Sydenham's Laudanum: Opium as a Seventeenth-Century Remedy

When the short biographies of Thomas Sydenham (1624–1689) were written in the centuries after his death, they remembered him for three things. His nineteenth-century editor, Robert Gordon Latham, put it this way: the common accounts say “he was famous for (a) his laudanum, (b) his cooling treatment of the smallpox, and (c) his administration of the Peruvian bark in agues.” The first of those three was a medicine made from a plant — the opium poppy — dissolved in wine and flavoured with kitchen spices. “Sydenham’s laudanum” became one of the best-known preparations in English medicine, and his words in praise of opium are still quoted in histories of pain relief.

This page tells that story as history and pharmacology. It traces the poppy through ancient medicine, the word “laudanum” before Sydenham, what his liquid preparation contained and why he said he made it, the diseases in which he used it, and then what came after: the isolation of morphine by Friedrich Sertürner, the modern understanding of how opioids act on the body, the recorded harms — poisoned infants and widespread addiction — and the laws of the early twentieth century that ended the era of laudanum sold over the counter. Ingredients are named only in a general way; no quantities, methods or doses are given, and nothing here is guidance on use.

Table of Contents

  1. The Poppy in Ancient Medicine
  2. Laudanum Before Sydenham
  3. Sydenham’s Liquid Laudanum
  4. Convenience and Uniform Doses
  5. No Medicine of the Value of Opium
  6. Opium in His Casebooks
  7. From Poppy Juice to Morphine: Sertürner
  8. How Opioids Act on the Body
  9. Lethal Lullabies and Addiction: The Recorded Hazards
  10. Regulation and the End of Laudanum
  11. Key Research Papers
  12. Connections
  13. Featured Videos

1. The Poppy in Ancient Medicine

Opium is the dried milky sap of the opium poppy, Papaver somniferum — the species name means “sleep-bringing”. When the unripe seed capsule is scored, a white latex oozes out and darkens as it dries; that dried latex is raw opium. It is one of the oldest medicines in the written record. A Danish history of the opium poppy and morphine by Steffen Norn and colleagues follows it through the physicians and naturalists of antiquity: the Greek botanist Theophrastus, the army physician Dioscorides, the Roman encyclopaedists Pliny and Celsus, Galen in the second century, and, in the Islamic world, Avicenna (Ibn Sīnā).

These writers knew the poppy for two main effects that every later physician would also describe: it eased pain and it brought sleep. It was also used to check diarrhoea and to quiet coughing. Dioscorides, whose De Materia Medica was copied and consulted for some fifteen hundred years, separated the juice of the capsule from weaker preparations made by boiling the whole plant, an early recognition that the strength of a poppy medicine depended on how it was made. The same ancient sources also recorded that too much of it could cause a sleep from which the patient did not wake — the earliest form of the hazard that runs through the rest of this page.

By Sydenham’s time opium came to Europe chiefly from the eastern Mediterranean and beyond, as cakes of dried sap traded by apothecaries. It was expensive, its strength varied from one batch to the next, and it was eaten as a solid, rolled into pills, or dissolved into liquids. The problem of variable strength is the thread that connects the ancient herbals to Sydenham’s own reasons for making a liquid form.

Back to Table of Contents

2. Laudanum Before Sydenham

The word “laudanum” is older than Sydenham. It is associated with the Swiss-German physician and alchemist Paracelsus (1493–1541), who used the name for a prized remedy of his own. Historians have never settled exactly what Paracelsus’s laudanum contained; accounts written after his death describe pills containing opium among many other ingredients, while some scholars doubt that his original preparation contained opium at all. The origin of the word is also uncertain. It is often connected with the Latin laudare, “to praise”, and sometimes with ladanum, an aromatic resin of the rock-rose used by ancient perfumers and physicians.

What is clear is that, over the following century, “laudanum” came to mean a preparation of opium. Seventeenth-century pharmacopoeias and apothecaries sold a variety of opium compounds under that name and others, many of them solid pastes or pills crowded with extra ingredients in the old tradition of complex remedies. The great compound antidotes of antiquity, such as theriac, also contained opium. Sydenham inherited this situation: opium was already the central ingredient of a family of medicines, but they came in many forms of uneven strength.

