Sawbones: A Marital Tour of Misguided Medicine - Sawbones: Pepto Bismol

Episode Date: December 5, 2023

Many of us know all the catchy jingle that lists all the things that Pepto Bismol is supposed to be good for. However, that ubiquitous pink medicine is maybe not so ubiquitous everywhere. How did this chalky liquid become so necessary for curing Americans' stomach woes – and does it actually do anything? Music: "Medicines" by The Taxpayers https://taxpayers.bandcamp.com/

Saw bones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, talk to you about some books. One, two, one, two, three, four. Well hello everybody and welcome to Saw Bones. Merrill Tiraviskyd in Medicine, I'm your host.

Peter Bray. I'm gonna say what's happening over there. I am a radio professional. I'm a voice professional. You can tell. Can I say my name now or are you gonna, would you like to talk some more first or? You should see Sydney's

give me the double bird. Why I'm not why I'm why the double bird. I'm Sydney McRoy. Dr. Sydney McRoy. She always say that. No, I don't. I never I know you were always like you should use the doctor and I never do. I would never I would have my first name legally changed Dr. Justin because I would never want anyone to refer me to. We had that just last week's episode, right, about Dr. Dr. Dr. Dr. Yeah. Dr. Dr. Dr. They just call me the doctor at Harmony House a lot of the times. That's cool.

I know. I didn't ask them to, this was not me. This sounds like something I have set up, but. I mean, I mean, with all due respect, honey, you are the doctor there. It's not, I mean, it is charming name, but it's also a factual state. Yeah, it's just because there's not another one. There's not another one, so you are in definite article. I like the doctor there. It's not, I mean, it is a charming nickname, but it's also a factual statement. Yeah, it's just because there's not another one.

There's not another one, so you are indefinite article. I like the definite article. Well, I guess I'll start talking since Justin decided this was the moment to take a very long swig of coffee. What is, hey, hey, hey, Smarl, who pee-peed in your cornflacid? You're like so spicy. Our youngest woke us up so early

And I had already now She's so excited about finding Clarice which is the name of our elf on the shelf that she gets up now Like 5 a.m. And wakes us up and won't go on to the elf on the shelf is bad and a bad idea I know folks. We know I know It's too late for that. We didn't instigate this legend in our household. It was instigated at a grandparents home and then it became strange that we did not have one. So we have been unwilling. Yes. Robed into the elf. We get it. Okay. Trust us. No one hates the elf more than us. Yes.

But we were woken up very early. I'm doing my best. I'm not Why are you firing on all cylinders? You are though at me. It's like so All I'm asked is just like I was in the same bed with the child I know Justin decided to take a nap and I couldn't once I'm up. I'm up. I can't like I don't nap once It's I should say once it's daytime. It's daytime. I'm sorry. This is not a nap. That was a false wake up. I don't I just went back to that. I don't like naps. It's daytime. I'm up. I'll sleep when it's dark. Um, but I made soup. That's what Sydney does every night. By the way, 530 to 530 during the winter.

12 hours. If the sun's down, she's down. That's a rule. I'm a summer girl. I made soup, it was great soup. I made soup at 8 a.m. is what I did. Now who's stalling? I thought you wanted to do a podcast. But the soup, Justin, the soup had a lot of spices. Yeah. And maybe some people find it hard on their tummies

if they don't tolerate things like garlic and chilean stuff, well, are your feet tired from the long walk you were taking? Thing wants to eat. You know what they bet, you know what they might need. Tell me said some pepto bismill. Were you on the stairs coming down to record? You're like, I got it. Is this what you burst in the door?

Right. This was on the fly. I just did this right now. I'll talk about it. Is this what I you burst in the door and you're like. This was on the fly. I just did this right now. I'll talk about it. This is what I you burst in the door and said, J-Man, don't sweat the adryo. I got it, baby. Then you put on your sunglasses.

Is that from, I don't have my sunglasses on. I have my glasses glasses on. I couldn't even put my sunglasses on unless I wanted to wear one over the other, which I have done before. And it's so uncomfortable. Spicy soup. Why are we talking spicy soup?

Because afterwards you might feel like you need. My girl, by the way, I get to brag. I should do it all. I should do the Dalekata in this soup. She grew the herbs in this soup. I didn't have enough. I didn't have enough for this soup. Yeah, I didn't have enough just yellow onion.

