Pharmacology is still in its infancy in Elan. Doctors and pharmacologists regularly seek out new and promising medicines. Though many breakthroughs have happened, it is a slow progression. Part of this is because of the methods used to create and test medicines. Clinical trials are becoming widely used, but little is known about controlled testing and proper dosage.
Antibiotics do not yet exist, even though microbes are known about at this time. The main treatments for infections still revolve around folk medicine. Since the 1880s, a handful of pharmacologists have been examining the possibility of synthesized antibiotics, but nothing has come of their research yet. Some antiparasitics exist, such as santonin.
Painkillers are greatly important. Salicylic acid was created in the 1830s and was used as a treatment but caused some unfortunate side effects. It was used to create acetylsalicylic acid in 1853 and this is now more widely used as its side effects are much less severe. Paracetamol (also called acetaminophen) is being introduced but phenacetin is currently far more popular.
Many other medicines are being used, but other popular ones of note include cocaine and opium. Cocaine was widely used clinically as an anesthetic (though chloroform is greatly preferred) and stimulant. Opium was derived into morphine, then diamorphine (more commonly known as heroin), and administered for pain. Quite popular was laudanum, a tincture composed of opium mixed with alcohol. Cocaine, opium, and opium’s derivatives were not regulated at the time, and could be purchased at any pharmacy. This caused a great deal of addictions and many deaths.
Folk medicine is still practiced and offered in communities far and wide. Though more widely practiced in un-urbanized parts of Elan, there are still places in the cities and larger towns where this medicine can be sought out. Not everyone believes in the efficacy of these treatments, but they have been shown to be more effective than the “scientific” methods of the past. What many don’t know is that some medicine would not exist without folk medicine. For example, salicylic acid was only isolated through the study of white willow bark. Additionally, certain folk medicines seem to be very potent in the prevention and treatment of certain infections (burdock, cloves, echinacea, fennel, garlic, etc.). There may be skepticism, but there have also been great successes.
Several notable pharmacologists in Elan have made a point to collect folk medicines and test them in various ways. This has led, like the example of salicylic acid above, to several new medications. Some applaud science for these advancements, unaware of the misattribution of the credit. Some appreciate that modern medicine is finally catching up to the knowledge that folk medicine practitioners have had all along. But others greatly resent the implication of their medicines needing to be “legitimized” by scientific methods. After all, every successful finding of these pharmacologists is turning folk remedies into patented drugs - widely produced and vigorously marketed. Commodification now seems inevitable, just as stopping it seems impossible.
It is important to note that folk medicine is not to be confused with the charlatanry of patent medicines. For information on patent medicines, please read the article here.
Most treatments in the 1890s, as long as they follow the allowed RP in game and other lore, are active in Elan. Treatments in Elan ideally follow the following four principles: autonomy, justice, beneficence, and non-maleficence. However, these depend on the ethics of the medical practitioners, the available knowledge, and the available facilities or resources.
It is worth noting that not all treatments that are challenged in the modern day real world are contested in Elan. Medical situations that involve the autonomy of the patient are addressed with the utmost respect towards the decision of the patient, as per the Medical Code of Ethics. There is no situation in which the sovereignty of the patient over themselves is disregarded or politicized.