1800-1985: Asthma Cigarettes

Elliot's Asthma Cigarettes*

So as you probably know by now by hanging out on this blog I had pretty bad asthma as a kid.  One day I walked into my doctor's office and he said, "Look, if you ever decide to smoke cigarettes, just let me know and I'll put you out of your misery myself."

The irony of that was a few days later I visited the Manistee County Historical Museum in Manistee, Michigan.  The museum is housed in the old A.H. Lyman Company building, which housed a pharmacy that was preserved.  On the shelves were antique medicines, one of which said, "Asthma Cigarettes."  What I saw was similar to what you see in the picture to the right.

Potter's Asthma Remedy*

If smoking was supposed to be so bad for asthma, I thought, why would doctors prescribe smoking cigarettes, and what was in them anyway?  


Years later I learned the following about asthma cigarettes:

• They didn't contain tobacco, but crushed and dried herbs from the nightshade family of plants called solanaceae, which included  datura strammonium, atropa belladonna, and the hyoscyamus niger, and Lobelia inflata.   
• Such plants contained an alkaloid called Atropine that causes mild bronchodilation, and made breathing easier. 
• The idea smoking is hazardous to your health is a relatively new idea. 

My quest took me all the way back to 4,000 B.C. which marked the dawn of the bronze age.  Ancient city states of Sumeria and the empire of Egypt were in their infancy, and the discovery of papyrus and cuneiform soon allowed societies the ability to communicate from one generation to the next.

Kinsman's Asthma Cigarettes*

The Ancient Egyptians had plentiful access to  atropa belladonna.  It was a pungent smelling herb that grew to be about three feet high with oval shaped, pointed leaves that grew about three to six inches long with reddish or purplish flowers.   (1)

Men and women experimented with this herb and discovered its poisonous effect which gave the plant the name deadly nightshade.  Egyptians would pick the leaves, stems and roots and dry them under the hot sun, and crush what was left.  The byproduct could be used in a variety of ways..

Encyclopedia.com describes how Egyptian women squirted drops in their eyes "for the allure given by large, black pupils: hence the name belladonna — ‘fine lady'."  It made pretty eyes prettier and helped beautiful Egyptian women woo men.

Ad for Schiffmann's Asthma Cure (1899)*

Physicians used it as a remedy for just about any respiratory ailment.  The dried and crushed herbs would be placed on bricks already heated on hot coals, and the smoke would be inhaled to provide temporary breathing relief.

However, there were risks for side effects, especially if too much was ingested or inhaled.  Side effects included dry mouth, increased, dilated pupils, nausea and headache.  Likewise, if taken in large quantities it caused hallucinogenic effects.  Yet I imagine if you couldn't breathe the hallucinogenic effect may be just as beneficial as the breathing relief.

Kellogg's Asthma Cigarettes*

About 100 A.D. physicians in India had access to datura strammonium, a herb that also produces an unpleasant smell and grows to be about five feet tall with a pale green stem with spreading branches and puplish leaves coarsely sedated along the edges.  Its flowers are white or purple.  (2)

By early experiments ancient societies learned of its poisonous qualities, and hence comes the description of the plant.  Datura comes from the ancient Hindu word for plant, dhatura.  Stramonium is a New Latin word meaning thornapple.  Strammonium originally came from the Greek word strychnos which means nighshade and mankos meaning mad.  (3)

Other than thornapple, common names I've found during my research that refer to strammonium are jimsonweed, Jamestown weed, drowny thornapple, Devil's trumpet, angel's trumpet, mad apple, stink weed and tolguacha.

Like belladonna, the leaves, stems and roots were dried and crushed into a powder that was stuffed into pipes and inhaled.  This was a remedy for diseases of the lungs or throat.  Although, as with any member of the nightshade family, there were toxic side effects.

The famous Greek physician Hippocrates wrote about stramonium and belladonna, and we know they were used as an asthma remedies by ancient Greek and Roman physicians.  Yet such wisdom was lost to western civilization during the dark ages of medicine, not to be reintroduced until 1802.