So I'd use the scallions I grew. I was proud. Okay. I don't think a lot about pepped abyss malt. I didn't come from a pepped abyss was proud. Okay. I don't think a lot about pepja bismol. I didn't come from a pepja bismol house. Okay. Yeah. We don't have it in our house now.

And I didn't have it in my house growing up. So it wasn't, you know, like, I feel like a lot of people use it, but it's not a thing you're a fan of either, right? Well, I hate it, but we were a pepto house. Like we were. I remember actually, when my dad used to, dad used to, I say he used to, he still frequently does, judges the chili fest. If you're ever around the September by the way, folks,

come down the chili fest. It's a lot of fun. You'll enjoy yourself. Anyway, dad used to be a judge in our memory. He had a holster that they gave him a like faux leather holster for his pepto bismol. They could like put in there because, you know, chili, hard on the tummy.

It's a bit of a gag. But I remember, that is my biggest memory of petrificing all. It was enough of a thing that like, they absolutely did it, but I could never stomach it. I mean, I find it repalent. It just wasn't something we ever used, and it's not for kids, so we wouldn't have it for our kids. When we say that several times throughout the episode,

it's not for kids. Not for kids, undercooked. Sorry kids. Sorry kids. Really, it's really more of an adult. There are lots of other medicines for kids that work better and are safer. It's not for kids. I also have always kind of thought like in their stuff that works better than that is that really what we need. I guess I'm biased against it. I'm kind of like you do you got a problem with it.

I do and so I'm glad we're doing this episode about it because I think I was a little bit unfairly biased against it. Oh really? Yeah, I think I think I was. But I did assume that everybody knew about it. It feels so ubiquitous. It does. Everyone knows about Pepto Bismol. Yes.

So I was really surprised when we got the following email, which we were given authorization to share. Hi, guys. I'd like to propose a brand episode. Well, you're not doing this though. No, no, no, no. This is what I said. Yes.

On the mysterious pink and kind of ominous looking substance that is pepped abysmal, back story, I'm from Iceland. And the other day I was at a pharmacy in my hometown, getting my meds when an American couple walks in. They wait in line and they go to the counter and ask for a bottle of pepped abysmal. When they are told the pepped abysmal is not sold in Iceland, they are flabbergasted. Wild. As am I.

They ask for something else that will sue the upset stomach, fix heartburn, relax your esophagus. And most importantly, it had to taste good. I was baffled. Is peptobizmal an olpatin medicine? Do adults drink it? Why is it that color? Why does it taste like this? Is it a cure-all?

Does it do anything? Please help me. All my best, Thora. Thank you, Thora, because I didn't know that there are a lot of places in the world where there's no peptobizmal. If you don't have peptobizmal, you probably have... There's probably a lot of products like it in where there's no pepto bismol. If you don't have pepto bismol, you probably have, there's probably a lot of products like it in your country where it seems weird

that it is even sold. It just seems like there is one in everybody's medicine cat, like you don't remember getting it, you don't know why you're having it. Everyone just has pepto bismol. You just have pepto bismol. We do not, because we're pretty strict about it, but like most people probably just have some

line around. Yes. Yeah. Especially like 20 years. I would say like, but a lot more prevalent in the era before, I feel like some of those pro pro pro pro pro Tom Hack pro Tom Hack inhibitors pro Tom pump inhibitors. Pro Tom pump inhibitors. They or PPI's really big. And I think peptobizmal got a little bit less ubiquitous whenever it was popping nexium and et cetera. Exactly. That's what you're talking about with proton pump inhibitors, things like nexium, previsoid, preilset, all those consments.

You're exactly right. I don't feel like it's as common, although I will say I'm asked for it a lot and the only reason that we don't commonly have it at Harmony House, because I kind of, I mean, like we get tons of donations that I don't like approve or disprove, they just arrive.

That's why we have occasionally, we have some homeopathic medicines within our donated pharmacy. For a bit. For long enough for me to say, oh, no, no, no, no. But we don't actually get donated a lot of pepto bismol. And I don't, when we do our purchasing, we have grants where

we can actually buy OTC over the counter mads, OTC. I don't usually think of it. But we do get asked for a lot. And if you're not familiar with it, the thing that, that, like, makes pepto bismol so well known, I think outside of everybody knows it's for stomach stuff, is it's color. It's bright pink. It's famously pink. It is so known for being pink that you can say something is Pepto Bismol colored,

and pretty much anybody would know what you meant. Didn't we talk about this during, remember that color episode where the person thought there was a certain thing? Bigger Miller pink. Like it is like that, like peptobizmal pink is just like it's ubiquitous. It is so pink.