Sydenham’s contribution was not to invent the name or to introduce opium to medicine. It was a particular, simpler liquid preparation, published under his name and adopted widely enough that “Sydenham’s laudanum” became a standard term in English and European pharmacy. The Paracelsus wing on this site tells the story of the older physician whose name the word first attached to.

Back to Table of Contents

3. Sydenham’s Liquid Laudanum

Sydenham set out his preparation in his book Observationes medicae (1676), in the chapter on the epidemic dysentery that struck London in the years 1669 to 1672. In the 1848 English translation published by the Sydenham Society, it appears as a “liquid laudanum”: opium dissolved in sherry wine, together with saffron, cinnamon and cloves, steeped and then strained. In other words, it was a tincture — a medicine in which the active substances of a plant are drawn out into an alcoholic liquid.

The other ingredients came from the same spice trade that brought opium. Saffron, the dried stigmas of the saffron crocus, had a long reputation of its own in the old materia medica and gave the liquid its deep colour. Cinnamon and clove were warming aromatics that physicians of the time added to many medicines, partly for their supposed virtues and partly to make a bitter drug easier to take. Opium on its own is intensely bitter. Sherry, a fortified Spanish wine, supplied the alcohol that dissolved the active parts of the opium.

This page deliberately gives no quantities, proportions or method beyond that outline. The original text includes amounts and drop counts — including for children — and they are omitted here. What matters historically is the form: a single liquid, made the same way each time, in place of a confusing range of solid opium compounds.

Back to Table of Contents

4. Convenience and Uniform Doses

Sydenham did not claim that his laudanum was stronger or more miraculous than opium itself. His stated reason was practical. In the Latham translation he writes: “I do not profess to consider that this form of laudanum has any advantage over the solid opium in point of strength. Its merit consists in being of a more convenient form, and more uniform in the action of its doses.”

That sentence anticipates one of the central problems of pharmacology. A plant medicine varies: the opium in one cake might be much richer in its active substances than the opium in another, and a pill made from a sticky paste is hard to divide evenly. A well-mixed liquid can be measured out in the same volume every time, so that each measure carries much the same amount of drug. For a physician who wanted to see what a medicine actually did — and Sydenham’s whole reputation rests on watching what happened to patients — a medicine that behaved the same way from one use to the next was a real advance.

The deeper solution came only when chemists could extract the pure active substances from the plant and weigh them. That step, taken by Sertürner more than a century after Sydenham’s death, is described below. In the meantime, a liquid of consistent make was the best available answer to the problem of variable strength, and it helps to explain why Sydenham’s version spread so widely.

Back to Table of Contents

5. No Medicine of the Value of Opium

Immediately after his recipe, Sydenham breaks off into one of the most quoted passages in the history of medicine. The 1848 Sydenham Society translation by Latham renders it: “And here I cannot but break out in praise of the great God, the Giver of all good things, who hath granted to the human race, as a comfort in their afflictions, no medicine of the value of opium, either in regard to the number of diseases that it can control, or its efficiency in extirpating them.”

He goes on to insist that the virtues of laudanum belong to the poppy, not to the person who prepares it. In Latham’s wording, all forms of opium come alike from the poppy, and their good effects are “the effects of its own natural virtue and excellence, and not due to any skill of any clever artificer whatever.” Then comes his strongest claim: “So necessary an instrument is opium in the hand of a skilful man, that medicine would be a cripple without it.” And he adds that “to know it only as a means of procuring sleep, or of allaying pain, or of checking diarrhoea, is to know it only by halves.”

A shorter, smoother English version of this praise — beginning with “all the remedies” it has pleased God to give — circulates widely in modern books and websites. That wording does not appear in the 1848 translation quoted here and seems to be a later paraphrase, so this page quotes only Latham’s text. The passage matters historically because it shows how a leading physician of the 1670s saw opium: not as a dangerous drug of last resort but as the most useful single remedy available to him, and a gift of nature rather than of the apothecary’s art. The hazards that later generations documented are set out in section 9.

Back to Table of Contents

6. Opium in His Casebooks

Sydenham’s books are built around diseases as he saw them in London, year by year, and opium appears throughout them. Its most famous setting is the one where the recipe itself is printed: the epidemic dysentery of 1669–1672, a severe bloody diarrhoea that killed many Londoners. In the seventeenth century the treatment of dysentery commonly included bleeding and purging; Sydenham used these too, as the physicians of his time did, and gave laudanum to quiet the gut and allow sleep. These are reported here as the practice of his century, not as a method.