In that year British physician and asthmatic James Anderson visited India and enjoyed the mild breathing relief he obtained after smoking a cigarette containing stramonium. (4)

Anderson reported his find to his friend Dr. Sims in Edinbergh, who published a report in the Edinbrugh Medical and Surgican Journal about the benefits of smoking cigarettes containing the leaves of datura stramonium.

After this report asthma cigarettes became popular for the treatment of asthma in Europe and America. (5)

American Indians were introduced to another member of the nightshade family called lobelia inflata. They smoked it for asthma relief, and it's for this reason many refer to it as Indian Tobacco or Asthma Weed.

American physicians were introduced to lobelia and used it for asthma releif, yet they also used it to make some patients vomit.  The idea here was that along with vomit toxins would be removed from the body to balance the humors and cure the ailment.  For this reason it was often referred to as pukeweed and vomitwort.  (6)

Atropine was finally derived from the belladonna plant in 1833.    By 1867 Atropine was isolated by von Bezold.  It was then determined to be a component alkaloid of the various nightshade plants found in India, including the datura strammonium, atropa belladonna, and the hyoscyamus niger (black henbane), and Lobelia inflata (7)


Ultimately it was learned that atropine is an anticholinergic agent in that it sits in the receptor sites of the neurotransmitter acytycholine and prevents it from causing bronchoconstriction (narrowing of the air passages in the lungs).  In this sense it's often referred to as a back door bronchodilator (as opposed to epinephrine being a front door bronchodilator in that it causes bronchodilation).

Potter's Patient Inhaler (funnel device)*

In the mid 19th century asthma cigarettes started growing in popularity.  Some cigarettes were prepared and sold by individual pharmacists.  Some asthmatics would purchase the necessary ingredients and stuff them into their pipes, or roll them into cigars or cigarettes.

By 1879 a an asthma cigarette craze struck America and Europe.  (8)  More and more companies entered the market in an attempt to benefit off the plight of asthmatics.  Belladonna, stramonium, lobelia, henbane, atropine, and even cannabis were packaged in cans and placed on shelves in pharmacies.

The products were marketed for just about any respiratory condition, including asthma, chronic bronchitis, whooping cough, cholera, croup, catarrh, and hay fever.  The product could be stuffed into pipes or rolled into into cigars and cigarettes.  In the 1880s technology progressed so some companies pre-rolled cigarettes and packaged them for the convenience of the asthmatic.

Asthma cigarettes from a variety of companies could be found on pharmacy shelves like the A.H. Lyman Company.  According the Inhalatorium, the most famous brands were:

Potter's Asthma Cigarettes*

• Schiffmann’s Asthmador
• Blosser’s
• Potter’s 
• Marshall’s
• Kinsman’ 
• Dr Guild’s green Mountain
• Kellogg’s  
• Page’s
• Regesan’s

In my studies the brand I've come across most often was Potter's Asthma Cigarettes, which you can see in the picture to the right or by clicking over to inhalatorium.com.

The main ingredient in Potter's cigarettes were stramonium, belladonna and atropine.  The Inhalatorium notes that Potter's also had a variety of asthma remedies that included cigarettes, incense, pills and powders to be inhaled by Potter's funnel device

Potter's Asthma Pills*

The cigarettes continued to be popular even after the discovery of epinephrine in 1900 and as the solutions of epinephrine and atropine became options for home use with the invention of the mass-producible electric nebulizer in the 1930s.

Sales of asthma cigarettes stayed consistent because they provided breathing relief, were less expensive than those other options, and they were available without a prescription.  Plus the nebulizers available were bulky, fragile and expensive.

Yet while asthma cigarettes were the preferred choice due to convenience and cost, that all changed in 1957 with the invention of the inhaler, and the release of the Medihaler-Iso and the Medihaler Epi.  These inhalers provided instant relief, were relatively inexpensive, and easily carried in pockets and purses.

