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Laudanum is a tincture of opium containing approximately 10% powdered opium by weight (the equivalent of 1% morphine).〔Also labeled Tr. Opii, Tinctura Opii Deodorati, Tincture of Deodorized Opium, Opii tinctura. Tincture of Opium, U.S.P, "yields, from each 100 cc, not less than 0.95 gm and not more than 1.05 gm of anhydrous morphine". Source: ''The Pharmacopoeia of the United States of America''. 10th Decennial revision (U.S.P. X). Philadelphia, USA. J. B. Lippincott Company, 1925 (Official from January 1, 1926), page 400.〕 Reddish-brown and extremely bitter, laudanum contains almost all of the opium alkaloids, including morphine and codeine, and its high morphine concentration makes it a potent narcotic. Laudanum was historically used to treat a variety of ailments, but its principal use was as an analgesic and cough suppressant. Until the early 20th century, laudanum was sold without a prescription and was a constituent of many patent medicines. Today, laudanum is recognized as addictive and is strictly regulated and controlled throughout most of the world. Laudanum is known as a "whole opium" preparation since it historically contained all the opium alkaloids. Today, however, the 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 anti-propulsive 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 and theoretically in the United Kingdom, although today the drug's therapeutic indications are generally confined to controlling diarrhea, alleviating pain, and easing withdrawal symptoms in infants born to mothers addicted to heroin or other opioids. Recent enforcement action by the U.S. Food and Drug Administration (FDA) against manufacturers of paregoric and opium tincture suggests that opium tincture's availability in the U.S. may be in jeopardy. The terms ''laudanum'' and ''tincture of opium'' are generally interchangeable, but in contemporary medical practice the latter is used almost exclusively. == History == Paracelsus, a 16th-century Swiss-German alchemist, discovered that the alkaloids in opium are far more soluble in alcohol than water. Having experimented with various opium concoctions, Paracelsus came across a specific tincture of opium that was of considerable use in reducing pain. He called this preparation laudanum, derived from the Latin verb ''laudare,'' to praise. Initially, the term "laudanum" referred to any combination of opium and alcohol. Indeed, Paracelsus' laudanum was strikingly different from the standard laudanum of the 17th century and beyond. His preparation contained opium, crushed pearls, musk, amber, and other substances. One researcher has documented that "Laudanum, as listed in the ''London Pharmacoepoeia'' (1618), was a pill made from opium, saffron, castor, ambergris, musk and nutmeg".〔“''In the Arms of Morpheus: The Tragic History of Laudanum, Morphine, and Patent Medicines''”, by Barbara Hodgson. Buffalo, New York, USA. Firefly Books, 2001, page 45.〕 Laudanum remained largely unknown until the 1660s when English physician Thomas Sydenham (1624–1689) compounded 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.〔 By the 18th century, the medicinal properties of opium and laudanum were well known. Several physicians, including John Jones, John Brown, and George Young, the latter of whom published a comprehensive medical text entitled ''Treatise on Opium'' extolled the virtues of laudanum and recommended the drug for practically every ailment.〔 "Opium, and after 1820, morphine, was mixed with everything imaginable: mercury, hashish, cayenne pepper, ether, chloroform, belladonna, whiskey, wine and brandy."〔“''In the Arms of Morpheus: The Tragic History of Laudanum, Morphine, and Patent Medicines''”, by Barbara Hodgson. Buffalo, New York: Firefly Books, 2001, page 104.〕 As one researcher has noted: "To understand the popularity of a medicine that eased -- even if only temporarily -- coughing, diarrhoea and pain, one only has to consider the living conditions at the time". In the 1850s, "cholera and dysentery regularly ripped through communities, its victims often dying from debilitating diarrhoea", and dropsy, consumption, ague and rheumatism were all too common.