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Coughs can range from a mild inconvenience to a chest-racking nuisance. But a deep dive into what people have used to treat them over the years may have you raising your eyebrows.

More than a hundred years ago, cough syrups were an unregulated industry, which meant manufacturers could (and did) add just about anything to their cough remedies.

From morphine to chloroform, keep reading to find out more about these suspicious syrups — and what manufacturers now use to treat a cough.

Cough syrups and tinctures have some very interesting beginnings. The following are some ingredients you may have found in cough syrups a hundred or more years ago.

Opium

Opium is a drug produced from the opium poppy plant, and it provides the chemical structural basis for many narcotic pain medications in use today. It’s not a new drug. Ancient Egyptians were known to trade opium. In the late 1800s, Americans used opium-laced cough syrups.

Another name for opium-containing ingredients in cough syrups is “laudanum,” which parents gave babies to reduce teething pain.

Of course, there weren’t any strict labeling laws regarding medications in the late 1800s to early 1900s. In 1906, Congress passed the Pure Food and Drug Act, which required manufacturers to disclose the ingredients in their products.

Shortly thereafter, more legislation and regulation regarding opium made this a (thankfully) less popular addition to cough syrups and other medications.

Morphine

Morphine is an opiate derived from the poppy plant. It was used to treat pain, particularly after the Civil War, when veterans used morphine to relieve pain from their injuries.

Morphine was also added to medications like cough syrups as a cough suppressant. Parents gave morphine-laced syrups to treat diarrhea in children, as constipation is one of the known side effects of opiates.

Heroin

Heroin is a drug made from morphine, which is made from the opium poppy. Like its poppy predecessors, manufacturers added heroin to cough syrups as a cough suppressant.

In 1895, German drug manufacturer Bayer released its latest cough syrup, which they sold under the brand name “Heroin.” While hard to believe, this cough syrup was marketed as a safer alternative to morphine in the treatment of ailments.

Chloroform

While chloroform is often featured in mystery novels to make unsuspecting victims lose consciousness, this common chemical was used for many years in cough medications and as an anesthetic. Old cough syrups such as Kimball White Pine and Tar Cough Syrup contained chloroform as a treatment for cough.

The Food and Drug Administration (FDA) outlawed the use of chloroform in medications in 1976, when research revealed chloroform increased cancer risks and could cause fatal respiratory and cardiac arrest.

One Night Cough Syrup

It may be the mother of all dangerous cough syrups. “One Night Cough Syrup” was sold in the late 1800s, and it contained alcohol, cannabis, chloroform, and morphine.

This mixture was available over the counter and promised to eliminate your cough in one night so you could sleep. With that combination of ingredients, it’s no wonder people lost consciousness fast.

Healthline

Understandably, cough syrups that contained narcotics (opium, morphine, and heroin) proved some of the most dangerous ones.

Narcotic medications act on the central nervous system in different ways. In addition to interrupting pain signal transmissions, they’re also thought to act on the brainstem as a way to suppress the urge to cough. However, doctors don’t know exactly how this mechanism works in the brain or body.

These early cough syrups could prove addictive and deadly if a person took too much. They contained medications that are now either illegal to use or used in very controlled environments.

Cough syrups are still available today, although thankfully with better-researched ingredients and labeled packaging.

Some cough products sold over the counter can still have potentially harmful side effects when used other than as directed, so it’s important to know how they work and why they’re prescribed.

Dextromethorphan (DXM)

This cough suppressant is available in over-the-counter cough medications. You may be surprised to find that DXM is an opioid. However, it doesn’t have pain-relieving effects, just cough-reducing ones.

DXM taken in large doses can cause a hallucinogenic effect, according to the National Institute on Drug Abuse. This means that DXM has some potential for addiction and misuse. Some people even mix it with alcohol or use it with marijuana to increase their high.

Promethazine-codeine

Promethazine-codeine is a cough syrup available only by prescription. Codeine is an opioid that can help suppress cough, yet it’s not as strong as morphine or heroin.

This cough syrup mixture can be a source of misuse, with some people mixing it with alcohol or taking it with other drugs.

Benzonatate

Benzonatate (Tessalon Perles) is a nonnarcotic medication available only by prescription to reduce cough.

The medication is structurally similar to local anesthetics, but doctors don’t know exactly how it works to reduce coughing. The “Perles” part of the medication is a good description: The medication looks like a yellow, pearl candy. For this reason, they must be kept out of reach of children, who may mistake them for candy.

Both DXM and promethazine-codeine are examples of medications that are effective when used as directed but dangerous when used in other forms. Using them for a short time in the smallest dosages possible is important to reducing unwanted side effects.

Other cough-reducing ingredients

These aren’t the only medications doctors may prescribe or recommend to treat cough. Some additional examples include:

These are all common ingredients in cough drops that may help to reduce cough.

Guaifenesin is another common ingredient in cough medications, but it’s an expectorant (it helps you cough up phlegm), not a cough suppressant.

A cough is the body’s natural reflex for eliminating harmful substances from your airways. However, there are several instances where coughs prove more harmful than helpful. This is often the case when you’ve been sick for a while, and the coughing makes your chest hurt and affects your ability to sleep.

It’s a good idea to see your doctor about your cough if it lasts for more than 3 weeks. Emergency symptoms that can come with a cough include:

  • coughing up blood, bile, or stool
  • severe chest pain
  • high fever

These symptoms warrant emergency medical attention. Otherwise, you should see a doctor any time your cough starts to interfere with your daily life or won’t seem to go away.

Cough syrups have very interesting beginnings. Today, they’re more tightly regulated, especially when it comes to prescription-strength cough medications.

It’s important to use cough medicine or supplements as directed. Failing to do so could result in side effects that can be much worse than a cough.