He also wrote of opium in other bowel complaints, in the painful colics of his day, in vomiting, and in the conditions he grouped under “hysteric” and “hypochondriac” complaints — historical labels for a mixture of symptoms that would be described very differently today. He gave laudanum to children as well as adults; the doses he recorded are not reproduced here. Sydenham himself suffered from gout for more than thirty years, and the history of his own illness is told on the Life and Times page.

Historians who have written about his practice, including A. W. Sloan, describe a physician who learned from the bedside rather than from books, kept careful records, and yet used treatments that were largely traditional. Opium fits that picture. It was an ancient remedy; what was new was the precision with which Sydenham described the circumstances in which he used it and what he saw happen afterwards. His wider method of bedside observation is the subject of the Clinical Observation and Legacy page.

Back to Table of Contents

7. From Poppy Juice to Morphine: Sertürner

For more than a century after Sydenham, every opium medicine still depended on the raw plant sap, with all its variation. The change came from a young German apothecary’s assistant, Friedrich Wilhelm Adam Sertürner (1783–1841). According to the history by Michael Goerig and Jochen Schulte am Esch, Sertürner, at about the age of twenty-one, isolated the “sleeping agent” of the poppy as a crystalline substance and first reported it around 1805. He described it again, more fully, in 1817 and gave it the name by which it is still known — morphine, after Morpheus, the Greek god of dreams.

Sertürner’s work did far more than produce a new drug. He showed that a plant’s medicinal effect could come from a single, definite chemical substance — one that was alkaline, could form salts, and could be purified and weighed. Goerig and Schulte am Esch describe him as the founder of alkaloid chemistry. Within a few decades chemists had isolated a whole series of plant alkaloids, among them codeine from opium itself and, in 1820, quinine from the cinchona bark that Sydenham had also championed (see The Jesuits’ Bark).

In one sense morphine was the fulfilment of Sydenham’s own goal of a medicine “more uniform in the action of its doses”: a weighed amount of a pure substance replaced a measure of variable plant extract. In another sense it intensified the hazards. Purified morphine was far more potent, weight for weight, than raw opium, and the invention of the hypodermic syringe in the 1850s allowed it to be injected directly. The Norn history traces how morphine went on to dominate nineteenth-century pain relief and how, despite long effort, an opiate that relieves pain without the risk of addiction has remained elusive.

Back to Table of Contents

8. How Opioids Act on the Body

Sydenham knew what opium did; he could not know how. The explanation came in the twentieth century, when researchers found that the brain, spinal cord and gut carry specific receptors — protein switches on the surface of nerve cells — to which morphine and related drugs bind. The Norn history notes this characterisation of opioid receptors as the modern chapter of the poppy’s story. Opioid receptors were demonstrated in the early 1970s, and soon afterwards the body’s own opioid-like messengers, the endorphins and enkephalins, were discovered. The poppy, it turned out, works because its alkaloids imitate signalling molecules the body already makes.

The main receptor for morphine is called the mu-opioid receptor. When a drug binds to it, nerve cells become less excitable and release less of the chemical signals that carry pain messages. The same mechanism, acting in different places, accounts for the whole list of effects that physicians from Dioscorides to Sydenham observed:

Repeated use also brings tolerance (the same amount produces less effect) and physical dependence (stopping produces a withdrawal illness). These are properties of the receptor system itself, which is why every opium preparation, from the ancient poppy juice through Sydenham’s laudanum to purified morphine, has carried the same risks.

Back to Table of Contents

9. Lethal Lullabies and Addiction: The Recorded Hazards

The darkest part of the history concerns children. In a 2016 review titled “Lethal Lullabies”, the paediatric historian Michael Obladen traced the use of poppy extracts to quiet crying and sleepless infants across some three thousand years. He documented thousands of reported lethal intoxications in infants, and a trade in proprietary opium “soothers” sold to parents and nurses in the nineteenth century, often without any clear statement of what they contained. Infants are especially vulnerable to the breathing-suppressing effect of opioids. According to Obladen, the practice was curtailed only after the international opium agreement signed at The Hague in 1912. Sydenham himself gave laudanum to children; his doses are not reproduced on this page.

