The Mysterious Heroin Pills for Smoking


In the 1920's and 1930's a very peculiar use of drugs sprang up in the Far East, grew to enormous proportions, and spread to the United States and other countries, before it partially died down again. This was the use of "red pills" or "heroin pills" in lieu of smoking opium.


Pages: 49 to 54
Creation Date: 1953/01/01

The Mysterious Heroin Pills for Smoking

In the 1920's and 1930's a very peculiar use of drugs sprang up in the Far East, grew to enormous proportions, and spread to the United States and other countries, before it partially died down again. This was the use of "red pills" or "heroin pills" in lieu of smoking opium.

These pills were strange mixtures, generally containing such ingredients as heroin, caffeine, a cinchona alkaloid (quinine, cinchonine, or cinchonidine), strychnine, and aspirin or salicylic acid, mixed with starch, cane sugar or milk sugar (lactose), a delicate perfume, and a little dye to colour the pills. They were commonly coloured red or pink, but sometimes black, yellow, or simply dingy white. They were smoked, not in the usual opium pipe, but usually in a vase specially adapted to the purpose. Their effect was much disputed then, and is still highly mysterious.

It is said that the first seizure of those pills took place in Shanghai in 1921, and that at first they were taken by mouth, as a "general tonic," rather than being smoked. However, they were extensively smoked within a few years.

In 1925 a sensational article appeared in the North China Daily News (Shanghai) concerning the new pills, in which it was stated that 5,000 ounces of strychnine and 2,000 pounds of caffeine were being imported into China each month for the manufacture of so-called "anti-opium pills" containing heroin. The general formula was given as follows: Heroin hydrochloride 2 oz. 2 drachms, strychnine nitrate ? oz., quinine sulfate 1 oz., caffeine 5 oz., milk sugar 48 oz., refined sugar 16 oz. With gum and water to "mass" this made about 10,000 pills of about 4? to 5 grains each.

The newspaper article stated: "It is true that as an 'anti' opium pill, the new product serves its purpose. It does in most cases lead to the abandonment of opium, but for the reason that the new 'smoke' is more attractive, more potent in its effect as a stimulant, and, in its effect on the system of the smoker, more deadly." An expert estimated that "the average life of an addict to the new habit can only be about four years." This opinion was one extreme; other experts have been unable to see how the pills could have any effect at all--as will be related later.

The International Anti-Opium Association at Peking, China, called the attention of the League of Nations to the situation. It was mentioned that "(This) is not the type of morphia pill used by the average Chinese addict, who has changed from opium to morphine. The latter pill is simply a mixture of morphia and household flour, and is crude in both form and manufacture." It was shown that imports through the Customs at Shanghai amounted to 48,236 pounds of caffeine and 2,701 pounds of strychnine in 1923, and 22,234 pounds of caffeine and 1,304 pounds of strychnine in 1924-almost all supposed to have been used in the manufacture of heroin pills.

J. F. Macfarlan and Co., a British drug house, had been making large shipments of strychnine nitrate to China, but at this time, learning of the use to which it was put, discontinued all sales of both strychnine and caffeine to China.

The general formula given by the North China Daily News--and on the whole it was confirmed later by actual analyses--indicated that approximately 20,500 pounds of heroin--10? tons--must have been used in 1923 just to make these pills. As the seizures of heroin coming into China in 1923 had totalled nearly a ton, an illegal importation of more than 10 tons seemed quite possible. (However, in later years the proportion of heroin to caffeine in the pills was generally lower than was assumed in this calculation.)

In 1923 there was so little effective control over narcotics that this and other huge amounts of heroin escaping from control had probably been manufactured "legitimately" in Europe. After the 1925 Convention went into effect (in 1928), such diversion was rapidly reduced. The narcotics dealers, however, began to manufacture heroin illicitly in China itself (and in other countries), and the use of the "heroin pills" continued to spread.

