8
The Adulteration of Opium
One
of the reasons why opiates featured so frequently in the poisoning
statistics when they were first published officially in the 1860s was
the extensive adulteration of the drug. Various additions made at
different stages on its journey from Turkish poppy plantation to retail
pharmacists and other shops made its strength variable and its effects
uncertain. The different types of opium on the market were variable
anyway. Egyptian opium was known to be less strong in morphine than
Turkish; this made the production of exact chemical compounds difficult
enough. When adulteration made this variability even more marked, it is
not surprising that the rate of accidental poisoning was as high as it
was. As Dr Normandy remarked in his Commercial Hand-Book of Chemical
Analysis, '... this most valuable drug, certainly one of the most
important and most frequently used in medicine, is also one of the most
extensively adulterated'.1
The adulteration of opium was part of a
general deterioration in both food and drugs which resulted from the
transition to an urban society. From the end of the eighteenth century,
the quality of many foods was declining. During the next hundred years,
adulteration became a widespread and remunerative commercial fraud .2
This was not simply a question of a straightforward desire for profit,
but the outcome of breakdown and change in old methods of food
production and, in the case of opium, of popular drug use. Just as
working-class families could no longer produce their own food, so, too,
the rural remedies comprising herbs and plants which could be freely
picked were no longer available when the country was several miles
away. The example of the Fens had demonstrated the replacement of
poppy-head tea brewed at home by commercially produced laudanum,
Godfrey's or paregoric bought from the local druggist or grocer.
Adulteration
was fostered, too, by the breakdown of traditional methods of control.
The old guilds, overseeing quality and sale, lost influence under the
impact of changed conditions. The fact that medicine and pharmacy were
in a state of flux in the early years of the nineteenth century has
already been mentioned. The change from the tradesman status of
surgeon-barber, apothecary or druggist had not yet been embodied in the
professional medical and pharmaceutical organizations of the 1840s and
1850s. The medico-pharmaceutical area was at this period a complex
mixture, and there is little doubt that, in general, sanctions against
adulteration were lacking or impossible to enforce .3
The stage at
which British analytical method rested in the first decades of the
century also made the detection of additions difficult. The great
advances in analysis and in the isolation of new alkaloids took place
outside England. The influence of French scholars such as Orfila and
Magendie has already been mentioned; but knowledge of this Parisian
school was limited in the early decades of the century. English
translations of Magendie's Formulary for the Preparation and Employment
of New Remedies were appearing at the end of the 1820s. Toxicology as
an academic subject was beginning to find its place in the medical
syllabus .4 Books like those by Christison and Pereira brought a more
scientific awareness of poisons; but by themselves they could do little
to check adulteration.
Given the tortuous route by which raw opium
travelled from its original peasant producer, often from one merchant
to another in the country of origin, it is not surprising that much
adulteration had already taken place before the opium was even shipped
to London. The peasants, under heavy obligation to opium merchants,
augmented their crop by adding foreign matter. Further adulteration
followed. Such a variety of agents were mixed in with the raw opium
that analysts were hard-pressed to identify them all. The anonymous
author of Deadly Adulteration and Slow Poisoning Unmasked (1830) noted,
`Good opium in a concrete state should be of a blackish colour, of a
strong fetid smell, a hard viscous texture, heavy; and when rubbed
between the finger and thumb, it is perfectly free from roughness or
grittiness.' But such quality was rarely encountered. `The drug is
liable to great adulteration, being frequently vitiated with cow dung,
or a powder composed of the dry leaves and stalks of the poppy, the gum
of the mimosa, meal or other substances.'5 Poppy capsules and wheat
flour appear to have been the most common adulterating agents, but
there were often others.6 In one ten-ounce sample of Smyrna opium,
Pereira found ten drachms of stones and gravel. Crude opium varied so
much that no definite reliance could be placed on its effectiveness in
given medical doses.' The development of `scientific' medicine clearly
needed to be able to rely on exact doses of the drug.
