Candy Medication — A Reader’s Guide

HISTORICAL INTRODUCTION.

THE IDEA of presenting medicine in candy form is really very old. The term confection, which originally meant a medicinal compound being derived from the Latin word "_conficere_," to put together, has been applied since the days of classical antiquity to mixtures of medicinal substances with saccharine matter. The only official relics of this once very extensive class of preparations are the confection of rose and the confection of senna; both of which, however, are also practically obsolete. The reason for this is not difficult to find. Neither of them come up to our modern ideas of a confection. We may officially call them a confection, but a youngster would be disrespectful enough to disagree with the pharmacopoeia.

More closely akin to candy are lozenges, and yet they are not real candy. The only one among them that is pleasant is the santonin lozenge; and it is the only one that is popular. An especially good imitation of candy form are the deservedly popular so-called German worm lozenges. It was acquaintance with these that led the writer to seek for other real candy medicaments. He could find only two such upon the market: viz., Calomel Tablets under the name of "Aromatic Calomel," and Phenolphthalein Tablets under various fanciful trade-names, such as "Purgen," "Phenolax," etc., unless "Candy Cathartic Cascarets," and the French candy laxative known as "Tamar Indien" were also to be included.

Convinced that administration in candy form would be ideal for children, the author took a number of years ago a course of instruction with a candy-maker, in the hope of finding in the confectioner's art some new form of pleasant administration for medicine. He made sulphur taffy and cod-liver oil chocolate creams;[1] but these and a large number of other attempts were unsuccessful. It may be of interest, in this connection, to note that, in 1911, Sir James Sawyer[2] published in "The Lancet" a process for the production of what he calls "cremulae" or medicated chocolate creams. They were prepared by evaporating a mixture of sugar and of milk to the consistency of paste, in which various medicaments might be incorporated, and which is then covered with chocolate, as in the popular chocolate drop. This is, as will be seen, a troublesome process. The author's studies in the candy shop seemed to point to "fondant" as the most suitable candy form for purposes of medication. "Fondant", however, has the disadvantage of becoming hard with age. Free from this objection and closely similar to the "fondant" is a rather lightly compressed tablet made of finely powdered cane sugar. And so finally the tablet form was chosen as the best and most convenient for candy medication--a form which was already in successful use, as has been stated, for the administration of calomel and of phenolphthalein. For such tablets the term _tabellae dulces_,[3] or sweet tablets, might be proposed.

TO BE SUCCESSFUL, sweet tablets must meet the following requirements:

1. They must be perfectly delicious sweets, attractive in form, color, and odor; and free from the slightest suspicion of disagreeable or medicinal taste.

2. They must disintegrate rapidly in the mouth; for a sick child will usually not suck candy as a healthy youngster would.

3. To constitute a real advance in therapeutics, it must be possible for the average pharmacist to prepare them extemporaneously, so that the physician may be able to fit the medicament to suit the case, and that the pharmacist may not be forced to carry in stock a large assortment of these more or less perishable goods.

In view of these exacting requirements, it may seem remarkable that over fifty different medicaments are at present available for administration in the form of sweet tablets. This has been accomplished by taking advantage of the fact that some medicines are practically tasteless; that modern synthetic chemistry has enriched our resources in this direction by the production of a large number of tasteless, or almost tasteless, and yet active substances; and that many of the isolated active principles of drugs are easily disguised. In some cases a chemical trick is successful, e. g., using a little alkali or a little acid to render the substance less soluble in the mouth. Some of the bitterest alkaloids, e.g., strychnine, have been rendered available for candy medication by the use of finely powdered fuller's earth, or of Lloyd's Reagent, to be described later. Quite a number of almost insoluble substances of slight but lingering taste can be made perfectly pleasant by saccharinization.

THE USES OF SWEET TABLETS.