History of American Quackery

Jonathon Erlen

Today we are going to look at a third approach to how Americans have attempted to handle their health care concerns while avoiding seeing a physician or other traditional health care professionals throughout the pre-20th century period, though this third approach is very much alive and well in 2003. This third, and by far the most dubious approach was and is medical quackery, though this is a very subjective term.

In your opinion today what is medical quackery? We now live at a time when there is probably more medical or health care quackery than ever before, because of the wide variety of means by which those practicing these deceptive practices can reach their vulnerable public ie: TV, radio, news media, and the internet.

The charge of being a “quack” is one of the most serious that can be hurdled at an individual and should not be used lightly. The individuals throughout American history who have been charged with practicing quackery have ranged from legitimate physicians who were practicing medicine outside the accepted scope of medical practice at a particular time-some who were probably simply scientifically deluded and really believed in what they were practicing-to individuals who had no medical or scientific training and knew what they were selling not only would not work but also, in many cases, would actually be harmful to their patients.

First lets look at why patients would turn to quackery in the first place. Some of the reasons Americans have turned to quackery are the same as those that drove them to irregular medical practitioners and health fads-namely a lack of confidence in what regular medicine had to offer, inaccessibility of regular doctors, and the inability of medicine to cure the diseases of their patients. Certainly well into the 20th century there were many diseases for which regular medicine had no cures, such as tuberculosis and cancer. The victims of these illnesses were ready prey for the quack and his seductive salesmanship.

What else could the unscrupulous quack offer patients that the honest physician, then and now, could not? The physician’s cure might be painful, while the quacks was pain free. The doctors’ charges were high, while the quack’s medicines were inexpensive. It might be difficult to find a doctor, while the quack’s offerings were easily procured at the neighborhood pharmacist without the need of a prescription. Perhaps the most important difference was that the honest physician would warn his patients that the treatment might be long and not work, while the quack could and did promise quick, full recovery through the use of his medications and devises.

What did the medical quack attempt to sell his audience of sick, or potentially sick Americans during the 19th century. A large variety of quacks created numerous medications and devises to cure the American public of a wide range of ailments, both real and imaged. A wide range of drugs, often called nostrums, were created and marketed throughout 19th century America. In the colonial period the colonists had relied primarily on patent drugs from England for their health care, such as Turlington’s Balsam of Life. Let me hasten to point out that when I say patent medicines I am referring to the bottle and/or label on the bottle, as this is what was patented.

The variety of these nostrums is almost overwhelming. Some were for specific diseases, though most nostrums claimed curative powers over a wide variety of ailments. One of the two most popular nationally marketed series of patent medicines during the first half of the 19th century were the nostrums produced by Thomas Dyott, a former shop blackener who rose to become the king of the nostrum makers in the early 19th century. He was one of the first to make effective use of America’s rapidly growing urban newspapers to market his ineffective cures, such as Robertson’s Infallible Worm Destroying Lozenges. An even more prominent early patent medicine promoter was William Swaim with his Swaim’s panacea, promising relief from a myriad of real and imaged diseases.

The golden era of patent medicines was the period from the Civil War to the end of the 19th century. With the growth of America’s newspapers and popular magazines and the expansion of public literacy the marketing of patent medicines became one of America’s leading growth industries. A constantly expanding supply of old and new nostrums were presented to the American public. Here are just a few examples from the thousands of patent medicines readily available at your corner drug store. Here is an advertisement for Hunt’s Remedy and another for that old standby peruna.

What were some of the standard advertising techniques used by the successful patent medicine merchant to sell his wares to the eager American public? One of the favorite advertising techniques widely used by 19th century American medical quacks were images depicting military victories - here we see the victory at the battle of TippyCanoe. During the Civil War nostrum makers on both sides of this conflict used military imagery to sell their nefarious products. Patriotism was always a good means to push a patent medicine, as depicted in these ads.

Beginning in 1796 with Elisha Perkin’s magnetic tractors, devise quackery has flourished in the United States. The 20th century has seen what seems like an unending number of devises that promise eternal youth, good health, and recovery from virtually any disease. Here is an ad for one of the many quack devises created by the leading quack of electrical healing devises in the first quarter of the 20th century, Albert Abrams. Here is the cancer curing devise created by Ruth Drown. The founded of the Academy of Scientology, L. Ron Hubbard, also developed this supposed healing devise. Here is a devise to create healing ozone for you to inhale.

While these advertisements may seem even somewhat humorous the effects of quackery has been and remains anything but funny. Focusing on the nostrums what were the actual hazards these patent medicines created for the guidable American public? Even the drugs that were almost all water and thus did not actually cause direct harm were harmful in that they kept the public from seeking real medical assistance if it was available-tell story of youngster taken from Childrens Hospital in Dallas by his parents to get laetril in Mexico.

However most of the 19th century patent medicines did contain potentially harmful ingredients. The two major standby’s in patent medicines were alcohol and narcotics. Here is an AMA anti-quackery poster illustrating the high level of alcoholic content in a patent medicine. Hostetter’s Bitters was tested and proved to contain up to 80% alcohol. Because of this harsh reality the Women’s Temperance movement and women’s clubs across America would join in the anti-patent medicine movement in the first decade of the 20th century. Nostrums in the last third of the 19th century often favored using a variety of narcotics to satisfy and hook their intended audiences.