There were
further additions to opium after its arrival in this country at both
the wholesale and the retail stage. Wholesale druggists were accustomed
to send raw drugs out to independent drug grinders for powdering, ready
for making various compounds. Adulteration here arose from two causes :
the demands of the wholesale companies, who allowed for an unreasonably
small percentage of loss in the grinding process; and the desire of the
grinders, too, to maximize their own profits. Arthur Hassall, a leading
campaigner on adulteration, told the 1855 Select Committee how this
came about:
A person having a drug which he wishes ground,
forwards a given weight of it to the drug-grinder. The drug is
generally returned to him of the same weight, or nearly so, and
sometimes it is even ordered to be returned weighing so much more. Now,
in the process of grinding, part of the moisture which all vegetable
substances contain escapes ... that loss is made up by adulteration ...
The
druggist knew that such a loss would occur and those with few scruples
in the matter acquiesced in the process. The retail chemist also had a
part to play in the process. There were certain tricks of the retail
trade. Morphia, for instance, an expensive item, often had powdered
opium with it. It was not unknown, too, for druggists to adulterate
powdered opium with the dried and pulverized residue left from the
process of preparing tincture of opium.
The drug was also used, to a
lesser extent, as an adulterating agent itself. It was one of several
substances added to increase the intoxicating properties of beer.
Evidence of the practice is scant, and may have owed much to
middle-class misunderstanding of the selling of opiates in pubs and
beer houses, or the habit of taking opium to counteract the effects of
too much drinking. It is possible, too, that adulteration with opium
was declining before the movement to reform such practices got under
way in the forties and fifties. As early as the reign of George III,
penalties had been laid down for the addition of opium by beer brewers
or beer sellers who mixed in `any molasses, honey, liquorice, vitriol,
quassia, cocculus Indicus, grains of paradise, Guinea-pepper, or opium'
or any of the extracts of these substances. They were liable to
forfeiture of both beer and additives and a fine of £200.8 The Act was
not enforced and adulteration continued; cocculus indicus was the main
substance used, but according to Accum's pioneering study of
adulteration in 1 820, his Treatise on Adulterations of Food and
Culinary Poisons, `opium, tobacco, nux vomica and extract of poppies'
were also known to have been added.9
It is likely that opium had
been employed in a small way as an adulterating agent in the first
decades of the century; but that such use was magnified by continuous
repetition of the story without investigation. As late as the 1890s,
allegations about the addition of belladonna, opium, henbane and picric
acid were still being made in supposedly objective surveys of the drink
trade, even though the last prosecution for the addition of cocculus
indicus had taken place thirty years previously.10 Opium was used
popularly as an antidote to over-indulgence in alcohol, and possibly a
popular preference in some areas for beer with opium added was
distorted by the interpretation put on it by the public health
campaign. Opiate use was a continuing undercurrent in Victorian
society's reaction to alcohol. In this case it was a useful argument
for the temperance side in the campaign against the brewers. But drink
interests, too, were not adverse to using the dangers of increased
opiate consumption as an anti-temperance bogey. Opium was a useful
polemical weapon for both sides.
Opium was part of the concerns of
those working to remove all harmful additions to food, drink and drugs.
In itself a part of the wider public health movement, the crusade
against adulteration was the same mixture of humanitarianism and
professional self-interest as the moves to restrict the open sale of
poisons. There was concern for the needs of working people. As Dr
Thomson noted, the working class were particularly at risk from
adulterated drugs -'the labouring classes, being less capable of paying
a higher price', were `more exposed to the administration of bad
drugs'.,,' But those who wished to replace such adulterated drugs by a
higher-quality product largely ignored the fact that low wages
effectively precluded working-class purchase of more expensive items.
