Laudanum is a tincture of opium containing approximately 10% powdered opium by weight (the equivalent of 1% morphine). Laudanum is prepared by dissolving extracts from the opium poppy (Papaver somniferum) in alcohol (ethanol). Reddish-brown in color and extremely bitter, laudanum contains several opium alkaloids, including morphine and codeine. Laudanum was historically used to treat a variety of conditions, but its principal use was as a strong pain medication and cough suppressant. Until the early 20th century, laudanum was sold without a prescription and was a constituent of many patent medicines. Laudanum has since been recognized as addictive and is strictly regulated and controlled throughout most of the world. The United States Controlled Substances Act, for example, lists it on Schedule II, the second strictest category. Laudanum is known as a "whole opium" preparation since it historically contained all the alkaloids found in the opium poppy, which are extracted from the dried latex of ripe seed pods (Papaver somniferum L., succus siccus). However, the modern drug is often processed to remove all or most of the noscapine (also called narcotine) present as this is a strong emetic and does not add appreciably to the analgesic or antipropulsive properties of opium; the resulting solution is called Denarcotized Tincture of Opium or Deodorized Tincture of Opium (DTO). Laudanum remains available by prescription in the United States (under the generic name "opium tincture") and in the European Union and United Kingdom (under the trade name Dropizol), although the drug's therapeutic indication is generally limited to controlling diarrhea when other medications have failed. The terms laudanum and tincture of opium are generally interchangeable, but in contemporary medical practice, the latter is used almost exclusively.
History
Paracelsus' laudanum Paracelsus, a 16th-century Swiss alchemist, experimented with various opium concoctions, and recommended opium for reducing pain. One of his preparations, a pill which he extolled as his "archanum" or "laudanum", may have contained opium. Paracelsus's laudanum was strikingly different from the standard laudanum of the 17th century and beyond, containing crushed pearls, musk, amber, and other substances.
British laudanum One researcher has documented that "Laudanum, as listed in the London Pharmacopoeia (1618), was a pill made from opium, saffron, castor, ambergris, musk and nutmeg".
Sydenham's laudanum In the 1660s English physician Thomas Sydenham (1624–1689) popularized a proprietary opium tincture that he also named laudanum, although it differed substantially from the laudanum of Paracelsus. In 1676 Sydenham published a seminal work, Medical Observations Concerning the History and Cure of Acute Diseases, in which he promoted his brand of opium tincture, and advocated its use for a range of medical conditions.
18th century By the 18th century, the medicinal properties of opium and laudanum were well known, and the term "laudanum" came to refer to any combination of opium and alcohol. In the 18th century several physicians published works about it, including John Jones, who wrote The Mysteries of Opium Revealed (1700), which was described by one commentator as "extraordinary and perfectly unintelligible". The Scottish physician John Brown, creator of the Brunonian system of medicine, recommended opium for what he termed asthenic conditions, but his system was discredited by the time of his death. The most influential work was by George Young, who published a comprehensive medical text entitled Treatise on Opium (1753). Young, an Edinburgh surgeon and physician, wrote this to counter an essay on opium by his contemporary Charles Alston, professor of botany and materia medica at Edinburgh who had recommended the use of opium for a wide variety of conditions. Young countered this by emphasising the risks '...that I may prevent such mischief as I can, I here give it as my sincere opinion... that opium is a poison by which great numbers are daily destroyed.' Young gives a comprehensive account of the indications for the drug including its complications. He is critical about writers whose knowledge of the drug is based on chemical or animal experiments rather than clinical practice. The treatise is a detailed, balanced and valuable guide to prevailing knowledge and practice. As it gained popularity, opium, and after 1820, morphine, was mixed with a wide variety of agents, drugs and chemicals including mercury, hashish, cayenne pepper, ether, chloroform, belladonna, whiskey, wine and brandy."
During the late 18th and early 19th centuries, patients undergoing surgery were often administered laudanum and alcohol, and had their hands restrained and bodies held down while the operation was performed.
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