Early alienists typically believed that an insane person needed to eliminate something from the body in order to get well. Copious bleeding and/or purging were popular ways to deplete a maniac’s excessive energy or excitement, but many alienists soon came to believe the procedure was too extreme. Instead, they turned their attention to the bowels.
Samuel Woodward, former superintendent of the Massachusetts State Lunatic Hospital, wrote in 1846 that it was “common for the bowels to be constipated in mania,” and advised a round of laxatives to help solve the problem. He also urged that these laxatives be gentle, but unfortunately turned to poisonous mercurial compounds to do the job. A popular concoction was “blue pill” which was generally a mixture of about one-third mercury, one-third rose oil, and small proportions of licorice, milk sugar, and possibly another quarter portion of hollyhock or marshmallow derivative. Two or three of these pills might represent close to a hundred times the level of exposure that the EPA considers safe today.
Mercury poisoning usually shows up first with headache, nausea, stomach pain, and later, with sore gums and loose teeth. Eventually, symptoms move on to the brain and cause loss of memory and insomnia, and often irritability, depression, and paranoia as well. Since the alienist’s goal for his patient was a daily evacuation of the bowels, patients could take something like calomel or blue pill for quite some time. And, the psychological type of symptoms as a result of mercury poisoning might well keep the sufferer both in an asylum and taking the medicine indefinitely.