Monday, March 20, 2017

1889: The Carbolic Smoke Ball

A part of an 1892 advertisement for the Carbolic Smoke Ball
The years 1889 to 1891 brought an influenza pandemic to London that wasn't necessarily life threatening, although it caused a significant amount of suffering.    (3, page 73)

The cause of influenza was a mystery at this time, and this sort of fed into the fear of it.  There were also few (if any) laws regulating medicine in those days, so this allowed anyone to enter the market, even if there was no proof his product was effective.

A scared and suffering populace was more than eager to do anything to prevent and treat the disease.  This created a perfect market for the Carbolic Smoke Ball.

For much of the 19th century there were a variety of recipes for producing powders to be inhaled for a variety of ailments of the respiratory tract and face.  Physicians recommending these powders knew they had to be "pulverized and "kept dry" at all times.

Physicians also recognized that inhaling the powders made patients cough, and this often resulted in coughing up the medicine, and trouble breathing.  So there were continued attempts to perfect the delivery system for such powders.  One such attempt was made by Dr. Fredrick Roe in the late 19th century, and in 1899 he patented his attempt as the Carbolic Smoke Ball.  (1)

Carbolic Smoke Ball Ltd. was manufacturer and vendor of the product (3), and it was marketed in London as a remedy for influenza, and thus the aim was to capitalize on the influenza scare.  It was a "hollow ball of rubber, with a nozzle at the top."  The nozzle was inserted into one of your nostrils, and the ball was squeezed to produce a fine cloud of pulverized powder.  The patient would inhale the powder into his respiratory tract.  (3, page 73)

The product was marketed with the claim that anyone who used it at least "three times daily for two weeks" and contacted influenza to contact the company for an award, a sum of 100 pound sterling.  Although claims against the company (like this one and this one and this one) ultimately resulted in the withdrawal of the offer.  (2)

The following advertisement was in various newspapers in November of 1891:
"100£ reward will be paid by the Carbolic Smoke Ball Company to any person who contracts the increasing epidemic influenza, colds, or any disease caused by taking cold, after having used the ball three times daily for two weeks according to the printed directions supplied with each ball. 1,000?. is deposited with the Alliance Bank, Regent Street, •shewing our sincerity in the matter. 
"During the last epidemic of influenza, many thousand carbolic smoke balls were sold as preventives against this disease, and in no ascertained case was the disease contracted by those using the carbolic smoke ball.
"One carbolic smoke ball will last a family several months, making it the cheapest remedy in the world at the price, 10s. post free. The ball can be refilled at a cost of 5a. Address, Carbolic Smoke Ball Company, 27 Princes Street, Hanover Square, London."
One lawsuit claimed the following (4, page 257):
The defendants advertised that they would pay 100£to any person who contracted influenza after using their carbolic smoke ball for specified period in accordance with directions supplied.  The plaintiff bought and used a smoke ball for the period and in accordance with the direction, and afterwards contracted influenza: that the advertisement, coupled with the performance of the condition by the plaintiff, constituted a contract on the part of the defendants to pay the plaintiff 100£; that such contract was not of wagering character (sic)nor policy of insurance within (sic)and that the plaintiff as entitled to recover the 100£.
In this case, judgment was given to the plaintiff, and the defendant (the Carbolic Smoke Ball Co.) appealed. The appeal noted that there is no evidence the lady contracted influenza, no evidence she was the actual purchaser, and no evidence she used the product as recommended.  The appeal stated she could have claimed she developed influenza "twenty years after using the smoke ball.  The advertisement must be treated as a mere expression of intention, not as a promise." (4, page 257)

The medicine inside ball was not known, however, according to the 1898 book "The Medical World," the ball contained "310 grams of a gray powder, which upon snuffing up the nose caused violent sneezing, and their is an odor of smoke due to a tarry body. Upon an examination made in our laboratory by H.W. Snow, it was found to consist of (finely powdered) glycyyrhiza and flour and one of the veratrums, probably white hellebore. The smoky body is some tar product, not easy to say just which." (5, page 38)

"The Medical World" states the product, which sells for $2.50, may provide temporary relief of the listed ailments, but not permanent relief.  The book recommends the following technique for using the product:
Directions —Hold the ball about one-eighth inch below the silk floss, with the thumb and forefinger of the left hand, about one and one half inches below the nose, and directly in front of the mouth. Snap rapidly on side of the ball, but only on the place softened and marked, during each inhalation, with the middle finger of right hand, which will cause the smoke to arise. (5, page 38)
After its initial release, the product was marketed for an array of ailments, not limited to hay fever, colds, catarrh, asthma, bronchitis, sore throat, hoarseness, snoring, sore eyes, croup, diphtheria, whooping cough, headache and loss of voice.  The product hung around well into the 20th century.

Further offerings:
  1. Sanders, Mark, "Pioneers of Inhalation,", slideshow presentation, accessed on 11/13/12
  2.  Bisgaard, Hans, Chris O'Callaghan, Hans Bisgaard, Chris O'Callaghan, Gerald C. Smaldone, editors, "Drug Delivery to the Lungs," 2001, New York, Marcel Dekker, pages 15-18
  3. Pathak, Akhileshwar, "Legal Aspects of Business," 2007, New Delhi, Tata McGraw-Hill
  4. Witt, John George, Frederick Hoare Colt, editors, "The Law Journal Reports," 1893, London, F.E. Streetens, pages 256-266, "In the Court of Appeal: Carvill v. The Carbolic Smoke Ball Co." This is a specific review of one of the lawsuits against the company.
  5. Taylor, C.F., editor, "The Medical World," volume 16, 1898, Philadelphia, 

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