Yes, you know what that is. You can use peptobizmal as a shorthand for pink. Right. It's so common. So what is it, I mean, I think the first thing to, what is it, it's a pink medicine, it comes in a liquid or a tablet. I think most of, most people think about the liquid,

but it does in a tablet too, if you'd prefer. And it is a staple, the active ingredient that we're gonna talk about is bismuth subsilicillate. There's a ton of generics of peptivismal. So if you see pink bismuth on anything, I mean, obviously if it says bismuth subsilussly, these are the same thing, essentially is pepto bismol. It's sold, I guess there's some other names pepto calm and biz backter, never heard those

met might be outside the US. Yeah. Brand names possibly never heard those names. Very common for that. What VIX has a different name in the in the UK, for example, like I think. Yes. So if you have a, but it's as far as I know, it's pink everywhere we go. Which doesn't come from the compound.

Bismuth, subsilustal, it is not pink, it's like beige in case you're curious. Well, so how does it work? We're not, it's interesting. It's one of those medicines where we don't know entirely all of the things it does or how. We know some of its mechanism action for sure, but there's still some more theoretical, like we also think it does this and we think it probably works like this too,

but we're not 100% sure. I always think that's interesting. There was a lot of advertising, like when the, during the, especially during, like I wanna say like the 90s, this is the most thing, where like it was one of those where the tagline of it listed all the different things it could do. It was like the heartburn, stomach, blah, blah, blah, something medicine.

It was just like, it was promoted for like, no matter what's wrong with you. It's all that's in the below your nipples and above your crotch, pepto bismol is there for you. Well, do you remember the, the, like, I remember what it can be used for because they said it so many times in the commercial that it became like that was, I was gonna quiz you, do you remember? Heartburn.

Uh-huh. Obstetect stomach. Uh-huh. Diarya. Uh-huh. Intergestion? Yes. Um, sour stomach. You're forgetting one thing. Ingestion. Yes.

That's sour stomach. You're forgetting one thing. For upset stomach, sour stomach, heartburn, acid in digestion. See the more recent one was nausea, heartburn, indigestion, upset stomach, diarrhea. You remember that? I'm going to need diarrhea clean so we can use it as a text tone for people. No, no, I won't do that. I wasn't gonna quiz you on that, but yeah, that was in the advertising program.

Which I remember all that. That was the wrong jingle. Yeah. Yeah. And so whether they put in, what's the new, what's the new? Naja. Naja, yeah. Yeah.

Yeah. See, this is where the breakdown is for me on peptobysmal because that would 100% exacerbate any nausea that I was expecting. Have you ever taken the tablets though because they don't, I mean, like, it's a little easier, I think than the liquid. I think liquid medicines, if you don't like the flavor of something, a liquid can be really rough, right? Yeah.

Like, Nyquillar Dayquil, if you don't like those meds. Yeah. They come in those meds. Yeah. They come in capsules now. Um, anyway, uh, oh, you know what else I just remember the three about this? Pink chicklets have the pepto-bizmal flavor. The, I remember like the ones that were pink. Yes. You think they're going to get to the flavor. Okay. So we're going to get to the flavor. All right. Um, okay. So the subsiluxly parts, when we say, bismuth, sub-solicilate that separated out, that might sound familiar to you if you, you know, certainly if you're a chemistry person. But also, like, do you take aspirin regularly?

Because then that salicylate, salicylid acid, you might start to see where this derivative. What is this, what is this compound of? Like, what is it, you know, used for? And also, maybe if you ever had acne and use some over-the-counter acne medications, Salicylic Acid, that's it. That's it, there's a thumbs with the gas. Gas stuff. No, no, no, that's Simethicone.

Salicylic Acid. That's a totally other thing. Salicylic Acid, is that within Stratx Pads? I believe some Stratx Pads do have it. Yes. Yeah, there's benzal peroxide and some stuff for acne. Then there's salicylic acid and other stuff for acne over the counter. But yes, if you have acne products, you look, you may see this.

