Panic over “symptomatuc refief” for throat problems

A report published in the national press in January suggests that panic is spreading through theatreland because of a shortage of Sanderson’s Throat Specific Mixture, a product that has been popular with actors, singers and other performers for a century and a half.

According to Amazon and dozens of other websites, the Sanderson’s concoction provides “symptomatuc refief” (sic) for sore throats, hoarseness, loss of voice and catarrh. Even respected pharmacy companies such as Weldricks refer to “symptomatuc refief” rather than “symptomatic relief”.

Sanderson’s Throat Specific Mixture was devised 150 years ago by GC Sanderson, a Manchester pharmacist who built up a business he called Theatrical & Dispensing Chemists. His throat product became popular with music hall stars such as Dame Nellie Melba and has maintained a reputation among thespians and vocalists ever since, including the distinguished tenor Plácido Domingo.

Apparently, a hacking cough has recently been sweeping the entertainment world, creating a soaring demand for Sanderson’s — just as one of its key ingredients has developed supply problems. More than 60,000 bottles are on order and the product’s current manufacturer, Infohealth, is struggling to bring new supplies to market. Dwindling stocks have led to a black market, and 200ml bottles that normally sell for around £4 are reportedly changing hands online for up to ten times the list price.

The current supply problem derives from a shortage of quassia wood, even though the Sanderson’s formulation contains just a tiny 0.0078ml of quassia liquid extract in each 5ml dose. Quassia has long been used as a bitter tonic. It supposedly has antibacterial and antifungal properties, although clinical trials have failed to prove its efficacy.

The main ingredient of Sanderson’s is acetic acid (the basic element of vinegar), at a concentration of 37.5mg in 5ml (0.75% w/v). At this strength, acetic acid is mildly antiseptic, with broad spectrum activity against streptococci, staphylococci, pseudomonas, enterococci, etc.

Another Sanderson’s component is capsicum, with 5ml of the mixture containing 0.025ml of capsicum tincture. Capsicum has long been used in gargles for throat irritation or infection, although it seems that it has never been evaluated comprehensively for effectiveness or safety.

Other ingredients include liquid extract of squill, with 0.025ml in each 5ml dose. Squill has an extremely bitter taste. It has for centuries been used as an expectorant, despite possible adverse cardiovascular activity. Another use is as a rat poison.

Although aimed mainly at theatrical performers, Sanderson’s Throat Specific Mixture has attracted a reputation beyond the world of entertainment — at least in Mr Sanderson’s Manchester, where I was raised. When I developed a sore throat as a young child my father persuaded me to gargle with the concoction. Decades later, I am still traumatised by the experience, which involved a burning sensation in my throat followed by extremely unpleasant bitter and sour tastes. I was so scarred by the incident that, as a youngster, I never again admitted to having a sore throat.

But if I had trained as an actor or singer rather than a pharmacist, perhaps I, too, would now be panicking about the product’s current supply problems.

Last updated
Citation
The Pharmaceutical Journal, February 2017;Online:DOI:10.1211/PJ.2017.20202352