Among adults, laudanum became one of the most widely used medicines of the eighteenth and nineteenth centuries. Because it was cheap, legal and sold without prescription, it was taken for coughs, diarrhoea, pain, sleeplessness and low spirits, and it formed the hidden base of many patent medicines. Addiction followed. Some of the best-known cases were among writers: the essayist Thomas De Quincey described his own dependence in Confessions of an English Opium-Eater (1821), and the poet Samuel Taylor Coleridge was another well-documented habitual user. Behind the famous names were very large numbers of ordinary people whose dependence went unrecorded.

Purified morphine, and later the injectable forms made possible by the hypodermic syringe, added a new wave of dependence in the second half of the nineteenth century, including among wounded soldiers and among physicians and nurses with ready access to the drug. The pattern documented over these centuries — genuine relief of suffering on one side, poisoning and addiction on the other — is the same one that defines the debate over opioid medicines today (see Chronic Pain: History and Discovery).

Back to Table of Contents

10. Regulation and the End of Laudanum

For most of the two centuries after Sydenham, opium preparations were sold as freely as any other household remedy. Control came gradually and from several directions at once. In Britain the Pharmacy Act of 1868 placed opium among the substances that only registered pharmacists could sell and required labelling as poison. In the United States, the Pure Food and Drug Act of 1906 required patent medicines to declare certain ingredients, opium and morphine among them, on the label — a change that exposed how many “soothing” remedies were built on opiates.

Internationally, the International Opium Convention signed at The Hague in 1912 was the first treaty to bind nations to control the trade in opium, morphine and related drugs. Two years later, the United States passed the Harrison Narcotics Tax Act of 1914, which required those who produced, dispensed or prescribed opiates and coca products to register and pay a tax, and confined their supply largely to medical prescription. Similar laws followed in other countries after the First World War.

Under these laws, laudanum as an everyday shop remedy disappeared. Opium tincture survives in some pharmacopoeias as a strictly controlled prescription medicine, and morphine remains one of the essential medicines for severe pain, but the bottle of laudanum on the household shelf belongs to history. Sydenham’s preparation thus marks a turning point in a long arc: from the ancient poppy, through a seventeenth-century physician’s attempt at a reliable liquid, to purified alkaloids, receptor science and the modern system of drug control.

Back to Table of Contents

Key Research Papers

  1. Norn S, Kruse PR, Kruse E. [History of opium poppy and morphine]. Dan Medicinhist Arbog. 2005;33:171-84. PubMed PMID: 17152761
  2. Goerig M, Schulte am Esch J. [Friedrich Wilhelm Adam Sertürner--the discoverer of morphine]. Anasthesiol Intensivmed Notfallmed Schmerzther. 1991;26(8):492-8. PubMed PMID: 1786314
  3. Obladen M. Lethal Lullabies: A History of Opium Use in Infants. J Hum Lact. 2016;32(1):75-85. PubMed PMID: 26163533
  4. Dewhurst K. Thomas Sydenham (1624-1689) reformer of clinical medicine. Med Hist. 1962;6(2):101-18. PubMed PMID: 16562238
  5. Sloan AW. Thomas Sydenham, 1624-1689. S Afr Med J. 1987;72(4):275-8. PubMed PMID: 3303370
  6. Pearce JM. Thomas Sydenham "The British Hippocrates". J Neurol Neurosurg Psychiatry. 1995;58(3):292. PubMed PMID: 7897408
  7. Low G. Thomas Sydenham: The English Hippocrates. Aust N Z J Surg. 1999;69(4):258-62. PubMed PMID: 10327115
  8. King LS. Empiricism and rationalism in the works of Thomas Sydenham. Bull Hist Med. 1970;44(1):1-11. PubMed PMID: 4909172
  9. Bloch H. Thomas Sydenham, MD (1624-1689): the father of clinical observation. J Fam Pract. 1994;38(1):80-1. PubMed PMID: 8289057

PubMed Topic Searches

  1. Opium in the history of medicine
  2. Laudanum history
  3. Sertürner and the discovery of morphine
  4. Thomas Sydenham history

Further Reading

Back to Table of Contents

Connections