Anyway, so it's in that same family. You may remember because we talked about aspirin on the show before. I'm fairly certain because it famously comes from Willow Bark. It's from plants. We derived salicylic, the salicylates, things that are salts of salicylates and salicylac acid from plants, from Willow Bark. It's in winter green leaves. And acetyl salicylac acid is aspirin. That is what aspirin is. Okay. So we know that that does something, right? Because we know this isn't a chemically active compound. We know that's medically active. And we know that it's

absorbed very well. When we take peptobizmal, we absorb enough of that for it to get into our bloodstream at therapeutic levels. To do something. We love it. Yes. The sub-salis-like part of medication, the way it's supposed to work, is to reduce inflammation, which is similar to what solosilates do in other compounds. Right? So, basically, it's going to get in there, reduce the inflammation in the intestinal or stomach wall, and that's going to make you feel better. That makes sense. Sure.

So, that is a sensible thing. The bismuth part is interesting. Bismuth is a metal. Oh, okay. Yeah. And it's actually very poorly absorbed. It gets into your stomach and it's broken down and creates bismas salts, which are insoluble pretty much. So you're not going to accumulate a ton of that, which is important to know, because accumulating a ton of bismuth is dangerous, which is, as we'll get into, part of why it's banned some places. But is it still having an effect, like even if you, if you're absorbing it? They have found that it has some, the salts themselves that are formed have antimicrobial activity, meaning they can kill and then prevent the adhesion of certain types of bacteria.

And then they have also found that it can increase the reabsorption of fluid. So if you're having diarrhea and you're worried about dehydration, there you go. So and it also can decrease inflammation and some secretions of stuff in the intestines. So there is some, there is definitely chemical basis for both of these components addressing these issues. So I think the question of, is this one of those fake cure-all patent medicines

that everybody, because I know that sounds like a wild thing to say, well, but it's been sold for this long. It has FDA approved uses. There are several that are like vetted by the FDA that we have studies to back up. But even with all that, we definitely have medicines that we use over the counter to this day. That people consider mainstays that do not do anything. That is not true.

Which first one comes your mind? Oh gosh, it's like any cold medicines. Yeah, that's right. It's tough. I mean, phyneileferin, right? Like, there's been a ton of recent data about the fact that finileferin, which is found in a lot of over the counter like, sinus or like combo cold meds. If you look at like one of those cold and sinus meds that have like five different things in them, finileferin is probably one of them

and it doesn't do anything. So, I mean, but unlike that, Pepto Bismill does do stuff. And like I said, it's supposed to treat nausea, heartburn, indigestion, upset stomach diarrhea. So you can see how it would become a mainstay of sort of, especially in the US, our home, you know, pharmacy, it everybody gets you to have on hand. Right. So there's definitely active compounds. And there are studies to back it up. Like I wanted to, one in particular, there was a 1987 study

that actually suggested you should take two tablets of peptobizmol four times a day if you're traveling to reduce your risk of travelers diarrhea. And it works. Really? Yes. Reduce the risk by more than 60%. That's wild. Yeah, it was a small study. People challenged it, of course, because it was smaller, but there definitely was evidence that taking peptobus mal not only could treat these things, but could actually prevent you from getting traveler's diarrhea. There've also been some placebo controlled studies to show that it can be used for dyspepsia, so like, upset stomach reflux, that kind of thing. And then for helicobacter pylori, which is a specific bacteria that causes stomach ulcers, it is commonly used. Now, this is an off-label perscribing, but it is commonly used in combination with two

antibiotics and a proton pump inhibitor to treat this infection. So, there's a four-drug regimen that is often prescribed for that. And that is part of it. So, it works for stuff. Hey. So, let's get into, like, where did it come from, who made it, and why is it not everywhere? Okay. After we go to the billing department.

Let's go. The medicines, the medicines that ask you make my copy for the mouth. Let's go! people about unremarkable topics all to help you slow down your brain and drift off to sleep. For instance, we have the remarkable Neil Gaiman. I'd always had a vague interest in life culture, food preparation. Sleeping with celebrities hosted by me, John Moe, on MaximumFun.org, or wherever you get your podcasts. Night night. Somewhere in an alternate universe

where Hollywood is smarter. And the Emmy nominees for Outstanding Comedy Series are Jet Pacula, airport Marriott, Cruffle, dear America, we've seen you naked, and Aula in the family. In our stupid universe, you can't see any of these shows, but you can listen to them on Dead Pilots Society.

