In 1895, doctors had a surprisingly wide arsenal of headache treatments, though most would look alarming by modern standards. The toolbox included coal-tar derivatives, bromide salts, morphine, cannabis, mercury compounds, and a newly emerging treatment from a fungus called ergot. Aspirin, the drug that would eventually dominate headache treatment, didn’t exist yet. It wouldn’t be synthesized until 1897 or reach the market until 1899.
Coal-Tar Analgesics: The Painkillers of the Era
The closest thing to a modern over-the-counter painkiller in 1895 was a class of drugs derived from coal tar, a byproduct of the booming industrial age. Three dominated headache treatment: antipyrine, acetanilide, and phenacetin. The Industrial Revolution had made mass production of these chemicals possible, and they became widely used across the United States and Europe for headache relief.
These drugs worked as fever reducers and pain relievers, filling roughly the same role that ibuprofen or acetaminophen fills today. Phenacetin, in fact, is a chemical relative of acetaminophen (Tylenol), which would eventually replace it. But in 1895, doctors prescribed these coal-tar derivatives freely, often in combination with other substances, without a full understanding of their long-term toxicity. Acetanilide in particular turned out to damage red blood cells and was eventually abandoned. Phenacetin lasted much longer before being pulled from markets in the 1980s for causing kidney damage.
Bromides and Sedatives
Potassium bromide was one of the most popular headache remedies of the late 19th century. Originally used as an anticonvulsant for epilepsy, it had a strong sedative effect that doctors believed helped with recurring headaches. As early as 1872, the physician Samuel Wilks had championed potassium bromide for sick headaches, claiming “it can scarcely be superseded by a better remedy.” By 1895, it remained a go-to prescription.
Chloral was another sedative in the mix, producing hypnotic and sleep-inducing effects. Doctors frequently combined several drugs into a single mixture for stubborn headaches. One famous example was Gowers’ Mixture, developed by the prominent neurologist William Gowers. It contained nitroglycerin, sodium bromide, a plant extract called gelsemium, strychnine, and chloroform. That combination stayed in clinical use remarkably long, all the way into the 1970s.
Morphine, Laudanum, and Opiates
For severe headaches, especially migraines, doctors in 1895 could and did turn to morphine. Injected morphine (then called “morphia”) was available, and laudanum, a liquid mixture of opium dissolved in alcohol, was widely accessible. That said, even physicians of the time recognized these drugs had serious drawbacks. Some doctors noted that morphine and other opiates were “perfectly valueless” as a permanent cure for migraine and offered little lasting relief in most cases. The unpleasant side effects of opium were well known, which partly drove interest in alternatives.
Cannabis as a Headache Remedy
Cannabis held a legitimate, respected place in Western medicine during this period. It had been part of the pharmacopoeia for headache treatment since the 1870s and was highly regarded by some of the most prominent physicians of the era. Its use for headache traced back to an 1843 proposal by physician John Clendinning, who recommended Indian cannabis sativa as a favorable alternative to opium precisely because opium’s side effects were so troublesome. By 1895, cannabis was an established headache prescription and would remain one well into the 20th century, not leaving the Western pharmacopoeia for this purpose until the 1940s.
Ergot: The First Migraine-Specific Drug
One of the most significant developments in headache treatment was happening right around 1895. Ergot of rye, a fungus that grows on grain, was emerging as the first substance that appeared to specifically correct the disordered bodily processes behind migraines, rather than simply dulling pain or sedating the patient. In the United States, physician W.H. Thompson published the first accounts of using ergot extract for migraine in 1894 and 1895, though European doctors had experimented with it earlier.
This was a conceptual leap. Every other treatment in 1895 was essentially a broad painkiller, sedative, or nerve suppressant. Ergot seemed to target something specific about the migraine itself, likely by constricting blood vessels in the brain. Ergot derivatives would go on to become the standard migraine treatment for most of the 20th century, eventually refined into the drug ergotamine tartrate.
The Kitchen-Sink Approach
What stands out most about headache treatment in 1895 is how many substances doctors would try on a single patient. Medical records from London’s Queen Square hospital describe one woman named Annie who, before her admission, had already been treated with tonics, quinine, antipyrine, phenacetin, and bromides. Once admitted, her doctors prescribed her calomel (mercury chloride), potassium bromide, brandy, a proprietary preparation called migranin, nitroglycerin, morphine, and chloral in various mixtures over the course of several weeks.
This wasn’t unusual. Without a clear understanding of what caused headaches at a biological level, doctors cycled through available drugs looking for whatever brought relief. Many of these substances, including arsenic and quinine, were also tried and dismissed as useless. The trial-and-error nature of the process reflected a medical profession that had powerful chemicals at its disposal but limited knowledge of how or why they worked. The concept of evidence-based treatment selection was still decades away, and the line between a medicine and a poison was often a matter of dosage and luck.