A Manhattan is whiskey plus two medicines. The vermouth is a wormwood wine that physicians prescribed for stomach complaints, and the bitters were formulated by an army surgeon for soldiers with digestive trouble. A gin and tonic is a malaria prophylactic with the dose turned down. Coca-Cola went on sale as a headache cure, Pepsi as a digestive aid, and 7Up as a hangover remedy that happened to contain lithium.

For roughly three centuries, the people who sold drinks and the people who sold medicine were the same people, often standing behind the same counter. The drinks outlived the diseases, the cures, and in most cases any belief that they cured anything. What survived was the recipe.

Spirits as medicine

Whisky

Distillation reached European medicine before it reached European taverns. Taddeo Alderotti, a physician in Bologna in the late 1200s, described fractional distillation and called the result aqua vitae, “the parent and lord of all medicines.” The name was translated wherever the technique went. In Gaelic it became uisce beatha, and English speakers converted that to “whisky.” The first Scottish record of this is a line in the Exchequer Rolls for June 1, 1495, granting Friar John Cor eight bolls of malt to make aqua vitae for King James IV. A boll was a Scots dry measure, about six imperial bushels for malt, so the friar received roughly 48 bushels: more than a king’s medicine chest required.

Bitters and the first cocktail

The spirit was also the pharmacy’s solvent. Alcohol extracts the active compounds from dried herbs and keeps the result from spoiling, which is why the stomach remedies of the era were tinctures of bitter plants, such as gentian, wormwood, orange peel, and cinchona bark. In London around 1690, an apothecary named Richard Stoughton began advertising one, a gentian-based elixir with 22 claimed ingredients, meant to be dropped into wine, brandy, or beer to settle the stomach. In 1712, he received letters patent for it, the second medical patent ever issued in England.

The word “cocktail” was in print by 1798, in a London newspaper, with no explanation of what it meant. The earliest known definition appeared on May 13, 1806, in The Balance and Columbian Repository of Hudson, New York, after a reader wrote in to ask what the paper had meant by the word the week before. The editor’s answer: “a stimulating liquor, composed of spirits of any kind, sugar, water, and bitters.” Read as a recipe, that is a dose of bitters diluted with spirits and water and sweetened with sugar. The first cocktail on record is a medicine made drinkable.

Drinks from the navy and the army

Grog

In 1740, a Royal Navy sailor’s daily ration was half a pint of rum at 54.6 percent alcohol, handed over in a single issue. Vice-Admiral Edward Vernon, commanding in the West Indies, changed that on August 21 of that year. His order diluted each man’s half pint with a quart of water and split it into two servings, the first before noon and the second in the evening. The ration was unchanged. Spread over a day and diluted four to one, it was meant to keep the crew working instead of drunk. Vernon wore a cloak of grogram, a coarse silk and wool fabric, and his sailors called him Old Grog. The watered rum was named after him.

That order mentioned citrus: men who were “good husbandmen” could buy sugar and limes out of their own pay to make the mixture more palatable. Taste was the purpose. The connection between citrus and scurvy was demonstrated seven years later, in a 1747 trial aboard HMS Salisbury, and the Navy began issuing lemon juice in 1795. The Merchant Shipping Act of 1867 extended the requirement to merchant ships, and “limey” entered the language. Grog’s reputation as a scurvy remedy rests on a misreading of Vernon’s order. The rum ration itself lasted until July 31, 1970.

Gin and tonic

Europeans had been treating fevers with the bark of the Peruvian cinchona tree since the 1630s, and in 1820 two French chemists isolated its active ingredient, quinine. The British administration in India issued it daily as a malaria preventive. It is intensely bitter, and the lore is that officers cut it with sugar, lime, and gin. Tonic water as a product came in 1858, when Erasmus Bond of London patented carbonated water with quinine in it, and Schweppes brought out Indian Tonic Water in 1870. The earliest known printed mention of gin and tonic, in the Oriental Sporting Magazine in 1868, recommends it to spectators at a race meeting, so the medicinal pretext had already been dropped.

The dose has changed since then. A preventive dose of quinine was on the order of a gram a day. The US Food and Drug Administration caps tonic water at 83 milligrams of quinine per liter, so a modern drinker who wants the original dose would need about twelve liters of tonic daily, plus whatever gin seemed proportionate. The line attributed to Churchill, that the gin and tonic saved more Englishmen’s lives and minds than all the doctors in the Empire, appears nowhere in his published work.

Angostura bitters

The bitters in a Manhattan or an old fashioned were an army medicine. Johann Siegert, a German physician, served as surgeon-general in Simón Bolívar’s army and ran the military hospital in the Venezuelan town of Angostura. In 1824, he began selling an aromatic bitters there as a stomach remedy for the troops. His sons moved production to Trinidad in 1875, where it still is. The town was renamed Ciudad Bolívar in 1846. The old name survives on the bottle.