In 1926 Dr. Knaffl-Lenz of Austria was asked to examine some of the pills for the League of Nations. He reported that they weighed about 0.25 gramme each, and contained 2.76 per cent heroin, 0.69 per cent strychnine nitrate, 1.38 per cent quinine sulfate, and 6.87 per cent caffeine, with some 66 per cent lactose and 22 per cent cane sugar. His experiments on the smokes "showed that in the combustion of smoking opium, as much as 15 per cent of the morphine contained in the opium passed into the smoke, but that in the combustion of anti-opium pills neitherstrychnine norheroin norquinine passes into the smoke; (but the smoke) contains up to 40 per cent of the caffeine content of the pills." (O.C.341(c)).

Dr. Knaffl-Lenz added that "The serious injury to the health of chronic smokers, said to result after a few years in death, is not on the face of it explicable .... The effect of the smoke is primarily due to caffeine."

The first seizures of such pills in Hong Kong took place in 1928. These pills contained 2 milligrammes of heroin each, and were otherwise composed of lactose with caffeine and traces of strychnine; coloured pink, and about the size of a pea. It was said that they could be bought in Shanghai at the price of $14 per bag of 10,000 pills, and could be sold in Canton at $20 per bag. The retail price was said to be one cent per pill. In 1928, the seizure in Hong Kong totalled about 200,000 pills. (O.C.862).

A "pipe" for smoking these pills was described as "cleverly constructed out of a small porcelain vase, into the neck of which a bamboo tube had been inserted, a hole being drilled in the side of the vase to hold the pill."

An advertising leaflet of one of the pill manufacturers (described as the "Nan Yang Medicine Manufactory'') was obtained in one of the seizures. In translation it read as follows:

"It is hereby announced that I have studied medicine for over ten years and have spent several years of painstaking work in inventing "CHAN LENG TAN," one of the most efficacious of medicines. Its healing power is rapid and its effectiveness surpasses that of all other medicines. Since it was put on sale it has been welcomed by all classes of people and has been confidently used far and near. It is unanimously applauded and said to be the best medicine in the world. Letters and telegrams of praise have been pouring in and as a consequence the business prospers day by day.

"Now, since people's honesty at the present day is not like it was in former days, and men's hearts are growing worse every day, there are numerous imitations. Among the imitators there are some who have no idea of the nature of medicine and are 'selling fish eyes as pearls,' giving the buyer no chance of distinguishing them. Such action is indeed highly to be resented. Considering that to deceive people with adulterated medicine is to injure their health, customers are earnestly requested to be careful in selecting the genuine goods so as to avoid being deceived.

"In view of the above, the proprietor has specially improved the packing and added more ingredients to the preparation as from the fifth moon of the year Ting Mau (1927), in order to stamp out the imitation medicine and to extend his business. This announcement is made specially. Gentlemen, if you are in doubt, please give us a trial and you will be convinced of the truth of our words." (O.C.862).

Such concern for the customers would almost convince one of the notion, suggested in another connexion, that the illicit drug dealers mix quinine with their heroin to protect the addict from malarial infection, sometimes transmitted by use of a common needle!

In the Annual Reports of China from 1928 to 1932 there was mention of the seizure of red pills, white pills, yellow pills, heroin pills, narcotic pills, strychnine, and caffeine. The appearance of the two last in lists of seized narcotics is often not understood.

The Government of China was so occupied with more serious narcotics problems that there is not much in the Annual Reports of China about the pills. Most of the available information comes from Shanghai and Hong Kong.

The Annual Report for 1932 of the Shanghai International settlement (O.C./A.R.1932/5), called attention to "extensive addiction to so-called red pills," and said, "They are probably smoked more than prepared opium, especially among the poorer classes, who cannot afford to smoke the latter. The effect of the pills is similar to indulgence in opium, but is more harmful.'' The analyses showed morphine rather than heroin but this was probably due to hydrolysis of the heroin to morphine during analysis.

In 1933 a League of Nations document communicated some interesting information from Macao and Hong Kong. (O.C. 1498).

