To modern eyes, health care 200 years ago was primitive at best, lethal at worse. A recent knee replacement inspired me to consider medical care and pain management. (A friend of mine told me that a knee replacement is essentially an amputation of one’s leg.) However, it is described, it is a painful procedure.

The choices for treating pain were limited. I think we have all heard the story of the wounded man being treated with a glass of whiskey and a stick clamped between the teeth. Alcohol was used to help the patient into insensibility as well as a disinfectant.

Another choice was salicylic acid, the active ingredient in aspirin. Of course, it wasn’t aspirin. yet; the distilling of salicylic acid did not take place until late in the nineteenth center. No, it had to be used in its natural state. The leaves of the willow tree was steeped into a tea which was given to the patient as an analgesic. As a blood thinner and an anti-inflammatory, it is given to surgical patients and heart attack patients alike. It is still one of the most widely used medications in the world.

Finally, there were the opiates. The sap of the opium poppy has been used for millennia to treat pain. Of course, none of the stronger extracts had been distilled from the poppy until 1820 (morphine) and beyond.

One of the early methods of gaining the analgesic effects of the opium was to steep the straw into a tea. (I allude to this in Death in Salem with a character addicted to ‘straw tea’.) But the most common method of ingesting opium was as laudanum, a tincture of opium and alcohol. A reddish brown liquid, it was extremely bitter. By the early eighteen hundreds, laudanum was common and during the eighteen hundreds it became an ingredient in many patent medicines. It was frequently prescribed to women for menstrual cramps and various aches and pains. As might be expected, addiction was prevalent. Mary Todd Lincoln, Abraham Lincoln’s wife, was an addict. Another fun fact: nurses would spoon feed laudanum to the infants in their care to help them sleep. And if that doesn’t make your hair curl, I don’t know what will.

Laudanum is still available by prescription.

Our world of Tylenol and Ibuprofen seems almost like paradise in comparison.