Vermouth and absinthe

Both are wormwood drinks, and wormwood was a stomach medicine for over two thousand years. Greek physicians around 400 BC steeped it in wine and prescribed the result for stomach complaints and intestinal worms. In 1786, Antonio Benedetto Carpano began selling a sweetened wormwood wine from a shop in Turin that looked like a pharmacy and served the court of Savoy. The German word for wormwood is Wermut, and Carpano’s drink became vermouth.

Absinthe is wormwood in distilled spirit rather than in wine, which makes it both stronger and more bitter. In the 1840s, the French army in Algeria issued it to soldiers as a fever preventive and water purifier, and soldiers returning to France kept drinking it. By 1910, France was drinking 36 million liters a year. The government banned it in 1915 as a cause of madness, a charge that modern chemical analysis of surviving pre-ban bottles does not support. The only drug in absinthe that did any harm was the alcohol.

Chartreuse

The Carthusian monks of France made the largest medical claim of any drink in this article: that theirs would extend life. In 1605, a French marshal gave the Carthusian monastery at Vauvert a manuscript recipe for an “elixir of long life.” It took the order until 1737 to work out how to make it, and the result, Élixir Végétal de la Grande-Chartreuse, is still sold in small bottles at 69 percent alcohol under the original medical claim. The monks released a drinkable version in 1764, 130 plants at 55 percent, which is the Green Chartreuse sold today.

Drinks from the drugstore

Soda water

In 1767, Joseph Priestley moved to Leeds and took a house next to a brewery, where he suspended bowls of water over the fermenting vats to absorb the carbon dioxide coming off them. His 1772 pamphlet proposed that the water might prevent scurvy at sea, and the Admiralty fitted apparatus to Captain Cook’s second voyage that year. It did nothing for scurvy. Apothecaries sold it anyway, and that is how soda water entered commerce: as a failed cure with a good reputation. Jacob Schweppe put the process into production in Geneva in 1783 and opened a London factory in 1792. A 1798 advertisement offered his soda water in three strengths, recommended for “complaints of the kidney or bladder, the stone, acidity, indigestion and gout.”

The soda fountain was an American invention, patented in 1819, and it belonged to the drugstore from the start. Gustavus Dows, a druggist in Lowell, Massachusetts, introduced a marble-cased fountain in 1858 and sold them for $225 each (about $9,000 today) to more druggists than he could supply. By 1919, the United States had 126,000 soda fountains. Pharmacists ran them for the same reason they later ran photo counters: they already had the equipment and the foot traffic. A druggist owned a carbonator, compounded syrups all day, and had spent his career disguising the taste of medicine with sugar and fruit.

Phosphates

The pharmacy’s contribution to flavor was acid phosphate, which a Harvard chemistry professor named Eben Horsford began selling in 1868. Its trade cards recommended it for “Dyspepsia, Indigestion, Headache, Mental and Physical Exhaustion, Nervousness, Hysteria, Night Sweats of Consumption.” Soda fountains adopted it as a substitute for lemon juice, since a bottle of acid phosphate gave a drink the same tartness and never spoiled. A few drops in cherry syrup and soda water made the cherry phosphate, the standard fountain drink of the late 1800s. In the 1962 musical, The Music Man, set in 1912, Marian Paroo orders a strawberry phosphate in the soda shop with Professor Hill.

Coca-Cola

The model for the American cola was a French wine. Angelo Mariani, a Paris chemist, began steeping coca leaves in Bordeaux in 1863 and sold the result at 6 milligrams of cocaine per fluid ounce. Pope Leo XIII awarded it a Vatican gold medal, and Ulysses Grant drank it while writing his memoirs.

John Pemberton was an Atlanta pharmacist who had been a Confederate officer. A saber wound to the chest in April 1865 left him dependent on morphine, and he spent the next twenty years formulating remedies that might replace it. In 1885, he released Pemberton’s French Wine Coca, a copy of Mariani’s wine with kola nut added, aimed at veterans with “nerve” complaints. Then Fulton County voted itself dry on November 25, 1885, effective the following July, and Pemberton needed a version without wine.

He sold the first glass on May 8, 1886, at Jacobs’ Pharmacy, for five cents, as a “valuable brain tonic” and a cure for headache and nervousness. In its first year the drink averaged nine glasses a day. Sales came to about $50, and advertising cost $74. Each glass carried roughly 9 milligrams of cocaine, which stayed in the formula until 1903. Pemberton sold off his shares in pieces and died in August 1888. Asa Candler had sole control by 1891 for a cumulative outlay of about $2,300.

The federal government’s complaint, when it came, was that the drink contained too little of the drugs its name promised and too much of one it did not mention. In 1909, agents seized a shipment of syrup in Chattanooga, and the case went forward under the name United States v. Forty Barrels and Twenty Kegs of Coca-Cola. The charges were adulteration, for added caffeine, misbranding, and for containing almost no coca or kola. The company settled in 1917 by cutting the caffeine roughly in half.