The Government of Macao reported the following about the method of smoking and the effects:

"Heroin pills are not swallowed but smoked; for this some paraphernalia is required--but it is, as the inquiries show, of a very simple and rudimentary kind.

"One of the most usual methods in Macao is to employ a small china jar in which a little hole has been made of the same size as the pill. A tube, generally of bamboo, is then placed in the mouth of the jar through which the smoke passes. One pill after another is set in the hole and brought up against the flame of a small oil lamp.

"The smoker, putting the tube to his lips and holding the jar in position, inhales the smoke caused by the slow combustion of the pill, until the pill is spent.

"Sometimes, instead of a jar, small china flasks are employed such as are used in China to contain Chinese wine. These flasks have a spout through which the wine flows, but as this spout is either curved or slanting, the pill cannot be placed therein. The smoker therefore breaks off the spout at its base, and places the pill in the small hole remaining. He then proceeds to smoke the pill in the manner explained above.

"Heroin pills produce a much more harmful effect on the physical condition of smokers than opium pills. The heroin-pill smoker's face is practically fleshless, and his strength decreases proportionately as his habit obliges him to consume an ever greater number of heroin pills .... The mental effects are practically the same as those produced by opium. Smokers say that they feel well and happy as long as the kind of torpor produced by the narcotic lasts."

The report from Hong Kong contained the following information, which as will be noted is precisely contrary to that from Macao so far as the effect of the pills is concerned:

"It appears that the smoking of red pills is becoming popular amongst the respectable merchant class, for three heroin divans have been discovered recently. The divans are said to charge $2 per 100 pills if sold for smoking off the premises, but a small fee only for smoking on the premises. The number of pills smoked is said to vary from 5 to 10.

"The Monopoly Analyst has conducted some experiments using the proper type of pill-pipe, and drawing air through by means of a filter pump. He has found that all the heroin which is not consumed in the flame is deposited With a brown tarry sugary matter inside the vase which is used to form the bowl of the pipe, and that no traces of heroin can be found in the smoke which passes over and could enter the mouth of the smoker. In the pill-divans the inside of the vase is occasionally cleaned of this tarry matter, which is chiefly the result of the burning of the sugar of milk contained in the pills. The use the divans make of this residue is at present unknown. These pills have been given to confirmed opium smokers to smoke and they all report that they are dissatisfied with the result; it has in fact no result whatever and they say it is 'a very dull smoke' compared with opium. The smoke produced is different from that of opium, and smells of burnt sugar. Acetic acid is produced fairly freely: this would come from the decomposition of the aspirin contained in the pills; the amount produced by the decomposition of the heroin would be very small indeed. The result of the experiments is to throw a doubt on the usefulness of heroin in the pill magma. Probably only a careful and continued medical examination of an addict smoking a certain number of pills a day would reveal whether there is really any narcotic effect produced by smoking these pills."

Slightly later information was that "The usual dose at one smoking is 10 to 20 pills and a heavy smoker can smoke up to 500 in one day. The bags of 1000 cost $10.00 each in Shanghai." The Annual Report of Hong Kong for 1933 (O.C./A.R. 1933/53) stated, "In several cases smokers in opium divans were found smoking pills which, on analysis, proved to contain no substance usually classed as a narcotic. These pills, which were generally a very pale pink in colour, and more roughly made than the genuine kind, were found always to contain caffeine as their chief con- stituent, together with quinine, cinchonine, aspirin, or strychnine. The number of cases in which they were found being smoked in opium divans suggested the question whether caffeine was not the chief ingredient demanded by the smoker, and heroin a refinement unnecessary for the unsophisticated."

Another Hong Kong report of 1933 (O.C.1498(a)) mentioned the finding of black pills. These "had the appearance of the old-fashioned 'anti-opium pill' which was in common use many years ago, and was composed chiefly of opium dross." But these pills were found to be "ordinary heroin pills" only dyed black. This was considered unusual as "the word 'RED' has come to mean in ordinary Chinese HEROIN pills." The Annual Report of Hong Kong,(O.C./A.R. 1933/53) also mentioned these black pills and said, "Presumably the alteration in colour was with the idea of passing them off as ordinary Chinese medical pills, many of which are black."

