Pepsi: the best drink to force on restrained mental patients

Here's a trove of scanned-in ads from a 1956 issue of Mental Hospitals, an APA's trade journal. Most striking are the ads advising psychiatric doctors that Pepsi is the forced fluid of choice for restrained mental patients, over the slogan "Pepsi Ad Libitum" (Pepsi for your pleasure).

"Mental Hospitals" magazine ads

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Lauranne

Far be it from me to defend psychiatric institutes of the 1950s, which I hear were pretty miserable places. But what peterbruells says above is correct. In medical jargon “forced fluids” doesn’t mean “fluid the patient drinks involuntarily”, it means “fluid the patient drinks for medical reasons beyond what their sense of thirst would naturally indicate”. I.e. “forced” here carries the meaning it does in “a forced smile”, not “a forced confession”. In many illnesses, the body’s natural sense of thirst fails to meet it’s actual fluid requirements. When you have a cold and the doctor tells you “drink plenty of fluids”- you’re being told in non-medical jargon what the ad there is saying in medical jargon: drink more than your body tells you to.

…As to whether caffeinated beverages are an appropriate fluid in that situation though- that’s entirely a different story. Caffeinated beverages satisfy the body’s thirst mechanism while simultaneously being a natural diuretic (making one pee more, and hence lose more fluid) and doing a terrible job at hydration. So actually they’re about the last thing someone should drink for “forced fluids”- better than nothing, but not that much.
- Brainspore
  
  Caffeinated beverages satisfy the body’s thirst mechanism while simultaneously being a natural diuretic (making one pee more, and hence lose more fluid) and doing a terrible job at hydration.
  
  I’ve heard that claim repeated many times but everything I’ve read on the subject indicates it’s a myth. You got a source?
Antinous / Moderator

Still better than that 80s campaign: Pepsi! It’ll Set Your Hair On Fire!
tsdguy

Don’t hold your breath Brainspore for a response. Bunch’o'crapola.

Now, I wonder if we can get a hold of scans from 1940′s mental hospital journals. I’m sure we’d see plenty of cigarette ads with doctors touting their beneficial quality for the typical mental patient.

Good for you and your patients. Cool, relaxing Lucky Strikes calm your deranged patient. Keeps you focused and your leucotome steady during eye socket lobotomy.
- phisrow
  
  Cigarettes certainly don’t do anybody’s lungs any good; but there is some interesting research on the apparent benefits of nicotine for a variety of psychological conditions…
- Antinous / Moderator
  
  1940s? The doctors at UC San Francisco were still smoking in the charting room across from the nurses’ station until about 1990 when the hospital went smoke-free.
Laina Lain

Those ads back in the day were a little bit frightening. xD
Anonymous

As someone who was dealig with withdrawal form serious affeinated carbon beverage addictio – although coke is my poison – while already an i -patient.. i am not sure how this makes me feel.
Anonymous

There’s a specific meaning of “ad libitum” in medicine. Wikipedia says it well:

Ad libitum is also used in psychology and biology to refer to the “free-feeding” weight of an animal, as opposed, for example, to the weight after a restricted diet or pair feeding. For example, “The rat’s ad libitum weight was about 320 grams.” In nutritional studies, this phrase denotes providing an animal free access to feed or water thereby allowing the animal to self-regulate intake according to its biological needs. For example, “Rats were given ad libitum access to food and water.”

In biological field studies it can also mean that information or data were obtained spontaneously without a specific method.

Medical prescriptions may use the abbreviation ad lib. to indicate “freely” or that as much as one desires should be used.
Anonymous

In medical and scientific contexts, ad libitum means as much as the subject cares to have.