Dr Pepper

Dr Pepper came from a pharmacist at Morrison’s Old Corner Drug Store in Waco, Texas, in 1885, a year before Coca-Cola. Customers ordered it as a “Waco.” The store’s owner renamed it, and the company’s own museum says it does not know why. “Dr” was a stock prefix on patent medicines, and the early advertising reads like one: the drink “aids digestion and restores vim, vigor, and vitality.” In the late 1920s the company hired a Columbia University physiologist whose research located energy slumps at 10:30, 2:30, and 4:30, and ran “Drink a bite to eat at 10, 2, and 4” for the next forty years. The period after “Dr” was dropped in 1950.

Pepsi

In New Bern, North Carolina, a pharmacist named Caleb Bradham began serving “Brad’s Drink” at his fountain in 1893, and renamed it Pepsi-Cola on August 28, 1898. The name alludes to pepsin, the digestive enzyme, and early ads called it “The Pepsin Drink” and promised that it “Aids Digestion.” Sugar speculation ended Bradham’s company. He bought heavily when the wartime price spiked from 3 cents a pound to 28, the price fell back to 5, and he declared bankruptcy on May 31, 1923. The assets sold for $30,000.

Moxie

A physician in Lowell, Massachusetts, began selling a bitter carbonated drink in the mid-1880s as “Moxie Nerve Food.” The advertising claimed cures for “paralysis, softening of the brain, nervousness, and insomnia,” and said it would “check the rum thirst.” The active ingredient was gentian root, the same bitter that had been in Stoughton’s elixir two centuries earlier, and the drink’s origin story (a South American plant discovered by a Lieutenant Moxie) was fiction. The slang sense of “moxie” is recorded by 1925, and Maine made the drink its official state soft drink in 2005. Moxie remains a regional favorite in New England.

Root beer

A Philadelphia pharmacist named Charles Hires sold a sassafras and sarsaparilla “blood purifier” called root tea, then renamed it root beer to appeal to working men who would not order tea. It came as a 25-cent packet of dry extract that made five gallons, and Hires advertised it as “the temperance drink.” The medicinal ingredient was later banned. In 1960, the FDA banned safrole, the main flavor compound in sassafras, after it produced liver tumors in rats. Modern root beer is flavored with safrole-free extract and wintergreen.

Ginger ale

Ginger has better medical evidence behind it than any other ingredient in this article. A 2015 Cochrane review of 41 trials concluded that ginger may relieve nausea, though it called the evidence limited and inconsistent. Nothing else here has even that. The drink’s history is mostly a history of taking the ginger out. English ginger beer in the 1700s was fermented and could reach 11 percent alcohol. A Belfast apothecary named Thomas Cantrell produced the first ginger ale in the 1850s, and a Toronto pharmacist, John McLaughlin, introduced Canada Dry Pale Ginger Ale in 1904, lighter and drier than the Belfast style, which made it the standard mixer for Prohibition gin. Most ginger ale sold today lists ginger only as “natural flavor.”

7Up

In St. Louis in 1929, a lemon-lime soda went on sale with lithium citrate as its selling point. The name on the label was “7Up Lithiated Lemon Soda.” Ads pitched it for hangovers, said it “takes the ouch out of grouch,” and recommended it “for hospital or home use.” The federal government forced the health claims off the label in 1936, and “Lithiated” was dropped from the name in 1937, apparently because lithium was no longer in the formula. An Australian psychiatrist published the first paper on lithium for mania in 1949, and the FDA approved it in 1970. The soda company removed the drug a dozen years before psychiatry adopted it.

Regulation, then Prohibition

The end of the patent medicine business began with a magazine series. On October 7, 1905, Collier’s began an eleven-part series called “The Great American Fraud,” and on June 30, 1906, the Pure Food and Drug Act was signed. The act required labels to disclose alcohol, morphine, opium, cocaine, heroin, and cannabis. It did not ban false cure claims. That took the Sherley Amendment of 1912, and the Harrison Narcotics Act of 1914 ended the sale of coca wine.

Fourteen years later, Congress returned whiskey to the drugstore. The Volstead Act, in force from January 1920, exempted liquor “for medicinal purposes when prescribed by a physician.” The limit was one pint per patient every ten days, written on a Treasury Department form that could be used once. A prescription cost about $3, and the pharmacist charged $3 or $4 more to fill it. A 1921 amendment cut the dose to half a pint and capped each doctor at 100 prescriptions per 90 days, which did little to stop a Detroit physician who wrote 475 in a single day. The historian Daniel Okrent estimates 11 million prescriptions a year through the decade. Walgreens had 20 stores in 1919 and about 400 by 1930. The company credits the malted milkshake, introduced in 1922. Okrent credits the whiskey.

The tonic shelf today

Pharmacists are still inventing drinks. A Newcastle pharmacist formulated Glucozade in 1927 as a glucose drink for convalescents, and Beecham sold it through chemists for fifty years under the slogan “Lucozade aids recovery.” In 1983, the company relaunched it with “Lucozade replaces lost energy,” and UK sales tripled to about £75 million by 1989. In Japan, Taisho Pharmaceutical launched Lipovitan D in 1962, and it could be sold only in drugstores until 1999. A Thai imitation, Krating Daeng, appeared in 1976, and its Austrian licensee launched Red Bull on April 1, 1987.

In eastern Massachusetts, a soda is still called a tonic.