"Rush's Thunderbolts" -- And I'm Not Talking About Limbaugh

"You two go behind those bushes, quick!"

Heard a radio segment about this, and had to check it out.  It seems Lewis and Clark took with them, among scads of provisions, hundreds of "Rush's Bilious Pills".  Constipation while seeking the Northwest Passage was simply not to be tolerated. And with mercury (mercury!) as an active ingredient, your constipation was blown right out of you, along with an internal organ or two.

Rush's Thunderbolts, indeed!

Rush's Bilious Pills

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American-made from imported ingredients — One significant medicine was not imported—the famous Bilious Pills of Benjamin Rush. (They were actually anti-bilious pills. A patient was said to be "bilious" when supposed poor flow of bile in the body caused a complex of symptoms including constipation, headache, and lassitude.)

Dr. Rush had expressly indicated to Lewis that when one of his men showed the "sign of an approaching disease . . . take one or two of the opening pills." Nicknamed "Rush's Thunderbolts," the pills were reputed to contain 10 grains of calomel and 10 to 15 grains of jalap, both potent laxatives. By opening up the bowels, Rush believed that the body would then expel the excess bile or other matter causing illness. (With active ingredients weighing at least 1295 mg, these would have been large pills indeed. A common aspirin tablet
weighs 5 grains or 1/4 the weight of the "thunderbolts.")¹

milder version of Rush's Pills remained an official compound until the 1940s. Here is the recipe for Compound Mild Mercurous Chloride Pills that appeared in the 1946 edition of the National Formulary (Washington, DC: American Pharmaceutical Association, 1946). This "mild" formula was nontheless a big gun, combining four purgatives of slightly differing qualities. Early 19th-century physicians regarded jalap as "active" and "rapid." Gamboge, from Cambodia, was a "drastic" and "powerful" purge. Calomel (mercurous chloride) was believed to stimulate the liver and the gall bladder, although the opposite was true. Colocynth, or bitter apple, from India and Saharan Africa, was termed a "drastic" and "powerful" purge. According to the United States Dispensatory2 of 1918, the compound extract of colocynth "combined with calomel, extract of jalap, and gamboge, . . . forms a highly efficient and safe cathartic, especially useful in congestion of the portal circle and torpidity of the liver." By the 1960s, newer drugs and concerns about heavy metal poisoning led to the disappearance of mercury compounds for internal use. Only a few external mercury-containing antiseptics remained into the 1990s.