At this time it was also mentioned that the pills contained very imperfectly acetylated heroin, so that the narcotic content was actually, in part, unconverted morphine.

Also in 1933 the Shanghai Municipal Police reported the seizure of some 48,000 ounces of "Opium substitutes (red, grey, and white pills)" an enormous increase over 1932, when some 7,000 ounces of such pills were seized. (O.C./A.R.1933/3).

In 1934 a report from the Shanghai Municipal Council gave some details about the manufacture of pills (O.C.S.205).

"The method of manufacture of heroin pills is comparatively simple and is usually carried out by ignorant workers under the direction of the clandestine manufacturer.... The pill mass is rolled and cut on an ordinary hand pill machine such as is used in any pharmacy and the pills are rounded by hand. They are then dried, either on trays in stands heated by a common earthenware stove or in desiccating cabinets in which are trays of quicklime.

"With the exception of heroin or morphine, the other ingredients making up the pill are legally obtainable at any drug store and their sale is not restricted. Neither is there any restriction to the importation to China of caffeine, strychnine, quinine and other cinchona alkaloids.

"There are a large variety of these pills in the illicit market. The best known types are the 'Tiger Brand,' the 'Fairy Horse Brand,' the 'Golden Dragon Brand,' and the 'No. 11 Brand,' but there are many others without labels. They are usually sold wholesale in packets, containing 1,000 and 10,000 pills."

The pills by this time generally contained more caffeine and less strychnine in proportion to the heroin than those of 1925; and they were usually smaller, although several different sizes were available.

Details were given of the seizure of some of the larger pill factories discovered during 1933. One, which turned out about 50,000 pills per day, manufactured three kinds: pink pills, containing heroin and scented with rose, white pills containing morphine, and black pills apparently without narcotic content. The pills also contained caffeine, quinine or other cinchona alkaloids, and a trace of strychnine, and weighed 0.07 gramme each (about 1 grain).

Another factory had been manufacturing the "Fairy Horse" brand of pills. The seizure included rose floral essence centifolia, jasmine oil, musk, red dye, powdered tragacanth, citric acid, strychnine, milk sugar, flour, and starch. Also raw opium, crude morphine, and morphine hydrochloride, although the only narcotic mentioned as contained in the pills was heroin. The usual pills were coloured uniformly throughout, but the "Fairy Horse" pills were white inside, coated bright pink. They weighed 0.065 gramme each (approximately 1 grain) and contained about 1.3 per cent of heroin, 8.0 per cent of caffeine, 2.2 per cent of quinine, and a trace of strychnine. The defendants arrested in the pill cases were all Chinese with the exception of one Japanese.

The same report mentions the seizure of two heroin factories, one of which was revealed by an explosion and resultant fire; and it is evident that at this time the heroin was locally manufactured, as well as the pills themselves.

It was also stated, "Since 1922 there has been observed a steady increase in (pill) addiction which in recent years has become prevalent to such a degree that it exceeds the smoking of opium itself. This widespread addiction is attributable to the fact that pills are comparatively much cheaper than opium. It is estimated (according to statements made by addicts) that 16 pills, which can be procured for 20 cents, have the same effect as approximately 50 cents worth of opium. Chiefly for this reason pill smoking has spread among a large section of the poorer people, many of whom were formerly addicted to the smoking of opium and are now turning to this form of vice which is more within their means."

Pill smoking in Hong Kong increased from 1934 to 1936, and continued to hold its own in spite of repressive measures up to 1939.

