As our correspondent correctly states, the drug from which the name (not the action) of the preparation is derived comes from Bolivia and has properties similar—but evidently inferior—to ipecac. That it possesses but little therapeutic value is perhaps best evidenced by the fact that, in spite of the propaganda made for it by Parke, Davis & Co., neither the drug nor any preparation of it is listed, so far as we know, by any other large pharmaceutical house, with one exception. Besides cocillana the preparation contains two other obsolete drugs, wild lettuce and euphorbia pilulifera. The activity of the “cough syrup,” it is needless to say, depends in the main on the drug which is more or less buried in the published formula: heroin hydrochlorid. At one time Parke, Davis & Co. admitted that the preparation owed its chief value to heroin. In a letter to the Council on Pharmacy and Chemistry the firm said:
“The physiologic action of this syrup is that which would be suggested by the constituents. Because of its activity the most prominent action would be that characteristic of heroin hydrochlorid.”
Without doubt the important ingredient, from the point of view of therapeutic potency, is the heroin; and it is this drug doubtless, that makes the mixture a good “repeater.” Syrup Cocillana Compound is a nostrum sailing under false colors. Whether its continued use is due to its mysterious, meaningless, misleading name or merely to insistent and persistent advertising methods of Parke, Davis & Co. is a question. Neither explanation is any credit to the medical profession which tolerates it, or to the physician who prescribes it.—(From The Journal A. M. A., Feb. 15, 1913.)
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.