For this installment of Med Op-Ed, we neglected to set our search parameters to 2026 and wound up looking back 50 or 100 or more years. We’ll update our query next time, but until then, let’s review: David Ferrier’s, MD, 150-year-old formula for cold relief (and a bit more), a call for humility in the practice of preventive medicine, and one doctor’s concerns about the use of informed consent.

Bismuth-Morphia Snuff Quells Sniffles Rapidly? (1876)

Topical trisnitrate of bismuth, combined with acacia powder and a small dose of morphia hydrochlorate, inhaled as a snuff at the earliest signs of coryza and repeated to maintain mucosal coating, may rapidly alleviate nasal catarrh, according to a report from Ferrier, assistant physician to King’s College Hospital, London, England, writing in The Lancet.

The Context

• Ferrier devised the formula upon feeling the onset of cold symptoms with a public speaking engagement looming the next day.
• He found that the snuff worked better than his usual regimen of “sudorifics and lying in bed” and subsequently recommended the treatment to others, including a student who described the relief as magical, with symptoms resolving in one evening.
• Although the snuff can be taken “in the ordinary manner from between the thumb and forefinger,” using a small gutter of paper or snuff spoon may be more efficacious and less wasteful, Ferrier suggested.

In Their Own Words

“Though a cold in the head gives rise to much discomfort and uneasiness, it is not usually considered grave enough to necessitate professional advice, and the unfortunate victim of nasal catarrh, with watery eyes, running nostrils, sneezing, and nasal speech, is more often regarded as a subject of ridicule rather than of sympathy or commiseration.”

Read it: How to Cure a Cold in the Head (PDF). April 8, 1876.

Preventive Medicine: Don’t Be Overconfident (1926)

A string of successes in preventing diseases such as smallpox and typhoid fever may lead to overconfidence among medical professionals, so clinicians must recognize the limitations of what is known about other diseases such as hypertension and cancer, according to an editorial in The Boston Medical and Surgical Journal (soon to be known as The New England Journal of Medicine).

The Context

• Efforts to control diseases caused by animal parasites, including hookworm disease, malaria, and amebic dysentery, have been effective, and significant progress has been made in managing acute bacterial diseases such as typhoid fever and diphtheria.
• Still, preventive strategies are lacking for pneumonia and the common cold, and vague notions of “hygienic living” are insufficient for preventing conditions such as arteriosclerosis and hypertension, the editorialists wrote.
• Cancer and diabetes are on the rise, and despite advancements in treatment, their prevention remains a challenge.

In Their Own Words

“The things which today we think might be of value from a preventive standpoint may be discredited by the knowledge of tomorrow.”

Read it: The Limitations of Preventive Medicine. April 22, 1926.

Does Informed Consent Hamstring Physicians? (1976)

“Informed consent” is a legalistic redundancy and often unworkable; genuine consent should mean physician and patient “think together,” with information tailored to the context rather than ritualized forms, according to Eugene G. Laforet, MD, writing in JAMA.

The Context

• A legal obligation to disclose all relevant information can be detrimental to patient care if it causes undue apprehension; some commercially available consent forms have detailed catastrophic complications in excruciating detail.
• In experimental situations, true informed consent is unattainable because the outcomes are unknown.
• Physicians should calibrate the depth of information they provide to the urgency of the situation, according to Laforet.

In Their Own Words

“In the final analysis, regardless of whether society or the medical profession or the law wants it that way, the best and probably only guarantee of a patient’s or subject’s rights is the integrity of his physician.”

Read it: The Fiction of Informed Consent. April 12, 1976.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.