The Annual Report of Hong Kong for 1934 stated:

"The Heroin Pill habit appears to be gaining ground rapidly. The 'Fierce Tiger' brand was not found so frequently as in 1933 but various local brands were popular.... (They) were usually of a lighter pink colour than the 'Fierce Tiger' pills and contained on the average one milligram of heroin per pill with the usual caffeine, cincho-nine, sugar or sugar of milk, gum, and possibly strychnine. It was noticed that the pills were slightly perfumed with rose water or vanillin solution. The poprular local brands were 'King of Flowers' (peony), 'Spring Waters,' 'King of Fragrance' and other adaptations of popular names.

"In some cases pills were seized which contained a small proportion of morphine-smokers however stated that these latter pills were not so popular as those which contained heroin. Heroin Pill divans were discovered on many occasions. In these divans no opium was smoked and it was noteworthy that conditions in those divans were cleaner than those in opium divans; in fact, a better class of smoker appeared to frequent these divans. In other cases, divans were raided in which both Heroin Pills and Opium were available. It appears that two or three Heroin Pills are equal to one pipe of good prepared opium and the advantages claimed by smokers of these pills for the use of the pills instead of opium are:

"(1) They are cleaner in handling and smoking.

"(2) They do not pollute the breath as does opium.

"(3) They do not cause constipation as does opium.

"(4) The smoking operation is comparatively quick and the smoker can return to business.'

"The pills cost HK $0.10 for five pills to HK $0.10 for three pills."

The 1935 Annual Report for Hong Kong stated, "The traffic in diacetylmorphine pills has increased enormously. During the year, 654,233 of these pills were seized in 310 cases.... There was no direct evidence of the import and export of these pills. All indications go to show that they are manufactured in Hong Kong in small hand-type factories. These factories do not appear to remain in one building for many weeks; the pills after manufacture are immediately passed on to wholesale distributors."

It was also mentioned in some reports that heroin was seldom found when a pill factory was seized; the narcotic was evidently brought in at the last moment and the batch mixed immediately.

The Annual Report of Hong Kong for 1936 stated, "The situation as regard Diacetylmorphine (Heroin) Pills became rapidly worse in the early part of the year. It became obvious that these pills were being manufactured on a large scale in Hong Kong and special investigations were carried out with the object of attacking the actual makers. Persons found in charge of factories or engaged in the manufacture of these pills were committed for trial at the Supreme Court.... In many cases persons were found actually making the pills with the usual hand pill machines.... The only known local use of Caffeine of any considerable extent is the manufacture of the pills under discussion. If the amount (of caffeine) available for local consumption is taken as 8,000 pounds or approximately 3,600 kilos (a very low figure) this gives Caffeine content for at least 180 million pills of the type usually found.

In view of the large seizures of these pills this figure probably gives an accurate idea of the local consumption.''

The narcotics cases at the Hong Kong Supreme Court in 1936 resulted in 46 persons convicted with sentences totalling 177 years. A table of seven pages was given tabulating the details in regard to seizures of pill "factories."

The Annual Report of Hong Kong for 1937 added the following information:

"Although the traffic in Diacetylmorphine Pills did not increase in Hong Kong during the year under review it still overshadows the whole drug situation in Hong Kong. During the year 3,936,230 of these pills were seized in 405 cases, the great majority of the pills being found in pill factories. Many persons were found carrying these pills and special mention must be made of the number of young persons who were not of the lowest classes found smoking these pills in pill divans.

"It was also mentioned that there had arisen a brisk trade in pills which were similar but contained no heroin. Enforcement was very rigorous and was believed to be getting the upper hand. However, the recorded caffeine imports were up to 12,768 pounds.

Again in 1938 the traffic in Heroin pills "did not increase." During the year, 2,713,181 pills were seized in 671 cases. Suppression measures were continued rigorously.

In 1939 the number of cases involving pills rose to 2196, from 891 in 1938, and 3,714,974 pills were seized. Caffeine imports were 14,340 pounds, and it was believed that at least 12,000 pounds of caffeine were intended for pill manufacture. Enormous quantities of pill ingredients were found in some cases, indicating that one factory could produce not less than 200,000 pills per day. Toward the end of the year the outbreak of war in Europe began to interfere with the supplies of pill materials.

