9th Annual 12th Night Giveaway: Day 5

If you do a survey of Sherlock Holmes fans, no doubt you’ll find that quite a few have niches of the Canon that they find particularly fascinating. I know quite a few tobacco/pipe/cigar aficionados, for instance. Physicians and teachers each have their own BSI collections, and one can find books, articles and lectures on topics ranging from transportation to numismatics to chronology to probably anything.

One thing I myself have found interesting are the two mentions of asthma in the Canon. One, of course, is the “unhappy John Hector MacFarlane,” of “The Norwood Builder,” easily winded as he reaches the top of the seventeen steps. The other is, quite possibly, Susan, in “The Three Gables” whom Watson describes as wheezy, and whom Holmes treats rather rudely (“wheezy people don’t live long”), even if she is one of the group hired by villainess Isadora Klein.* “Paregoric” is the stuff, he tells her–and paregoric was first invented as an asthma remedy in at the beginning of the 18th century, although today it is actually contraindicated for those with asthma and other lung conditions.**

So, what other medications might Susan and John Hector have tried? What might well-meaning relatives have put in their Christmas stockings? For this article, I looked at newspapers of the time, which had no lack of ads for asthma relief:

Now, while I have been an asthmatic since at least high school, and probably before, I went quite a long time undiagnosed, and without good health care. So I can tell you that sucking on a cough drop or hard candy can help with asthma, simply because it’s a distraction and can help you control your breathing. I once spent the better part of a day lying still in bed, working my way through a bag of Hall’s. Was this a good idea? No. Did it keep me out of the ER? Possibly. BUT–Keating’s was not just a mentholled-up candy. It contained, according to the “Quack Doctor” website, licorice, sugar, tragacanth gum as a binding agent, ipecacuanha, and not opium, but morphine. Ipecac can work as an expectorant in small doses–and in large ones, it’s an emetic. It’s possible that someone experiencing some kind of bloating might interpret the shortness of breath due to that condition as an asthma flare-up, and find relief in, well, purging. And morphine might relax you–…but neither of those will actually alleviate an asthmatic bronchospasm–in fact, morphine and other opiates can actually aggravate an asthma attack. **, ****

I am thus far unable to find any information on what was in this “ozone paper.” It might have contained another common medication inhaled as smoke, potassium nitrate. Ozone itself has been tried as an air purifier since the late 1890’s (Nikola Tesla invented the first portable ozone generator), but unfortunately, as clean as ozone smells, it will make it hard for you to breathe, and can kill you.†

This nostrum also required that the patient burn it–every half hour during an asthma attack, and three times per day when not having asthma issues. It contained a preparation of Datura stramonium, also known as thorn apple or jimson weed, part of the nightshade family. It apparently can work as an antiparoxysm medication, and the 19th century asthma specialist, Dr. Henry Hyde Salter, thought it worked sometimes. But honestly, if the asthma sufferer had to burn some every half hour during an attack (a miserably long time) it seems very likely that the attack resolved itself, and Himrod’s Cure just happened to be in the room at the time. Given the poisonous effects of D. stramonium and its plant family in general, this is another patent medicine we are well rid of.††

Tobacco is another asthma remedy that shows up in 19th century medical publications. The key, apparently, going from Dr. Salter’s book, On Asthma: Its Pathology and Treatment (2nd edition, 1882), was not that an asthmatic become a seasoned smoker like, say, Sherlock Holmes, but that they use tobacco so little that it made them feel incredibly sick.

The effect of tobacco is exactly the same, only the depression that it produces is more profound, amounting to actual collapse, and the relief, therefore, more speedy and complete. In those who have not established a tolerance of tobacco its use is soon followed by a well-known condition of collapse, much resembling sea-sickness–vertigo, loss of power in the limbs, a sense of deadly faintness, cold sweat, inability to speak or think, nausea, vomiting. The moment this condition can be induced the asthma ceases, as if stopped by a charm.

Henry Hyde Salter, MD FRS, On Asthma, Its Pathology and Treatment, p.99

That sounds just marvelous.