The podcast that brings you hilarious comedy pilots that the networks and streamers bought, but never made journey to the alternate television universe of dead pilot society on maximum fun.org. So Sidney, why is this not a ubiquitous thing? Why are we not all absolutely obsessed? Um, well, I'm going to get into why it's not. I want to tell you like, while I've, while I've made a case for the fact that it does actually do some stuff, right? Um, and I, and this doesn't mean everybody should always be taking peptobizmol. I always try

to, that would be wild. I always try to list what the side effects and like contraindications. And as always, you shouldn't, nothing, nothing I'm telling you is any sort of medical advice. Everybody's cares individualized. Please seek the help of your own healthcare professional. No. It was not a podcast. It was not a podcast. Your doctor can't be a podcast.

I'm sorry, folks. I've done the research. But the thing that it was used for originally, the thing that it was made for, it probably wasn't the best treatment for. So peptobizmol, and I will say the use of these bismuth salts, like we find in peptobizmol actually date back to like the 1700s, the idea that they could be used for diarrhea is an older idea. But what we know now as Pepto Bismill,

or at least the roots of it, really start in 1901. And I searched and searched for the name of this doctor. All I find is a New York doctor, a New York doctor made this stuff, a New York doctor. I don't know who the New York doctor. A New York doctor. A New York doctor. I searched and searched.

I'm like Googling like, who is the New York doctor who made Pepto Bismill? Hey, I listed. Somebody's gonna know this and tell me. Hey, yeah, somebody will know and tell you but like, hey, no lie, we've been doing this show long enough. I hear that Pepto Bismill is exactly growing about the person who's been in it.

And my alarm bell started to go off like, uh-oh. What don't you want to find out? Uh-oh. Now see, it's 1901. Usually when the roots are a little foggy, it's because it was a Nazi. That's usually a... That is what, okay.

I'm sorry, I didn't want to say. Well, that's a lot of medical history. This would have been a weird time. It's 1901. Yeah. But still. Still. But still, no, there is.

And I mean, for good reason. It's also possible that he stole it from to me who isn't a white man. Because that is the other one that gets that tends to a cloud that. And then sometimes it's a little bit of astroturfing where the company is going back and making up a backstory. I am not saying in any way. We just, that Procter and Gamble has done this. Absolutely.

I'm not asking the question. I'm saying that. I'm saying that there are times where you see this sort of story of like the doctor who came up with this or whatever and that's maybe not really true, just to sell something. One way or another, somebody came up with it. And the way the story goes is that it was so popular, this compound that was originally called Bismisol mixture cholera in phantom. That sounds like a fantasy novel.

The epic of bismissol mixture cholera in phantom cycle one mixture cholera and phantom. So business was a good name, but he it was so popular. He or she, but it's 1901. Let's be honest probably probably he probably he that he could not keep up with the demand because he was making it at home. Right. And so in order to try to make enough to meet the demand, he basically sold his formula to Norwich Faracal Company with this original name, Bismissal.

And they were manufacturing it in like 20 gallon drums of Bismissal to get out there. And we're also agreed with this sale. We're definitely changing the name just the moment we can. And they, and by the way, if you, you probably guessed from mixture cholera in phantom, it was originally aimed at babies with cholera. Yes. That's who they, that's what it was made for. Like, we had this really deadly disease because cholera was and still is today, if not treated

and managed properly, if you don't have the right resources to treat it. cholera was definitely very dangerous for the young who can't sustain a ton of fluid loss, you know, easily. And so they would become severely dehydrated and maybe die of cholera. So this was supposed to help treat that diarrhea and, you know, keep you alive until you kind of ran its course, which can happen with cholera. Although today, I will say we treat it totally different way. We don't use peptobizmol with cholera. Although today, I will say we treat it totally different like we don't use peptobysmal for cholera. Certainly we use fluid replacement and antibiotics.

Because we have antibiotics now, I think. They're great. In 1919 is when we see it renamed peptobysmal and we see it marketed under that name. And later, of course, Norwich would be acquired by Proctor and Gamble, who sells it today. That was in 1982. So a very long time that Norwich pharmaceuticals made this drug. It was bright pink from the beginning. Do you know why?

Why? The flavor? Kids like pink. I don't know, man. The original creator of the medicine made it pink. It's just an artificial dye. It has nothing to do with what's in it. It has nothing to do with what's in it. It has nothing to do with what it does.