Without other means of effective medical treatment, drugs from the
corner shop, adulterated as they were, were the only ones available for
many families. Nor was it coincidence that the movement against
adulteration coincided with, and was largely inspired by, professional
organization in both medical and pharmaceutical circles. As with moves
to restrict the open sale of poisons, the anti-drug-adulteration
campaign owed much to professional strategies. Improvement of the
quality of drugs prescribed and dispensed was a necessary corollary of
the change from tradesman status to that of a qualified and
monopolistic group with restricted entry.
The first landmarks in the
campaign, in particular Accum's Treatise on Adulterations of Food and
Culinary Poisons (182o), Deadly Adulteration and Slow Poisoning
Unmasked (1830) and the inquiry of 18i9 into the price and quality of
beer, concentrated on the additions made to food and drink. But medical
and pharmaceutical organization brought with it a widening of the
campaign to include drugs as well. Agitation among pharmacists against
such adulteration began as soon as the Pharmaceutical Society itself
was established in r841. Jacob Bell, writing in the first issue of its
Journal in 1841, chose adulteration as his subject and recognized at
least in part that the campaign would lead to a more expensive product.
12 Jonathan Pereira's early work on adulteration was also addressed
particularly to pharmacists.
Increased medical organization also
lent weight to the campaign. The Edinburgh Royal College of Physicians
appointed a committee to inquire into drug adulteration which reported
in 1838. Detailed work by Professor Christison revealed the extent of
adulteration of opium. The laudanum he purchased from seventeen
different shops, fourteen in Edinburgh and three in a major Scottish
country town, gave wildly varying morphia percentages.13 Dr Thomson's
report to the 1839 Poor Law Amendment Act Select Committee confirmed
Christison's findings and emphasized the role of the drug-grinder in
the process of adulteration.
Thomson's evidence was given wide
publicity in the Lancet and it was this journal, under the editorship
of Thomas Wakley, which was as always in the forefront of medical and
public health radicalism, and which became the driving force behind the
whole adulteration campaign. Its famous `Analytical Sanitary Commis
sion', an inquiry published in the journal in 1853-4, revealed the
details
of adulteration, not only of food and drink but also of drugs, and
especially of Opium. 14 Nineteen out of twenty-three samples of gum
opium purchased in the interests of the investigation were found to be
impure, poppy capsules and wheat flour being the most common additives.
The investigations and reports of a Commons Select Committee chaired by
Mr Scholefield, M.P. for Birmingham, in the following years, and the
publications of Dr Hassall, gave increased publicity to the
adulteration of opium.15
Opium adulteration was left untouched in
the first general attempts to control adulteration. The 186o Act merely
covered the adulteration of food and drink. In any case, the Act was
largely inoperative and not until the passing of the 1872 Adulteration
of Food, Drink and Drugs Act did the sale of adulterated drugs become
punishable. The 1875 Sale of Foods and Drugs Act, the foundation of all
present legislation, specifically provided against the addition of
injurious materials to drugs in Section 4. Section 6 of the Act,
stating that no food or drug was to be sold which was not of the
nature, substance and quality of the article demanded, was the basis
for many adulteration prosecutions. The adulteration of beer, too, was
specifically dealt with by the 1885 Customs and Inland Revenue Act,
although most prosecutions came under the Sale of Food and Drugs Act;
Section 8 made the adding of any matter except finings an offence. 16
Quality
improved, and by the end of the century the adulteration of opium was
uncommon. Of seventy samples of laudanum examined in England and Wales
between 1906 and 1908, only two were adulterated. In Birmingham, 12 per
cent of the samples of paregoric bought between 1892 and 1913 were
adulterated; but in the fourteen years between 1915 and 1929, all
sixteen samples bought were genuine. The adulteration of imported raw
opium was still a matter of complaint, but inside the country both
standards and quality were improved." The anti-adulteration campaign
was thus, so far as opium was concerned, the epitome of a successful
public health reform movement. Legislation, together with improved
standards of health, had succeeded in largely banishing the addition of
harmful agents to the drug. It also had its implications in the context
of the growth of concern about the use of opiates around the middle of
the century. Poisoning statistics and the evidence of adulterated
opium's uncertain and sometimes dangerous action were the first factors
which emphasized a need to impose controls and gave a role to the
professional groups.
