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Western pharmacology underwent a profound transition in the last half of the millennium. Previous to the Renaissance, medicines were derived simply from natural ingredients, which had more-or-less known effects on diseases. After modern scientific methods and reasoning became widespread, medicine moved to the use of purified chemicals from various sources, along with empirical determination of their effectiveness. The 1800's were caught in the dead center of this, with various physicians and pharmacists swearing by any number of untested and often unsafe "scientific" treatments. Add the advent of mass communication to this, and you end up with ample opportunity for unashamed quacks to be confused with physicians offering more medically sound treatments.

The once widely used medication known as Blue Mass is a perfect example of this. It was recommended variously as a treatment for dysentery, constipation, syphilis, malaria, gonorrhea, melancholia, worms, tuberculosis, toothache, and more. To be fair, it probably was equally effective for all of those diseases -- which is to say, not effective at all.

Oh, and the important part: It's active ingredient was calomel, HgCl, a chloride salt of everybody's favorite way to get heavy metal poisoning, the element mercury. In other words, it was a placebo (at best) that happened to be deadly poisonous.

Blue Mass preparations varied between pharmacists, coming in either solid pills or a liquid form. Generally the bulk of the preparation was some kind of buffering agent, as mercury chloride is a powerful emetic at most any dosage, and of course a medicine should stay down for it to be effective. Chalk was a common buffering agent, and one line of reasoning guesses that the drug's name was due first to blue chalk being used in the preparation. Flavoring agents were common in liquid variants, and it is likely that some pharmacists added blue dye to make the product distinctive.

I was able to find one complete recipe for the liquid form, taken from one Dr. Jack Welsh's Medical Histories of Union Generals. It is:

Abraham Lincoln used Blue Mass as a treatment for his depression (known as melancholy at the time) before being elected president. During the 1850's, in particular, Lincoln's affliction became worse and worse, and was known along the legal circuit he traveled as a lawyer. Outbursts of rage happened irregularly, in at least one occasion leading to a physical attack upon another person in the courtroom. Insomnia, tremor, and bizarre behaviour also occurred, all symptoms of mercury poisoning. In 1861, after his inauguration as president, he stopped taking the medication and his symptoms disappeared, replaced by the patience that would mark his presidency. As a side note, Ulysses S. Grant is known to have taken the drug; no doubt plenty of other figures of the time did as well.

To test whether Lincoln was actually suffering from mercury's effects, researchers formulated Blue Mass pills for assay. They used the ingredients licorice root, rose water, honey, sugar, rose petals, and mercury chloride, which were commingled in a mortar-and-pestle and rolled out on a pill shaper befitting the period. Grey, peppercorn-sized pills were the result, each of which contained about 65 mg of mercury. The assay showed that with the usual daily dose of two or three pills, the patient would receive a bit less than 9000 times the currently accepted daily mercury exposure allowance.

Treatments for Syphilis were understandably much in demand at the time, and Blue Mass was used for that as well. Specifically, it could be gargled for mouth sores, applied in a wash for eye inflammation, and painted on to open sores on the skin. One moralistic saying of the time, an encouragement for soldiers to abstain from visiting prostitutes, went "An evening with Venus -- a lifetime with Mercury.”

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