When You Could Sign for Opioids

 

In the context of Pocahontas County, West Virginia, "Mild Tincture of Opium"—more commonly known by the trade name Paregoric—holds a significant place in local Appalachian history. It was once a staple of the "family medicine chest" in the mountains, used for everything from infant colic to chronic coughs.¹

What is Paregoric?

Paregoric is a camphorated tincture of opium.² Historically, it was distinct from "Laudanum" (Tincture of Opium) because it was much weaker.³

• Composition: It contains approximately 0.4 mg/mL of morphine along with anise oil, benzoic acid, camphor, and glycerin in an alcohol base.⁴

• Medical Use: Historically, its primary use in Pocahontas County (and rural Appalachia) was as an antidiarrheal and a soothing agent for "fretful" children.

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Local Context: Pocahontas County & Appalachia

In the late 19th and early 20th centuries, medical care in Pocahontas County was often remote and self-administered.

• The "Soothing" Remedy: Because doctors were often a long ride away in Marlinton or Cass, mothers relied on paregoric. It was famously rubbed on the gums of teething babies or given in small drops to quiet crying infants.⁵

• The "Exempt Narcotic" Era: Until the Controlled Substances Act of 1970, paregoric was often sold "over the counter" (OTC) at local pharmacies without a prescription, provided the buyer signed a narcotics ledger.⁶ In many rural West Virginia counties, these "signature books" became a record of the community's dependence on the drug.

• The Transition to Regulation: As federal laws tightened, paregoric moved to Schedule III (and later Schedule II for the pure tincture). In Pocahontas County, the decline of paregoric marked a shift from traditional home-remedy culture to modern pharmaceutical regulation.

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Key Distinctions

It is critical to distinguish between the two types of opium tinctures, as confusing them has historically been fatal:

Feature	Paregoric (Mild Tincture)	Laudanum (Opium Tincture)
Morphine Content	$0.4\text{ mg/mL}$	$10\text{ mg/mL}$
Potency	1/25th as strong as Laudanum	Full strength
Historical Status	Often sold OTC (pre-1970)	Always required prescription
Color/Taste	Clear to honey-colored; anise (licorice) flavor	Dark reddish-brown; very bitter

Historical Records in WV

If you are looking for specific local history, the Preserving Pocahontas digital archive often contains mentions of old pharmacies (like the Marlinton Drug Store) where these ledgers were kept. Many older residents of the county still recall "Parepectolin" (a mix of Paregoric, Kaolin, and Pectin) which was the last common iteration of the drug used for stomach upsets.

Would you like me to look for specific historical pharmacy names or doctors in Pocahontas County who were active during the peak era of paregoric use?

In Pocahontas County, the use of Paregoric (Mild Tincture of Opium) was deeply intertwined with a small circle of dedicated country doctors and landmark pharmacies. During the "peak era"—roughly from the 1900s through the 1960s—the following names were central to the community's medical landscape.

Prominent Historical Pharmacies

The pharmacy was the community hub where Paregoric was dispensed, often from large glass carboys into small, amber personal vials.

• The Marlinton Drug Store: Located on Main Street in Marlinton, this was one of the most significant institutions in the county. It was not just a pharmacy but a publisher of local postcards and a gathering spot. It operated during the years when Paregoric was an "exempt narcotic," meaning it could be bought by signing a ledger.

• Pocahontas Drug Company (c. 1908): Housed in the historic Yeager Building in Marlinton, this pharmacy served the booming population during the height of the timber industry and the arrival of the railroad.

• The Cass Drug Store: Serving the company town of Cass, this pharmacy catered to the rugged workforce of the West Virginia Pulp and Paper Company. In isolated logging camps, "mild" tinctures were often the only accessible pain relief.

Notable "Country Doctors"

These physicians were known for "doing it all"—from delivering babies at home to performing surgery on kitchen tables. Their practices spanned the era when opium-based tinctures were standard treatment for gastrointestinal distress and coughs.

• Dr. Norman Price ("Doc Norman"): A legendary figure in Marlinton, he was famous for his tireless house calls. He practiced during a time when medical instruments were limited, and a bottle of Paregoric was a staple in his medical bag for treating "fretful" infants and summer diarrhea.

• Dr. Roland Sharp: Based in the "upper end" of the county (near Slaty Fork and Green Bank), Dr. Sharp was a beloved figure who practiced for decades. He represented the transition from old-world medicine to the modern era.

• Dr. James "Jim" Price: Brother to Doc Norman, he was part of a medical dynasty in the county that saw the rise and eventual regulation of opium-based home remedies.

• Dr. H.W. McNeel: An earlier practitioner in the Hillsboro area ("Little Levels"), whose era predated modern antibiotics, making tinctures like Paregoric essential tools for managing symptoms of serious illnesses like dysentery.

The "Signature Book" Era

In Pocahontas County, as in much of rural West Virginia, Paregoric was often sold without a prescription until the 1970 Controlled Substances Act.

• The Process: A customer would walk into the Marlinton Drug Store, request an ounce of "Paregoric," and the pharmacist would present a Narcotics Register.

• The Record: You had to write your name, address, the date, and the "intended use" (usually listed as "stomach ache" or "colic").

• The Culture: Many older residents still recall the distinct licorice (anise) smell of the medicine and the fact that it was one of the few items that required a "formal" signature in an otherwise informal mountain economy.

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Preserving the History

If you are looking for primary records (like old ledgers or medical bags), two local resources are invaluable:

1. The Pocahontas County Historical Society Museum: Located in the Frank and Anna Hunter House in Marlinton, it houses artifacts from these early medical practices.

2. Preserving Pocahontas: This digital archive often features photographs of the early interiors of the Marlinton Drug Store and Pocahontas Drug Company.

Would you like me to look for specific details on the "Narcotics Ledgers" or the specific pharmacists who ran the Marlinton Drug Store?