It has nothing to do with bismuth or solicitates or any of the things. It has nothing to do with the flavor that we're going to get into. It was just pink because it was pink because kids like pink. But that was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the... That was the.... At the time that, well, and that's exactly what I was going to say while it is not, not, not recommended for kids today, back then they didn't know about something called rise syndrome. And this is why we don't recommend it for children now is you may have heard if your kid has chicken pox, well, nobody gets chicken pox in places where the vaccine is available these days.

But when we were little, we got chicken chicken box. Or if your kid, I know it makes me, it does me feel, or if your kid gets the flu or some other viral illness, you may have heard, do not give them aspirin. Have you ever heard that? Yes. Yes. This is why, because of the development of something that can be severe and fatal, possibly called rise syndrome, which can cause neurological damage and liver damage and all kinds of complications from the interaction between the original viral illness and then administering aspirin. So we know not to give kids aspirin and since this is a solicit as well, you also should not give them peptid bismol. Of course, we didn't know all this back in 1901

when it was first made for that. The formula that was originally made in 1901, which would then be changed when it was first made for that. The formula that was originally made in 1901, which would then be changed when it was reformulated in 1919 and called Pepto Bismill. The original formula was pepsin, Pepto. Pepsin, which was known at that point to be a digestive enzyme that can help break the stuff down, help with digestion. Zinc salts, salal, which is a bismuth compound, that's for that. Comes from an oil of winter green,

along with some sort of artificial color to make it pink. The winter green part, by the way, is interesting. Why is that? Because it is not, so if you look at the flavor of the original, it was oil of winter green or tea berry. Because the tea berry is the berry of the winter green plant. Okay. You know the flavor of winter green. Yes. Would you say that pepped up a bismont taste like winter green?

No. No, but you did say it was minty, right? It has a minty ish, yeah. Yeah, that it is. It's minty ish. It's the tea berry. Yeah. It's the oil of winter grain.

It's the tea berry. Tea berry gum, I know. They used to have it like, it's like the old timey thing. Yes. That flavor people used to enjoy for whatever reason. Minty ish. It's like gross minty, like worst mint, worst. I'm a big mint guy.

The only mint I can kind of mess around with the experiment. I can get into the experiment sometimes. People like, well, I love mint stuff, T, like worst, worst, I'm not a big man guy. You only meant I can kind of mess around with this experiment. I can get into this experiment sometimes. People like, well, I love mint stuff, but people like tea berry. People like, people like the taste of pepto. People are wrong about lots of stuff. But that's why even though the current formulation of pepto bismond, like I said,

the main act of ingredient now is bismis subsolicly. So the pepsin is no longer in there. It does still contain the same, like the original pepda bismond does still contain the same flavor from that winter-green plant, except it's not, instead of using actual winter-green oil, they just use methyl solucilate, which is the same compound that gives winter-green oil its flavor. We just synthetically derive the chemical and make it, right? But like, that's the,

so original flavor, pepto bismol, tea berry, winter green oil, that's what you're tasting. That is what that, that's why it's pink, but tastes minty. Mm, okay. And maybe that's what's off-putting to you, is that we don't think of pink as the color of something that's minting. It is a, that's a really indirect.

If it was like white or green, I wonder if I would, but I need to chuck a whole bottle of hip to bismond, see how well. And that also, that also, I'm realizing also as we're talking like I have not ingested the stuff probably in 30 years. I can't remember the last time I tasted it. This also, well, no, I've taken the pills. I can think of times actually in traveling when I've taken the pills, but not the liquid.

But that's that, and that's probably is why it now comes in two flavors. Cherry. And original. Yeah. That cherry flavored probably makes more sense for people, maybe visually, and what they expect. Like it looks pink, it tastes like cherry that I get it.

But some people still prefer that original flavor, that mintyness. I don't think cherry is any great shade either. I'm not a big cherry person every year. So I don't know. On that note, they've actually done studies to see if the color of medicine affects the way people respond or what they look for, what they'll buy is what they're really looking for, right? Like what people are going to buy and have a positive reaction to. affects the way people respond or what they look for, what they'll buy is what they're really looking for, right? Like what people are gonna buy and have a positive reaction to.