And just in case you were wondering, people did also try cannabis (also called “Indian hemp”). Of this treatment, Salter wrote:

The Indian hemp, Cannabis sativa, is much given in India as an anti-asthmatic, and among the natives has a great reputation. I can easily imagine from its physiological action that its reputation is well deserved. It is at once a stimulant and a sedative. I should be inclined to think it would act best in small stimulant doses. Given in this way it produces the same effects as coffee, only in a more marked degree–it exhilarates, imparts great activity and intensity to the intellectual faculties, and exalts the functions of animal life. In any case in which coffee is useful I should expect that Indian hemp would be so in a greater degree. I think in large doses it might even do harm, from its hypnotic tendency. In this respect there is the same objection to it as to opium. I can say but little of it from my own personal experience. I have not often prescribed it, and in the great majority of the cases in which I have it has been a complete failure.

Henry Hyde Salter, MD FRS, On Asthma, Its Pathology and Treatment, p.128

And what of Dr. Watson’s favorite prescription, brandy? Unlike our Baker street friend, Dr. Salter, even in 1882, was not a fan of medicinal alcohol, at least for asthma. He relates two cases: one of a woman who used whisky, and another of a man who chose brandy–both mixed with very hot or boiling water, who swore that these were the only things that relieved what seems to have been absolutely horrific attacks. Salter believed that alcohol should be a last-resort prescription; those who used it tended to become habituated to it, requiring more and more to get the same relief. Granted, this was the golden age of the temperance movement, but I don’t think we can disagree with the doctor when he writes that “Alcohol is a thing the use of which is much more easily begun than left off.” (Salter, p.128) And while Salter doesn’t mention it, we now know that alcohol can actually cause asthmatic reactions in sensitive people, due to sulfites and/or histamines in the drink. ††† Accidentally aspirating alcohol can, in some cases, trigger a sudden, strong asthma attack that, if help is not immediate, may prove fatal.

That brings us to one final remedy: coffee. Strong, hot, black coffee has long been recommended for asthma sufferers–as has tea and, in a pinch, caffeinated cola. The caffeine can help to improve airway function to a slight degree, and the effect can last as long as four hours. Dark chocolate, which contains theobromine, can also be useful; theophylline, like caffeine and theobromine a xanthine, was once commonly given to asthmatics in pill form. But let’s be honest–these are no competition for albuterol, corticosteroids, and other medications we have available today. ‡

So perhaps the best gifts for John Hector McFarlane and Susan would be ten pounds of the best coffee beans, chocolates, or…..

Well, I’m pretty sure I’ve asked the most obvious Holmesian question about Cadbury’s before. So let’s do something simple:

Do Holmes and Watson drink cocoa in the Canon? If so, where?

And the prize? Perfect for any of you who actually read this blog entry.

My phone is dead, so this is a screenshot of another copy, but the one on offer has a library jacket and is in excellent condition–tight binding, clean pages, etc. I have this “theory” that Sherlockians buy books constantly, but never, ever get around to reading them, which is why they stay so nice.

As always, to win this prize, send in your answer to the above question via blog comment or FB message. And, if you are asthmatic–take your meds as prescribed!!!!!!!

Day 4 Winner!

To be honest, I wondered about the Day 4 prize. I know I’ve offered an identical volume in a different year, so I wasn’t sure people would be interested in this one. But you were! Tonight’s winner is Jim Bennett, who answered that James Ryder learned about fencing from a friend named Maudsley, who had just got out of Pentonville. Ryder has Holmes to thank that he didn’t get a turn in that prison himself.

Footnotes:

*This is also the story which features Holmes’ disappointingly racist reaction to Steve Dixie. And yes, I know it’s the 19th century, etc. etc., but 3GAB is still not one of my favorite stories.

**SO DON’T TRY IT. AS A MATTER OF FACT, DON’T TRY ANY OF THE ASTHMA REMEDIES DESCRIBED HERE. THEY ARE ALL NEGLIGIBLE AT BEST, AND LETHAL AT WORST.

***https://www.aaaai.org/about-aaaai/newsroom/news-releases/opioid; ether and chloroform were also used as asthma treatments, but physicians agreed they should only be administered by a professional, and never by oneself, as if one passed out while inhaling it, leaving the cloth or cone over their nose and mouth, chances were excellent that they would never wake up.

†https://www.sciencehistory.org/distillations/a-killer-of-a-cure

††https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2844275/; D. stramonium also appeared in medications as one of its variants, D. tatula.

†††https://www.medicalnewstoday.com/articles/313460#alcohol-use-and-asthma

‡https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7053252/#:~:text=Caffeine%20appears%20to%20improve%20airways,cause%20misinterpretation%20of%20the%20results.

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