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.