Pink, people definitely assume a sweeter, not necessarily fruity, but we do assume if something's pink, it will taste sweeter. So it would be a good medicine for if you're trying to attract children to medicine. Now I would say that if you're trying to attract children to medicine, that's not, I mean, great. If you're trying to attract children in medicine, that's not. I mean, yeah. Great. If you're trying to make medicine that a child needs more palatable, I can see it that way. Right. Famously, the amoxicillin you may have taken as a child

is pink. Yeah. Tastes like bubblegum. Yeah. That's it. Yeah. But that's also why we've also done studies to show people see a red or orange medicine and assume it is stimulating and we'll keep them awake. And if they see a blue or green medicine, they assume it will make them sleepy or drowsy or calm. Can you think of a perfect example of that in Martin like? Michael. Yeah, and dayquil. Yeah, all that's true. Yeah. Dayquil is red or orangeish. Yeah. Michael is blue greenish, I don't know. Yeah, which, and that is probably intentional because you will see it and think,

this will put me to sleep and I want to sleep. Yeah, this looks like night. Yeah. Good. This one looks like the sun. I'm gonna eat this this morning. Yeah, this one looks like the sun. I'm gonna eat it and stay awake all day. Yeah.

God would know. I know, there are studies that show all that. Like there are, and I mean, again, a lot of this goes into the marketing piece of it. But that's food too, right? McDonald's and all the other restaurants use a lot of red yellow because it makes you hungry. And we're just big dominoes. Oh, red yellow, I could eat. But as you say that, I'm now thinking about eating McDonald's French fries because they're yellow in a red box and that makes me hungry, so think about. So that's where the flavor and the color and all that come from. Why is it not everywhere, the bismuth part?

So there have been scares in the past about bismuth-containing medications, accumulating, which it can, right? Like any metal, even though it's not very well absorbed, if you're taking enough of it in high doses over time, you will get some of that in there, right? Right. Now, they have done a lot of studies to show that if you're taking pepdo bismol or any other bismuth, substance as prescribed appropriately. Then this is not something that should happen. However, if you don't take it appropriately,

and we all know that one guy, right? Like there's gonna be that one guy who's gonna take a ton of something. Yeah, my dad would be the guy. My dad would be the guy that hurt himself, peppered, piz. Your dad would do that? Yeah, I think so. Can I say, though?

Me and was knocked himself out, thumping ammonia onto cutyliter, so out, dumping ammonia on the kitty litter. So I, or bleach on the kitty litter. So he poured bleach, trying to clean up the kitty litter, and he knocked himself out with the fumes. So yes, I do think that the person that makes a half of my genetic material, it would as sad as it makes me to say, I heard himself with too much better bismill. Can I, maybe this will come for you and if your dad hears this and then anyone else who does this,

if you are thinking, oh no, I am that guy or that person, I should say, I shouldn't say that guy, I should say that person. If you're that person, probably that guy. Let's be honest. If you're that person, I will say I recently learned after I had this interaction in my day job that sometimes patients will think that their antibiotics will work better if they give themselves like their own little loading dose. Like I'll take a couple right away or three or four right away to really get it in there and get it working. And then I'll follow the directions on the bottle.

Right. But I want to give myself a boost. And I started asking around about that and found that that is way more widespread a belief than I ever was taught in medical school to realize that a lot of people think, well, maybe a little more, we'll get it in there and make it work faster. And like with medicine, the dose makes the poison, right? Like, sometimes more helps more, sometimes more does not, and can be very dangerous.

But I think that that's a, it's a good thing to recognize is a lot of people have that belief and are doing it with the best of intentions. And we have a lot of things in popular culture that lead to that. I'm rewatching house. Do you know how often a patient is responding to a medicine and house tells them And we have a lot of things in popular culture that lead to that. I'm rewatching house. Do you know how often a patient is responding to a medicine and house tells them to double

the dose? Do you know how wild as a medical professional it is to hear somebody who's supposed to be a doctor telling someone like double the dose of their antibiotics to make them better faster? That's not a thing. That's not, I mean, there are, yeah, again, yeah. Well, it's only got 44 minutes. They got to crank.

There are medicines that higher doses will make them more effective, but then there are other medicines where it's like, you use this dose or you don't use this dose, but that's it, that's the thing, that's what works. Anyway, so that was a side note, but you know there's gonna be somebody who's gonna overuse a medication,

and that's the concern in countries, like specifically France does not allow these kinds of compounds, and there's some other places. So like in Europe in general, it's not very popular, and obviously in Iceland, it's not something that's sold because of that concern that if your body accumulates enough of those bismuth salts, you could develop some neurotoxicity, some damage to your neurological system, which is a big deal, right? So that is why, you know, and you'll find like travel blogs that will recommend if you're going overseas, just take Pepto-Bismol with you because there is no guarantee that wherever you're going will have Pepto-Bismol available to you, which again, just speaks to how like

