Tuesday, January 17, 2012

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.  When I was 18 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 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 was a pharmacy.  In the back the old pharmacy shelves classic medicines.  On the box of one of these boxes was written: "Elliotts 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?  

What's in 'em?

Recently I set off on a quest to learn more about this interesting "medicine."  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, the hyoscyamus niger, Lobelia inflata and similar plants.  Indian Hemp and Cannabis are similar herbs also included in some brands.
  • Such plants contained an alkaloid called Atropine that causes mild bronchodilation, and made breathing easier. 
  • Smoking wasn't considered hazardous; it was actually seen as beneficial. 
Who first inhaled 'em?

It's difficult, if not impossible, to know when people first inhaled fumes of herbs to provide breathing relief or hallucinogenic effects.  In all likelihood it occurred by chance as the herbs were tossed onto hot coals and incidental inhalation resulted in hallucinogenic effects.  Later on an asthmatic inhaled these fumes, and he felt relief.  The herbs were probably believed to be a gift from the spirits or gods.

The first recordings of inhaling the herbs was around 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 by writing, perhaps with a reed stick.

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)

Folks experimented with this herb and discovered its poisonous effect.  When too much was inhaled the person died.  This gave the plant the reputation as the "deadly nightshade."  Egyptians soon learned the best recipe involved picking the leaves, stems and roots, drying them under the hot sun, crushing what was left, and using the byproduct 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. (1)

Ad for Schiffmann's Asthma Cure (1899)*
Physicians used it as a remedy for just about any respiratory ailment.  The dried and crushed herbs were tossed on bricks preheated on hot coals, and the smoke was inhaled to provide temporary breathing relief.  Over time a funnel was sometimes added to channel the smoke toward the patient's airway.

Inhaling the herb also provided a hallucinogenic effect, especially if enough was inhaled.  This may have been beneficial to the asthmatic as well, considering it helped take their minds of their trouble. Inhaling the smoke may have been beneficial to anyone suffering from a chronic illness, and was probably smoked regularly simply for recreational hallucinations.

However, there were risks, such as dry mouth, increased heart rate, dilated pupils, nausea and headache. If ingested or inhaled in high enough quantities, it may even cause death, hence the name deadly nightshade.

Kellogg's Asthma Cigarettes*
Who smoked the first pipes?

Again, it's impossible to know who carved out, let alone smoked the first pipes.  It's also impossible to know for whom the first pipe was carved for, nor what herbs were stuffed inside it.

It's possible the idea of using a sharp tool to hollow out a piece of wood for smoking herbs may have occurred to various inventors in various societies at different times.  The component smoked depended on what herbs were available.

For example, in India the incentive to carve out pipes was to smoke strammonium, belladonna, or Indian hemp for it's hallucinogenic effect. The fact the herb had other medicinal properties may have been learned later, or earlier.  Who knows?

Yet what we do know is the first medicinal use of pipes to smoke a medicine for asthma-like symptoms was recorded in ancient India around 100 A.D.  There were many herbs the Indians had access to, and one such was datura strammonium.  The herb 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 empirical means its entertaining effect was learned, as well as its poisonous qualities when too much was inhaled or ingested, which mainly included hallucinogenic effects.  At times it must have been observed the medicine made you mad, which may explain the name.

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.  It was obvious by these names the side effects of inhaling too much was well known

Like belladonna, the leaves, stems and roots were dried and crushed into a fine powder the Indians stuffed into their pipes and smoked it.  The benefits obtained must have been of higher quality than simply inhaling fumes from igniting the herbs on bricks.  Although either technique may have been used, depending on what the patient had access to.

Obviously the herb may have been used for entertainment, although medicine men and physicians ultimately learned of the medicinal benefits.  By 100 A.D. Indian physicians recommended smoking  strammonium for diseases of the lungs and throat, or simply for its hallucinogenic effect.  Again, the hallucinogenic effect may be desired when no other remedy was applicable

The famous Greek physician Hippocrates wrote about stramonium and belladonna, so we know Greek physicians had access to such wisdom.  With the fall of Cordova Greek medicine made its way to Rome, so we know the Romans had access to it too.   With the fall of Rome all such knowledge was lost for over a thousand years.

So how did such wisdom come to us?

