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Blue mass (also known as blue pill or pilula hydrargyri) was the name of a mercury-based medicine formerly common from the 17th to the 19th centuries. The oldest formula is ascribed to one Barbarossa, in a letter to Francis I of France.
Blue mass was used as a specific treatment for syphilis from at least the late 17th century to the early 18th. Blue mass was recommended as a remedy for such widely varied complaints as tuberculosis, constipation, toothache, parasitic infestations, and the pains of childbirth.
A combination of blue mass, and a mixture called the common black draught, was a standard cure for constipation in early 19th century England and elsewhere. It was particularly valued on ships of the Royal Navy, where sailors and officers were constrained to eat rock-hard salted beef and pork, old stale biscuits (hardtack), and very little fruit, fiber, or other fresh food once they were at sea for an extended period.
It was a magistral preparation, compounded by pharmacists themselves based on their own recipes or on one of several widespread recipes. It was sold in the form of blue or gray pills, or syrup. Its name probably derives from the use of blue dye or blue chalk (used as a buffer) in some formulations.
The ingredients of blue mass varied, as each pharmacist prepared it himself, but they all included mercury in elemental or compound form (often as mercury chloride, also known as calomel). One recipe of the period included (for blue mass syrup):
- 33% mercury (nearly one-third, measured by weight)
- 5% licorice
- 25% Althaea (possibly hollyhock or marshmallow)
- 3% glycerol
- 34% rose honey
Mercury is known today to be toxic, and ingestion of mercury leads to mercury poisoning, a form of heavy-metal poisoning. While mercury is still used in compound form in some types of medicines and for other purposes, blue mass contained excessive amounts of the metal: a typical daily dose of two or three blue mass pills represented ingestion of more than one hundred times the daily limits set by the Environmental Protection Agency in the United States today.
Use by Abraham Lincoln
It is well known that Abraham Lincoln used blue mass regularly, but there is debate over what ailment the medicine was intended to address. Historians most commonly state that Lincoln used blue mass in the treatment of constipation. Some historians suspect that Lincoln used blue mass to treat his "melancholy" (probably clinical depression). It may have been both, as it was commonly believed during the time period that problems of digestion, the failure of the liver to properly secrete bile, could lead to mental disorders. The following statement made by one of Lincoln's friends lends support to this theory,
Lincoln's melancholy never failed to impress any man who ever saw or knew him. The perpetual look of sadness was his most prominent feature. The cause of this peculiar condition was a matter of frequent discussion among his friends. His liver failed to work properly—did not secrete bile—and his bowels were equally as inactive. "I used to advise him to take blue-mass pills," related Stuart, "and he did take them before he went to Washington, and for five months while he was President, but when I came on to Congress he told me had ceased using them because they made him cross.
Lincoln's use of blue mass may have altered his behavior, and may explain the erratic behavior and violent rages to which he was subject over a period of years prior to the Civil War in the United States. Some historians believe that this explains the contrast between his earlier behavior (while he was perhaps suffering from mercury poisoning from his use of blue mass) and his later behavior during the war (after he had stopped taking blue mass), given that most of the effects of mercury poisoning are reversible.
There is, however, evidence that Lincoln continued to take blue mass. An interview given by his wife Mary Todd Lincoln to a correspondent from the Pittsburgh Chronicle suggests that Lincoln continued his use of the medication, despite his earlier statements to the contrary. In the interview Mrs. Lincoln described an instance in which her husband's "usual medicine", the mercury based "blue pills" made him terribly ill. Mrs. Lincoln "recalled the fact that her husband had been very ill, for several days, from the effects of a dose of blue pills taken shortly before his second inauguration." She said he was not well, and appearing to require his usual medicine, blue pills, she sent to the drug store in which Harrold was employed last and got a dose and gave them to him at night before going to bed, and that next morning his pallor terrified her. "His face," said she, pointing to the bed beside which she sat, "was white as that pillow-case, as it lay just there," she exclaimed, laying her hand on the pillow—"white, and such a deadly white; as he tried to rise he sank back again quite overcome!" She described his anxiety to be up, there was so much to do, and her persistence and his oppressive languor in keeping him in bed for several days; said he and she both thought it so strange that the pills should affect him in that way; they never had done so before, and both concluded they would get no more medicine there, as the attendant evidently did not understand making up prescriptions.
Unfortunately, since no hair samples from Lincoln during this period are available, it is impossible to determine whether or not he was truly suffering from mercury poisoning while he was taking the blue mass.
Other famous historical figures, such as Ulysses S. Grant, may also have taken blue mass regularly.
- Frazer, William. Elements of Materia Medica. Dublin, 1851, p. 173.
- Marten, John. A Treatise of the Venereal Disease. London, 1711, p. 630.
- King's American Dispensatory, 1898.
- Herndon's Lincoln: The True Story of a Great Life, by William Herndon and Jesse William Weik, Vol. III, The Herndon’s Lincoln Publishing Company, Springfield, Illinois, 1888, p. 588 fn
- Perspectives in Biology and Medicine, volume 44, number 3 (summer 2001):315–32
- Manier, Jeremy (17 July 2001). "For Lincoln, ancient cure worse than his malady". Chicago Tribune. Retrieved 14 April 2014.
- Sacramento Daily Union, Volume 29, Number 4497, 21 August 1865, Late Atlantic Intelligence