The nostrum makers had a fairly free hand throughout the 19th century in the marketing of their dubious products. Occasionally a reform minded physician or pharmacist would protest the lack of quality in the patent medicine field, but these few voices were ignored by the American public. America’s newspapers and magazines relied on patent medicine advertising for much of their income, thus they were unwilling to publish any anti-nostrum articles for fear of loosing their financial underpinning.

The pharmacy industry was in an even more difficult situation in regards to patent medicines. While the professional pharmacists might know about the low quality of these nostrums much of their business depending on selling these products. If the drug stores refused to sell these nostrums the grocery stores would and the pharmacists would loose much of their business.

By the final decades of the 19th century physicians and pharmacists who were opposing the patent medicine industry gained an important new professional ally, the agricultural chemist. Following the Civil War with the boom in the food industry manufacturers had learned how to use chemistry to improve the marketability of their foods; however, this also lead to a adulteration of these food products’ quality. Concerned agricultural states turned to chemistry to uncover this fraudulent use of chemicals in food products. These new agricultural chemists also became allies of patent medicine reformers and did much of the laboratory work that exposed the harsh ingredients found in most nostrums.

While some newspapers would have liked to print the findings coming out of the agricultural chemists’ labs they were prevented from joining this crusade by the “red clause” that became a part of the standard advertising contract between newspapers and patent medicine proprietors. In this contract created by the nostrum manufacturers to prevent negative publicity in the news media, was a phrase stating that the contract for advertising would be null and void if the state government passed any form of anti-patent medicine legislation.

The real crusade against the patent medicine makers was lead by a few brave editors of America’s leading popular, not scientific, magazines. Ladies’ Home Journal, edited by Cyrus H. K. Curtis, lead this crusade in the 1890’s. This magazine published the editorials written by Edward Bok that showed the Hostetter’s Bitters and Peruna were actually alcoholic beverages, not medicines. This information aroused protests against these nostrums by the WCTU and other women’s organizations. In 1904 Curtis hired Mark Sullivan, a Harvard trained journalist, to track down the dirt on the patent medicine industry.

Adams had studies pre-medicine at Hamilton College and done extensive training as a muckraking journalist working at McClure’s Magazine. He was perfectly suited to undertake the task of revealing the secrets of the patent medicine trade. He purchased numerous nostrums and took them to chemists and pharmacists to have their supposed effectiveness tested and to discover their actual ingredients. He even interviewed the maker of Peruna, Dr. Samuel D. Hartman, who willingly told Adams the secrets about his nostrum, secrets that would later appear in Adams’ articles in Collier’s.

The first of these articles appeared in the October 7, 1905 issue of Collier’s under the collective title of “The great American fraud.” Using illustrations and graphic details Adams shocked Americans into confronting the harsh realities of the patent medicine world. In discussing Peruna Adams correctly stated that it had about a 28% alcoholic content, while another nostrum, Liquozone, was 99% water, thus making it a totally fraudulent antiseptic. Adams saved his strongest language in condemning the numerous concoctions that contained either cocaine or opiates, thus making their unsuspecting users into lifelong addicts without their knowledge.

The patent medicine manufacturers who feared a conspiracy to end their freedom to distribute their harsh wares were correct. Added to the muckraking journalists, the women’s temperance movement, and reform minded physicians and pharmacists were the forces of the Progressive movement in government at both the state and federal levels. One man in particular would spear head the final drive to the passage of the 1906 Pure Food and Drug Act, Harvey Washington Wiley.

Attempts to pass federal legislation to protect the public from impure foods and drugs date back to 1879 but the effective lobbying from The Proprietary Medicine Manufacturers and Dealers Association, along with strong states rights activities in Congress blocked all pre-20th century legislation of this type, usually before it could even come to the floor of Congress. Wiley’s efforts would finally overcome these pro-patent medicine forces, but not before a mighty struggle.

With growing national public support and with the President now firmly behind them the Senate and House took up pure food and drug bills early in 1906. Congress was under intense national pressure to pass some form of protective legislation. Still the patent medicine forces looked as if they had killed the bill in the House through inaction when an outside event finally forced action on this measure. In the spring of 1906 a little known socialist author, Upton Sinclair, published his muckraking masterpiece, The Jungle, accurately depicting the terrible conditions present in the Chicago meat packing industry-how many of you have read this book?

Wiley and his crusading colleagues, including the muckraking journalists, the AMA, the American Pharmaceutical Association, a wide range of women’s clubs, and the American public had finally defeated the patent medicine industry. Or had they? What did Mr. Wiley’s Law, as this legislation came to be called, really require of the nostrum makers? This law did require that all labels on medicine bottles, patent and regular, tell the truth about the presence and amount of a limited number of what were considered dangerous ingredients, such as alcohol, the opiates, chloral hydrate, and a few other items. The medicine makers were not required to divulge any of the other ingredients, no matter how far fetched they were, on these labels.

The 1990’s have actually seen a decline in the authority of the U.S. Food and Drug Administration to oversee this area of public health. Nutritional supplements have been mostly removed from FDA supervision, letting GNC and other large and small firms reap fortunes from selling these type of potentially lethal goods. The political power, first of the AIDS lobby and later of the breast cancer advocates, have forced the FDA to approve new drugs for use with minimal advanced testing. There is no vehicle to curtail the sale of almost any form of false health care product and pseudo-knowledge over the internet. Thus we can say that medical quackery is alive and thriving today as never before in world history and there is no end in sight to the misery it will create.