Easy to use & fast acting Medihaler (1957)

As sales of asthma inhalers went north, sales of asthma cigarettes went south.  Yet despite the decline in sales, they were still a viable over the counter option until the early 1980s.

There were growing concerns at this time that teenagers were purchasing asthma cigarettes not for asthma relief but for their hallucinogenic effects. (9)  So studies were conducted to confirm whether or not asthma cigarettes really worked, and whether they should be taken off the shelves.

By this time there were many other options for asthmatics, which included safer asthma rescue medicine such as Ventolin and Alupent, theophylline, and a refined and safer version of Atropine called Ipatropium Bromide (Atrovent).  These medicines could also be delivered in preset doses via inhalers and solutions to be nebulized.

H.L. Elliot and J.L. Reid described in a 1980 article published in the British Journal of Clinical Pharmacy a study that concluded asthma cigarettes made of "herbal preparations containing Atropine-like alkaloids" were just as effective as using ipatropium bromide (Atrovent).

Dr. R. Schiffman's Asthma powder*

The researchers concluded that "an overdose of of asthma cigarettes is manifestly capable of producing pharmacological effects (hallucinations, delerium, tachycardia)." They also concluded that the dose of medication getting to the lungs is "variable and unpredictable."

Likewise, they noted that "In view of increasing evidence of abuse, there appears to be good reason to restrict availability of these preparations. Although a herbal cigarette might possibly be recommended for the asthmatic who insists on continuing to smoke," a majority of asthmatics would get just as much benefit with fewer side effects by using thier Atrovent inhaler. (10)

By 1985 asthma cigarettes were removed from the shelves of all U.S. Stores.  Yet while being generally extinct in western nations, they are still available in some third world nations.

I will leave you today with a recipe for asthma cigarettes from the National Druggist, Volume 30, 1900:

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(W.B.C. Cleveland Ohio)  The following formula is one that the writer has used for several years occasionally, and has found effective and not unpleasant, provided that the cigarettes are used not to frequently, or to excess:

• Strammonium leaves..........................8 parts
• Green tea leaves............................8 parts
• Lobella Leaves..............................6 parts
• Plantain leaves.............................2 parts

Mince the leaves to a condition suitable to rolling in cigarette form, and moisten the mixture with cold saturated solution of potassium nitrate in water, dry thoroughly, and pack in air tight cans or jars.  Lavel "Asthma Cigarette" mixure.  Directions:  When an attack of asthma is imminent take sufficient of the mixture to make one or two cigarettes of the ordinary size, roll in cigarette paper, and smoke slowly, inhaling the smoke as deeply as possible.  If relief is not afforded by the first, a second cigarette should be used.

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References:

1.  "Belladonna," Encyclopedia.com,  http://www.encyclopedia.com/topic/belladonna.aspx
2. "Plants poisonous to livestock," Cornell University's Department of Animal Science,  http://www.ansci.cornell.edu/plants/jimsonweed/jimsonweed.html
3. "Plants poisonous to livestock," ibid
4. Sneader, Walter, "Drug discovery: a history, 2005, England, page 96\
5. Sneader, ibid
6.  University of Maryland Medical Center, "Lobelia,"  http://www.umm.edu/altmed/articles/lobelia-000264.ht
7.  Encyclopecia.com
8. "The Scarcity of Cubebs," The Chemist and Druggist," 1887, Feb. 26, page 268 of  Chemist and Druggist: A Weekly Trade Journal, 1887, Vol. XXX, January to June 1887
9. Jackson, op cit, page
10. H.L. Elliot and J.L. Reid, "The Clinical Pharmacology of a Herbal Asthma Cigarette"British Journal of Clinical Pharmacy (1980, 10, 480-490) 
11. *  Picture used with permission from Inhalatorium.com.  Check out the site for more picutures, ads and descriptions of asthma cigarettes and other asthma remedies.

Further reading:  

• Jackson, Mark, "'Divine Stramonium': The Rise and Fall of Smoking for Asthma,"  Med Hist., 2010 April; 54(2): 171–194.