deeply ingrained it is in the American psyche as something you need. Yeah. Take it with you when you go overseas because what if you can't get pepper and baseball? I don't think about it. And then again, it is helpful. We have studies that show for travelers diarrhea. So there's a good reason. It can interact with some meds like war friends specifically. So as with anything, if you're thinking of starting and over the counter medicine, it's always better, especially something you think about taking all the time,

you should talk to your healthcare provider. It's not for kids, especially under 12, do not use it. It's not for cats, it's very dangerous for cats. I don't know why you wanna give it to your cat, but don't. It's bad cats. It's the boobs, obviously. Over six weeks, you should not be using it.

So if you're thinking you need it longer than that, you really need to be talking to a medical professional at that point about whatever is causing you to think you need pepto-bizmal. And it can turn your mouth or your poop black, especially if you eat a lot of sulfur-containing foods or you're taking a medication that's sulfur-based, like, back drum is an antibiotic that is.

And it's pounding those eggs. Anything that contains a lot of, there's a reaction, your mouth and tongue can turn black and then you're definitely can turn your poop black, which can be very scary for people. Can't you get that from the... Just black. Just black. It is temporary and it is harmless. The actual turning black of your tongue or your poop, but it can be confusing because your

poop can also turn black if there's blood in it, digested blood, so it can be upsetting and scary and lead to unnecessary testing if you think, you know what I mean? So it's good to know. It's good to know this stuff. And one other wild thing, we just figured out the chemical structure, how it looks under a micro, like how it would look if you could blow it up and look at what the chemical structure looks like. We just figured that out last April, like last year, 2022.

It was very difficult to derive the chemical structure of the business subsilux late. And it took that long. It's been around since this exact compound has been around since what did I say, 1919, and we just last year figured out exactly what that structure looks like, which I think is pretty cool. Well, Sid, if I'm proctoring Amble right now, I'm breathing a little sigh relief. You know, when I heard the Sidster was coming for Pepto, I probably was on pins and needles,

but I feel like you've been very fair. I think, I mean, it does, it does the stuff it says it's going to do more or less. And obviously it's caught on because it's catchy and it's pink and it's been around for so long. But I think that there is something to the fact that it does actually do something that probably makes it so ubiquitous. I don't know. I mean, that's a bad argument to make because a lot of people were taking those cold medicines with phenol effort. Now I will say these are not, it is not the end all be all for nausea vomiting or for nausea, heartburn, indigestion, upset stomach diarrhea. I don't necessarily take it for any of those things.

There are other medicines and I would argue some that probably work a little better. See, now they're getting worked up again. They're like, she's going back in. Is she going to drop something else on us? It's not curing. Well, I mean, I think the, here was the last question. Is it a cure all? No. Well, I mean, I think the here was the last question, is it a cure all?

I think that if you use it to manage those symptoms, that's one thing. It is not curing anything, per se, right? Right. It's not gonna, if you have like an underlying problem that is causing it, it's not gonna cure it, it's gonna help alleviate some of the symptoms of the underlying problem, which is always means if the problem persists,

please seek medical attention. Don't sit at home and take more peptobizmal. Thank you so much for listening to our podcast. We hope you have enjoyed yourself. It's almost, it's almost, um, candlelight's time here. Hey, yeah. Yeah. And it is, it is the perfect time to go secure your tickets for the virtual candlelight spectacular. We do it every year. It's always fun. It's going to be December 16th at 9 p.m. Do you want to, do you want to give him any hint? We'll be returning to our beloved medicine called Christmas franchise. That's like, and I'm, I'm will liberate you to say at this time. And, and there will be

songs. There will be songs. It's going to be a lot of fun. And it is also going to be a great benefit to Harmony House. A shelter that Sydney has a lot of experience with that provide services for people experiencing homelessness in our area. You can get tickets right now head on over to bit.ly4dslashcandalites2023, got lots of guests, got lots of fun, got lots of songs, got lots of tears. I don't know, you have to watch it find out. And if you purchase that, by the way, you don't have to watch it live.

There's a VOD for 15 days after the show. So fantastic. I hope you'll make it. Thanks to the taxpayer and fuse for a song medicines as the intro and outro program. Thanks to you for listening. That's going to do it for us until next time. My name is Justin McRoy. I'm Sydney McRoy. And it's always don't drill a hole in your head. Alright! Yeah!

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