Mysterious powder no longer a treatment for asthma

DEAR DR. ROACH: Back in the early 1930s, I had asthma. My dad had asthma all his life. When either of us had an attack, my dad would use a powder called Green Mountain Powder. He would set fire to some of the powder, and we would inhale the smoke. It worked very well.
       You could buy it in powder form and cigarettes, over the counter. Then later you had to have a prescription for it.
       I went to see a doctor sometime in 1980. While I was waiting for him to come in the room, I smelled an odor. When he came in, I asked him what that odor was. He said that it was a paper that you could set fire to that smelled like marijuana. It was used to educate people to the smell. I told him that the odor smelled like Green Mountain Powder. He didn’t know about Green Mountain Powder. A pharmacist told me that Green Mountain Powder was a hallucinatory drug. What is Green Mountain Powder? Is it marijuana? — J.M.
       ANSWER: The Green Mountain Asthma Cure began in 1869, when Dr. J.H. Guild of Rupert, Vermont, formulated dried leaves of stramonium and belladonna (not marijuana), intended to be a treatment for asthma when smoked. Stramonium leaves (also called “devil’s snare”) contain atropine, which does have some activity against asthma. In higher doses, it can be hallucinogenic. It is not as effective as modern treatments for asthma, and inhaling smoke of any kind can worsen asthma.
       Medications intended to be smoked were quite common in the late 19th and early 20th centuries. Green Mountain Powder was popular through the 1950s until it was banned in 1985. Other people have noted that Green Mountain Powder smelled much like marijuana.
       DEAR DR. ROACH: My mom’s doctor decided that at 95, she needs to have a memory retention test, after many years of my saying that her short-term memory was getting much worse. His assistant tested her, and said she falls into the “high moderate” range, where the limits are Superior, Medium, Moderate and No Memory (can’t recall the correct word). He put her on Donepezil HCL 5 mg, and I have to take her to his office every two weeks for a vitamin B-12 shot. Is this regimen supposed to stop the progression of the memory loss? Does it work, or is this just a “Medicare charge”? It’s been two weeks, and the only thing Mom has is an upset stomach! I think the memory is just getting worse. Any suggestions? — T.H.
       ANSWER: Donepezil (Aricept) is a treatment for dementia — usually Alzheimer’s disease, although it is sometimes used for other types of dementia. Although it is used frequently, its effectiveness is modest. It slows down the progression of disease somewhat in most people, and about 10 percent of people have a significant improvement. Two weeks is not long enough to determine whether the medication is working. Most experts recommend a six-month trial. Unfortunately, stomach upset is a common (as high as 20 to 30 percent) side effect that sometimes limits the ability to use this medication. Her doctor is likely to redo the memory test when she returns, and that information, along with reports from the family on effectiveness and side effects, will determine whether to keep her on the medication.
       READERS: The booklet on Alzheimer’s disease gives a detailed presentation of this common illness. Readers can obtain a copy by writing:
       Dr. Roach
       Book No. 903
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       Orlando, FL 32803
       Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.
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       Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at 628 Virginia Dr., Orlando, FL 32803. Health newsletters may be ordered from www.rbmamall.com.
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