For example, when rats are fed ad libitum, they can eat as much food as they wish, their diet is uncontrolled.
hassenpfeffer

Nurse: “Okay, Mr. Jones, now that we’ve pumped both your buttchecks full of Haldol, would you like a refreshing Pepsi?”
Mr. Jones: (stares mindlessly at nothing and drools profusely down chin)

I’ve worked at a psych clinic and attached inpatient unit. Colas are not very high on the “patient needs” lists.
- Anonymous
  
  It’s a pleasant pick-me-up. I’m sure many Pepsi drinkers exhibit similar symptoms to Mr. Jones prior.
Anonymous

“All I wanted was a Pepsi/ Just one Pepsi/ and she wouldn’t give it me/ just a Pepsi…”
Snig

Also weird giving caffeinated beverages to patients.
Anonymous

While ‘ad libitum’ may literally mean at your pleasure, in biology and medicine it means freely available. In the case of a caged rat it often describes a water bottle always full and easy to access. An even worse connotation I would say.
dagfooyo

I read this as a humorously-worded invitation for the doctors themselves to drink Pepsi, not administer it to their patients. I know that’s not quite as bizarre, but it does make a lot more sense.
- Anonymous
  
  Or of course, this could just be a fun example of 50′s era social corruption!
Anonymous

“Ad libitum” isn’t *exactly* “for your pleasure.” It’s more like “at your pleasure,” or “as needed.” Basically, it’s a liberal dosing instruction.
Anonymous

Hydrating mental patients in the 50s with pepsi isnt too bad of an idea.

It tastes pretty good to most people, so they wont get tired of chugging it… like they might with water.

It contains caffeine which would possibly work as a mild stimulant to patients who probably were sedated in most situations, given that virtually all psych meds back then (antipsychotics, antidepressants) were sedatives.

And finally, it contains sugar, which is an essential element in rehydration, as it allows sodium to be more easily transported across the gut (i.e. gatorade, pedialyte).

As for caffeines diuretic effect.. yes, it has one, but it does not come close to counteracting the fluid taken in by soft drinks.

How do I know this stuff? I’m a pharmacist.
Kosmoid

In a clinical context, “ad libitum” could be seen as meaning that it is able to be giving freely, or as much as one desires. The use of the term “forced fluids” here makes this highly ironic.

This is like saving Evian is the preferred choice for all your water boarding needs. But on second thought, if I were faced with the prospect of forced inspiration and controlled suffocation, I’d want something that was filtered, if you please.
Anonymous

Mom just get me a Pepsi, please
All I want is a Pepsi, and she wouldn’t give it to me
All I wanted was a Pepsi, just one Pepsi, and she wouldn’t give it to me.
Just a Pepsi.

They give you a white shirt with long sleeves
Tied around you’re back, you’re treated like thieves
Drug you up because they’re lazy
It’s too much work to help a crazy

I’m not crazy – Institutionalized
You’re the one who’s crazy – Institutionalized
You’re driving me crazy – Institutionalized
They stuck me in an institution,
Said it was the only solution,
to give me the needed professional help,
to protect me from the enemy – Myself

Suicidal Tendencies
Paul Coleman

All I wanted was a Pepsi.

http://www.youtube.com/watch?v=LoF_a0-7xVQ
- Anonymous
  
  Awesome comment, dude; I knew what it was immediately. “All I wanted was a Pepsi.”
Jake0748

Hmm… drinking glass and straw both made of glass, for use in mental hospital, nothing much can go wrong there.

Oh well, at least they HAD mental hospitals back then.
- narddogz
  
  Glass straw?
  
  The proper way to deliver Pepsi to patients in a 1956 mental hospital would be to use the Krazy Straw.
  
  Krazy Straw! *BOOOIIINNNG* Krazy Straw! *HEEHEEHEE*
  
  http://www.youtube.com/watch?v=ZliF3UvGavU
peterbruells

Hmm… It is my understanding that â€žforced fluidsâ€œ means that patients should be encouraged to drink instead of relying on their sense of thirst.
knoxblox

Great. I’m in restraints AND I hate Pepsi.
Toff

I suppose you could call “Pepsi ad libitum” a “slogan,” but it’s written like a prescription, following the symbol for prescription.