A long time passed before British physician and asthmatic James Anderson visited India and enjoyed the mild breathing relief he obtained after smoking a cigarette containing datura strammonium.  The year was 1802.  (4)

Anderson returned to England and reported his find to his friend Dr. Sims in Edinbergh.  Sims trialed it, noted the benefits, and published a report in the Edinbrugh Medical and Surgican Journal.  After this report asthma cigarettes were entered into British and American pharmacopoeia, and ultimately became popular for the treatment of asthma in these western nations.  (5, 12 page 55)

Of course it also should be noted here that there were no standards or regulations regarding dosing in those days, and no recommendations as to how much of a medicine should be consumed, or in this case inhaled.  Dr Sims reportedly died a year after his report from an apparent overdosing of Belladonna.  (5, page 55)

So American Indians smoked pipes too?

Yes, American Indians smoked dried herbs stuffed into pipes too.  Now, did they get this wisdom from travelers from far off lands, or did they come up with the idea on their own.  No one knows for sure, and either theory is a possibility.

Either way, American Indians had access to another member of the nightshade family called lobelia inflata.  Various folks experimented and observed it's effects when ingested and inhaled, and soon it was learned of the hallucinogenic effect.  At first it must have been tossed into fires, later on heated bricks or in pots, and ultimately the herbs were stuffed into pipes and smoked.

Now did they come up with this on their own, or did they get the idea from others.  Your guess is as good as the best historians.  Either way, they smoked it for relief of asthma symptoms and for other benefits too, 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)

What was the secret ingredient?

Well, there had to be something in the nightshade family of plants that produced the medicinal effect, and this component was the alkaloid Atropine.

Atropine was first 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)

Early studies showed atropine was the potent component in the plant, the same component that dried secretions, increased heart rate, opened air passages, and produced a hallucinogenic effect.  It was the ingredient that that made the nightshade family of plants so sought after.

What started the Asthma Cigarette craze?

By the mid 19th century the market for inhaling ingredients and powders grew steadily.  Some pharmacists gathered the ingredients and sold them to individuals.  Some folks placed some powder on plates, igniting it and inhaling the fumes.  Some stuffed it into homemade pipes, inhaling it that way.  Others rolled it into cigarettes, inhaling it that way. 


Some pharmacists gathered the ingredients and further prepared them into powders to be further prepared by the patient.  Some pharmacists went a step further and rolled the powder into cigarettes that could be purchased in packs.  So there were a variety of options.
Potter's Patient Inhaler (funnel device)*

By 1879 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.  By the 1880s technology progressed so some companies pre-rolled cigarettes, packaged them, and sold their product at pharmacies.

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.  This was among the most popular brands in Britain.

The main ingredient in Potter's cigarettes were stramonium, belladonna and atropine.  Mark Sanders over at Inhalatorium.com 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*
An asthmatic patient of mine who grew up in 1950s America said she remembered her dad smoking cigarettes from a green package.  We later figured the produce was Dr. Schiffmann's Asthmador Cigarettes.

When did the craze end?

The end of asthma cigarettes was slow. Even as better products were introduced to the market, asthmatics didn't want to give up something that worked for them. It's no different than today's asthmatics fussing over the end of popular medicines like Chromolyn, epinephrine and theophylline.

Asthma 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, asthmatics still lit up the powders.

Sales of asthma cigarettes and powders stayed consistent because they provided breathing relief, were less expensive than those other options, and were available without a prescription.  Plus the nebulizers available were bulky and fragile, as well as 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 sales went north, asthma cigarette sales went south.  Yet despite the decline in sales, the cigarettes were still a viable over the counter option until the early 1980s.

The end came due to growing concerns 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:

Asthma Cigarettes------
(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.

So there you have it, the history of asthma cigarettes.  It was an options that provided hope and some relief for many asthmatics for a long time.  

eferences:
  1.  "Belladonna," Encyclopedia.comhttp://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.
  12. Smyth, Hugh D.C, Anthony J. Hickey, "Controlled Pulmonary Drug Delivery," 2100, Springer New York Dordrecht Heidelberg London
Further reading:  

2 comments:

  1. Grammatical error:
    "It's also impossible to know for whom the first pipe was carved for, nor what herbs were stuffed inside it. "

    Error correction:
    "It's also impossible to know for whom the first pipe was carved, nor what herbs were stuffed inside it."

    Removal of the second "for" is all that is needed to correct this sentence. I haven't read the entire piece, but couldn't let this pass without comment. Happy blogging!

    ReplyDelete
  2. Very interesting account. In fact I was one of those teenagers in the late 70's who discovered the narcotic effect. We used to stew the leaves up in tea and drink it. Recollecting, it wasn't a particularly nice buzz, but very, very debilitating ...

    ReplyDelete

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