〔''In the Arms of Morpheus: The Tragic History of Laudanum, Morphine, and Patent Medicines'', by Barbara Hodgson. Buffalo, New York: Firefly Books, 2001, pages 44-49.〕 By the 19th century, laudanum was used in many patent medicines to "relieve pain ... to produce sleep ... to allay irritation ... to check excessive secretions ... to support the system ... () as a soporific".〔''Licit & Illicit Drugs'', by Edward M. Brecher and the Editors of Consumer Reports. Boston, USA. Little, Brown and Company, 1972. See chapter 1, "Nineteenth-century America-a 'dope fiend's paradise'", pages 3-7.〕 The limited pharmacopoeia of the day meant that opium derivatives were among the most effective of available treatments, so laudanum was widely prescribed for ailments from colds to meningitis to cardiac diseases, in both adults and children. Laudanum was used during the yellow fever epidemic. Innumerable Victorian women were prescribed the drug for relief of menstrual cramps and vague aches. Nurses also spoon-fed laudanum to infants. The Romantic and Victorian eras were marked by the widespread use of laudanum in Europe and the United States. Mary Todd Lincoln, for example, the wife of the USA president Abraham Lincoln, was a laudanum addict, as was the English poet Samuel Taylor Coleridge, who was famously interrupted in the middle of an opium-induced writing session of ''Kubla Khan'' by a "person from Porlock".〔See Dr. Anne Beidler's ''The Addiction of Mary Todd Lincoln'' Laudanum was used in home remedies and prescriptions, as well as a single medication. For example, a 1901 medical book published for home health use gave the following two "Simple Remedy Formulas" for "dysenterry" : (1) Thin boiled starch, 2 ounces; Laudanum, 20 drops; "Use as an injection (as an enema ) every six to twelve hours"; (2) Tincture rhubarb, 1 ounce; Laudanum 4 drachms; "Dose: One teaspoonful every three hours." In a section entitled "Professional Prescriptions" is a formula for "diarrhoea (acute)": Tincture opium, deodorized, 15 drops; Subnitrate of bismuth, 2 drachms; Simple syrup, 1/2 ounce; Chalk mixture, 1 1/2 ounces, "A teaspoonful every two or three hours to a child one year old." "Diarrhoea (chronic)": Aqueous extract of ergot, 20 grains; Extract of nux vomica, 5 grains; Extract of Opium, 10 grains, "Make 20 pills. Take one pill every three or four hours."〔''Medicology or Home Encyclopedia of Health'', by Joseph G. Richardson. New York, Philadelphia and London: University Medical Society, 1901, pages 1276 and 1282.〕 The early 20th century brought increased regulation of all manner of narcotics, including laudanum, as the addictive properties of opium became more widely understood, and "patent medicines came under fire, largely because of their mysterious compositions".〔''In the Arms of Morpheus: The Tragic History of Laudanum, Morphine, and Patent Medicines'', by Barbara Hodgson. Buffalo, New York, USA. Firefly Books, 2001, page 126.〕 In the US, the Food and Drug Act of 1906 required that certain specified drugs, including alcohol, cocaine, heroin, morphine, and cannabis, be accurately labeled with contents and dosage. Previously many drugs had been sold as patent medicines with secret ingredients or misleading labels. Cocaine, heroin, cannabis, and other such drugs continued to be legally available without prescription as long as they were labeled. It is estimated that sale of patent medicines containing opiates decreased by 33% after labeling was mandated.〔Musto, David F. (1999 (3rd edition)). ''The American Disease: Origins of Narcotic Control''. Oxford University Press. ISBN 0-19-512509-6. https://books.google.com/?id=7VrQy2d8PxYC.〕 In 1906 in Britain and in 1908 in Canada "laws requiring disclosure of ingredients and limitation of narcotic content were instituted".