Merriam-Webster’s Medical Dictionary, for example, defines “ad libitum” as: “without restraint or imposed limit: as much or as often as is wanted â€” often used in writing prescriptions.” So, the irony via the double entendre “without restraint” is actually even greater than simply with “for your pleasure.”

Wish the scanner had given full citations. Though these seem likely to be real, we shouldn’t necessarily be so accepting.
Anonymous

Pepsi, for the shameless advertising campaign!
Lauranne

>> I’ve heard that claim repeated many times but everything
>> I’ve read on the subject indicates it’s a myth.
>> You got a source?

> J Ren Nutr. 2007 Jul;17(4):225-34.
> Caffeine and the kidney: what evidence right now?
> Bolignano D, Coppolino G, BarillÃ A, Campo S, Criseo M,
> Tripodo D, Buemi M.

> Caffeine, or 1, 3, 7-trimethylxanthine, is one of the
> most frequently consumed active drugs worldwide. (…)
> A review of the current literature reveals conflicting
> opinions regarding the prolithiasic effect of this
> substance, whereas its diuretic action is least disputed
> and more easily observed. Caffeine may have a toxic or
> preventive effect in some physiologic or pathologic
> conditions. Some of these incongruences may depend on
> several factors, such as dosage, prior chronic exposure,
> genetic-enzymatic axes, and concomitant drug consumption.
> While awaiting further insight from forthcoming studies
> on the issue, we may reach a preliminary conclusion that,
> as yet, there is no evidence contraindicating the consumption
> of the equivalent of 3 to 4 cups of coffee per day in healthy
> or nephropathic subjects. However, particular attention
> should be paid to the elderly, children, and patients on
> concomitant treatment with analgesics or diuretics, whereas
> in subjects with a family or clinical history of calcium
> lithiasis a moderate caffeine consumption should be
> associated with an adequate fluid intake.

There’s the most current I could find on PubMed.

Short version: 3-4 caffeinated beverages per day are fine for healthy adults (possibly unless you have a history of kidney stones), and have variable effects on ill people, depending on their illness, what medications they’re taking, and other factors.

I can see from the responses above that I was unclear, and I apologize- I didn’t mean caffeinated beverages are bad for normal, healthy people drinking to thirst. I meant they’re bad as forced fluids for rehydrating sick, medicated, dehydrated people, which is what the ad was in reference to. My apologies.
- Anonymous
  
  “3-4 cups of coffee” has more caffeine than you’d get in twelve cups of Pepsi.
angusm

I wondered what it took to get people to drink that stuff.
dross1260

Joan Crawford approved!
Maddy

This belongs in a Madmen eppie. I would love to see Draper creating this … for whatever nefarious reason …
dculberson

“Never too sweet?”

Apparently Pepsi has a different dictionary than mine, where “never” actually means “always.” Pepsi is sickeningly sweet.
Tiferet

@Lauranne: If caffeinated beverages don’t hydrate people, then I’m not sure why I’m not dead. Occasionally I drink chocolate soymilk but 95% of what I drink is Diet Coke or sweet tea (with splenda). Due to various meds I’m on, my kidney function is frequently tested; it’s always been fine. (I’ve been a caffeine addict since I was 4–if I go off it, after 2 days I’m incapacitated by the headaches. I’m pretty sure it started as self-medication for ADHD, which went undiagnosed for years because I was smart enough to compensate until I hit college courses that required the ability to plan ahead.)

That said, Pepsi is disgustingly sweet–after years of drinking diet drinks by preference I had a Pepsi Throwback, and it was like drinking liquid candy. Which it is in fact. I would think that there would be a huge danger of rotting the patients’ teeth from force-feeding restrained patients Pepsi–one of the reasons I switched to diet drinks is that my teeth have suffered enough.