Technically, then, The Journal was incorrect in making the implication that the medical profession was not apprised of the fact that Aubergier’s Syrup of Lactucarium contained morphin; practically it was right. The information that Comar & Co. gave to physicians was buried in its advertising “literature” so that it is fair to assume that not one physician in ten thousand knew—previous to the Food and Drugs Act—that Aubergier’s Syrup of Lactucarium contained morphin.—(From The Journal A. M. A., Nov. 9, 1912.)