References
1. A. Normandy, Commercial Hand-Book of Chemical Analysis (London, George Knight, 1850), P. 438.
2. J. Burnett, Plenty and Want. A Social History of Diet in England (Harmondsworth, Penguin Books, 1968), pp. 100-101.
3.
See, for example, S. W. F. Holloway, `The Apothecaries' Act 1815; a
reinterpretation', Medical History, to (1966), pp. 107-29 and 221-36
which criticizes the old view of the Act as a progressive, reforming
measure which allowed the apothecaries greater powers of inspection.
See also his `Medical education in England, 1830-58: a sociological
analysis', History, 49 (1964), pp. 299-324, for an analysis of
developing organizational and structural changes in the medical
profession.
4. See S. W. F. Holloway, History, op. cit., for the
advent of Parisian medicine and toxicology; also R. H. Shyrock,
`Medicine and society in the nineteenth century', Journal of World
History, 5 (1959), pp. 11646. Some of the earlier toxicology lectures
are reported in the Lancet, e.g. A. Cooper, `Of vegetable and mineral
poisons', Lancet, 2 (1826), pp. 169-73.
5. Anon., Deadly
Adulteration and Slow Poisoning Unmasked, or Disease and Death in the
Pot and Bottle (London, Sherwood, Gilbert and Piper, 1830), p. 134; J.
R. McCulloch, Dictionary of Commerce (London, Longman, 1832), PP.
798-800.
6. A. Normandy, op. Cit., p. 438.
7. P. P. 1854-5, V I I
I : First Report from the Select Committee on the Adulteration of Food,
Drink and Drugs, qs. 455-470. See also P.P. 1854
5, op. cit., q.
I17; and `Evidence of Dr R. D. Thomson on the adulteration of drugs
before the Select Committee on the Poor Law Amendment Act', Lancet, r
(1838-9), pp. 797-801.
8. A. Normandy, op. cit., pp. 60-66.
9. F.
Accum, A Treatise on Adulterations of Food and Culinary Poisons
(London, Longmans, 1820), p. 205; Deadly Adulteration, op. Cit., p. 55
and Anon., The Tricks of the Trade in the Adulteration of Food and
Physic
(London, David Bogue, 1856), p. 99.
10. J. Burnett, op. cit., p. 266.
11. R. D. Thomson, Lancet, op. cit., pp. 797-801.
12. J. Bell, `On the adulteration of drugs', Pharmaceutical Journal, r (1841-2), pp. 253-62.
13. R. Christison, Observations on the Adulteration of Drugs (Edinburgh, Adam Black, 1838), p. 13.
14.
`The Analytical Sanitary Commission', Lancet, r (1853), pp. 64, 116 17,
251-3; 2 (1853), PP. 555-6; 1 (1854), PP. 10-14, 51-4, 77-81, 107 8,
165-8.
15. P. P. 1854-5, V I I I : First Report, op. cit.; P. P.
1856, V I I I: Report from the Select Committee on the Adulteration of
Food Drink and Drugs; A. H. Hassall, Adulterations Detected: or Plain
Instructions for the Discovery of Frauds in Food and Medicine (London,
Longman, 1857).
16. W. J. Bell, The Sale of Food and Drugs Acts, 1875 to r907, 5th ed by Charles F. Lloyd (London, Butterworth, 1910), p. 9.
17.
J. F. Liverseege, Adulteration and Analysis of Food and Drugs ...
(London, J. and A. Churchill, 1932), pp. 501-2; H. H. L. Bellot, The
Pharmacy Acts, 1851-1908 (London, Jesse Boot, 1908), p. 45; `Sale of
paregoric deficient in opium', Pharmaceutical Journal, 3rd ser. 20 (1889
90) P• 925.