〔 The Harrison Narcotics Tax Act of 1914 restricted the manufacture and distribution of opiates, including laudanum, and coca derivatives in the US. This was followed by France's ''フランス語:Loi des stupéfiants'' in 1916, and Britain's Dangerous Drugs Act in 1920.〔 Laudanum was supplied to druggists and physicians in regular and concentrated versions. For example, in 1915, Frank S. Betz Co., a medical supply company in Hammond, Indiana, advertised Tincture of Opium, U.S.P., for $2.90 per lb., Tincture of Opium Camphorated, U.S.P, for 85 cents per lb., and Tincture of Opium Deodorized, for $2.85 per lb.〔''Frank S. Betz Co. 1915 Catalog No. N-15''. Second edition. Hammond, Indiana, USA. Frank S. Betz Co., page 320.〕 Four versions of opium as a fluid extract were also offered: (1) Opium, Concentrated (assayed) "For making Tincture Opii (Laudanum) U.S.P. Four times the strength of the regular U.S.P." tincture, for $9.35 per pint; (2) Opium, Camphorated Conc. "1 oz. making 8 ozs. Tr. Opii Camphorated U.S.P (Paregoric)" for $2.00 per pint; (3) Opium, Concentrated (Deodorized and Denarcotized) "Four times the strength of tincture, Used when Tinct. Opii U.S.P. is contraindicated" for $9.50 per pint, and (4) Opium (Aqueous), U.S.P., 1890, "Tr. (assayed) Papayer Somniferum" for $2.25 per pint.〔''Frank S. Betz Co. 1915 Catalog No. N-15''. Second edition. Hammond, Indiana, USA. Frank S. Betz Co., page 318.〕 In 1929–30, Parke, Davis & Co., a major US drug manufacturer based in Detroit, Michigan, sold "Opium, U.S.P. (Laudanum)", as Tincture No. 23, for $10.80 per pint (16 fluid ounces), and "Opium Camphorated, U.S.P. (Paregoric)", as Tincture No. 20, for $2.20 per pint. Concentrated versions were available. "Opium Camphorated, for U.S.P. Tincture: Liquid No. 338" was "exactly 8 ''times the strength of Tincture Opium Camphorated (Paregoric)'' (in original ), U.S.P., "designed for preparing the tincture by direct dilution," and cost $7 per pint. Similarly, at a cost of $36 per pint, "Opium Concentrated, for U.S.P. Tincture: Liquid No. 336", was "four times the strength of the official tincture", and "designed for the extemporaneous preparation of the tincture".〔''1929–1930 Physicians' Catalog of the Pharmaceutical and Biological Products of Parke, Davis & Company'', pages 87-88.〕 The catalog also noted: "For quarter-pint bottles add 80c. per pint to the price given for pints." Toward the middle 20th century, the use of opiates was generally limited to the treatment of pain, and opium was no longer a medically accepted "cure-all". Further, the pharmaceutical industry began synthesizing various opioids, such as propoxyphene, oxymorphone and oxycodone. These synthetic opioids, along with codeine and morphine were preferable to laudanum since a single opioid could be prescribed for different types of pain rather than the "cocktail" of laudanum, which contains nearly all of the opium alkaloids. Consequently, laudanum became mostly obsolete as an analgesic, since its principal ingredient is morphine, which can be prescribed by itself to treat pain. Until now, there has been no medical consensus on which of the two (laudanum or morphine alone) is the better choice for treating pain. In 1970, the US adopted the Uniform Controlled Substances Act, which regulated opium tincture (Laudanum) as a Schedule II substance (currently DEA #9630),〔http://www.justice.gov/dea/pubs/scheduling.html, visited July 31, 2010). Also under Schedule II are opium extracts, opium fluidextract, opium poppy (''Papaver somniferum''), granulated opium, powdered opium, and raw or gum opium, each with an individual DEA number.〕 placing even tighter controls on the drug. By the late 20th century, laudanum's use was almost exclusively confined to treating severe diarrhea. The current prescribing information for laudanum in the US states that opium tincture's sole indication is as an anti-diarrheal, although the drug is occasionally prescribed off-label for treating pain and neonatal withdrawal syndrome. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「laudanum」の詳細全文を読む スポンサード リンク
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