THE QUEST TO QUELL QUACKERY

(Alternate title for article break  THE PATENT MEDICINE MENACE)

by Pam North

Medicine shows had their origins long before the United States became a 
nation, beginning in fourteenth-century Europe.  American medicine shows 
employed traveling entertainers who could draw audiences to which the 
"doctors" could direct elaborate sales pitches hawking their cure-alls.  The 
major firms of the era, such as the Kickapoo Indian Medicine Company 
(headquartered in Connecticut, nowhere near any 19th-century center of 
Indian population) used the medicine show as a vehicle for their 
promotions, and also published a variety of advertising materials to promote 
their products independently of the show.  These publications often allied 
their nostrums with the herbal knowledge of the American Indian, exotica, 
religion, patriotism, mythology or new developments in science - anything to 
sell the products.  Nostrums permeated American society by the late 19th 
century, and there were no constraints to prevent the extravagant claims made 
as to theirproducts' curative powers, nor to keep their contents from 
including questionable and dangerous ingredients, as in the morphine and 
alcohol-laced syrups for teething and colicky babies.  Patent medicine makers 
extolled the nearly-magical virtues of their products to cure any and all 
known diseases, such as cancer, arthritis and tuberculosis.  They advertised 
baldness remedies, bust developers, manhood restorers, and answers to 
feminine physical complaints.  They held no monopoly on the market; the 
ethical pharmaceutical industry, which advertised directly to the health 
professionals, sold their share of patent medicines as well.

Patent medicines' long and shady history in America reaching its zenith in 
the late 19th century, when the population became more urban and somewhat 
more capitalized, a ripe target for charlatans best characterized by the 
dictum, "caveat emptor."  Communications had expanded; the printed word 
became a crucial venue for the proliferation of patent medicines; the rise of 
advertising in America, not coincidentally, paralleled the rise of nostrums.  
At the same time, the biomedical sciences in this country were still in their 
infancy, with medicine ill-equipped to deal with most diseases.  Countless
enterprising and unscrupulous individuals were prepared to step in and make 
claims to alleviate physical suffering.

The success of patent medicines was attrbiutable to several factors.  Access 
to medical practioners was very limited, especially in rural areas, and 19th 
century medical technology was primitive by today's standards.  These 
products, appealing in their highly-touted abilities to cure, offered ease 
and convenience of purchase (from the traveling show or the local general 
store), and were a preferred alternative to some of the unpleasant medical 
procedures (such as bloodletting) of the era.  Many of the patent medicines 
contained alcohol (some were almost entirely alcohol) and narcotics (morphine, 
cocaine and opium), and these ingredients usually had the effect of making 
the patient feel better for a while, even if they fell short of the claims 
of being wonder cures. 

Quacks developed successful marketing techniques, but they also promoted their
interests by using their econmic strength to subdue any curiosity in the press.
By the 1890s, patent medicine manufacturers used so-called "red clauses" 
(contracts of silence) in their advertising contracts with newspapers and 
magazines.  These muzzle clauses voided the contract if a state law regulating 
nostrums was passed.  Many editorials thus were not only silent on the need 
for such laws, but actively campaigned against them. An estimated annual 
figure paid out to newspapers by the proprietary medicine companies exceeded 
twenty million dollars - averaging more than one thousand dollars to each 
newspaper in the United States.  Charlatans and their trade associations were 
not able to successfully stifle the entire issue, however.  A few muckraking 
journalists helped expose the red clauses, false testimonials and claims, and
products' harmful ingredients.  A series written by Samuel Hopkins Adams in 
Collier's in 1905, entitled "The Great American Fraud," followed by another 
series on doctors who advertised fake clinics, revealed many startling and 
disturbing facts to the American public. The publication of another work by 
socialist Upton Sinclair, entitled The Jungle, a fact-based novel about 
immigrant life in the meat-packing industry of Chicago, primed the final push 
for federal law.  The first federal Food and Drugs Act was passed four months 
later.  The wriitngs of Adams and Sinclair had a major impact on passage of 
the bill, as did the untiring work of other organizations. The law prohibited 
adulteration and misbranding of food and drugs, and though it had many 
shortcomings, it was definitive and beneficial.  The federal legislations of 
the early 20th century, both in the U.S. and Canada, in which manufacturers 
were required to list the ingredients in their products, and were prohibited 
from making false promises and claims about benefits and results, almost 
brought about the demise of the entire industry.  Some products continued to 
be sold well into the 1950s and beyond,however,  but in altered form.  The 
legislation, while not eliminating quackery completely, brought disclosure 
and accountability into the marketplace, an important first step in consumer 
protection.






Illustrations for article are at:
http://www.nlm.nih.gov/exhibition/ephemera/medshow.html