Meanwhile in Shanghai, where the use of the pills had begun, a decline had set in. The seizures from 1933 to 1938 were as follows:

1933 -
ounces "opium substitutes"
1934 -
ounces "opium substitutes"
1935 -
ounces "opium substitutes"
1936 -
ounces "narcotic drug pills"
1937 -
ounces "narcotic drug pills"
1938 -
ounces "narcotic drug pills"

The Annual Report for 1938 of the Shanghai International Settlement stated, "In former years, red pills were the chief drug of addiction among indigent Chinese owing to their cheapness compared with other types of drugs. During the year, however, addiction to red pills was practically non-existent in the Settlement, as was evidenced by the fact that, while police surveillance and suppressive measures continued unabated, there were only two addicts arrested, as against forty-eight in 1937." In fact, this figure should be compared with that of 3,496 Chinese convicted in 1934 for conducting pill smoking dens or smoking pills.

As pill smoking spread from Shanghai, pill manufacture did also, as it was a very simple procedure. The first seizures of heroin pills in the United States were in 1932. These perhaps came from China but within a few years pill factories were discovered in the United States.

Mr. Peter Valaer, who reminisced for the Bulletinin volume III No. 1, was the author of an article on "The Red Pill, or the Opium Substitute" in American Journal of Pharmacy 107, 199-207 (1935). Mr. Valaer distinguished two main types of pills. One type contained close to 2 per cent heroin while the other contained only a few tenths of a per cent, or even as little as 0.1 of a per cent. Pills of the latter type were a number of times declared "blanks" (containing no narcotics) by different analysts, until some experience had been gained in analysing them. There were also genuine "blanks." The pills were particularly mentioned in the Annual Report of the United States for 1936, both as being smuggled from China, and as being manufactured in the United States, particularly in Chicago. They were also discussed in the Annual Report of 1937. In 1938, however, it was said:

"There were no large seizures of red heroin pills. In fact, the traffic in this form of drug appears to have dwindled to insignificance."

In 1941 the traffic in red heroin pills had disappeared, in the United States.

Post-war reports from Hong Kong show that there also the pill smoking habit eventually died down greatly. The 1949, 1950 and 1951 Annual Reports state that "The habit of smoking pills containing heroin still exists; but on a scale considerably less than that which existed prior to 1942." In 1950 there were 156,660 pills seized - about 2.54 kgs; in 1951 there were 36,315 pills seized, or about 0.6 kilogramme.

In retrospect considerable mystery still attaches to the heroin pills. How was such a mixture hit upon? It was said that the pills were not smoked at the start, and the conjecture has been made that they may have been originally intended for "cold pills." The content of strychnine rather than atropine is against this idea. During the years the pills were in vogue, the strychnine content declined to the vanishing point, but on the whole the formula was remarkably stable.

How much narcotic effect did the pills really have when smoked? It may be noted that there was another type of heroin smoking. In the Annual Report of the Shanghai Municipal Council for 1938, it was stated:

"Heroin has also the advantage (over opium, to the addict) that it can be smoked in the end of a cigarette or with a mixture of tobacco in an ordinary tobacco pipe and the addict can therefore indulge in the habit without having of necessity to resort to clandestine dens like the opium smoker of the same class."

Mr. Valaer in his article in 1935 indicated an opinion that the sublimate of caffeine from the red pills carried along some of the other drugs, including heroin. But, even if this was the case, how much effect would so little heroin have, and how explain the many pills that contained heroin indeed, but in scarcely more than traces? Many pills individually contained to start with only 1/250 grain of heroin (about 1/4 mg), or even less - down to about 1/1000 grain (about 0.07 mg).

Our knowledge of the chemistry and pharmacology of smokes is extremely little. Was the narcotic use of the pills chiefly a fad? There is evidence both ways. Although it seems that the addicts must have obtained some narcotic effect from smoking the heroin pills, the fact that the use of the pills has tended to decline or even die out possibly indicates that they do not give much satisfaction to a confirmed addict.