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This article originally appeared in the July/August 2005 issue of Update, the bimonthly publication of the Food and Drug Law Institute.
Suzanne White Junod, Ph.D.
FDA Historian
"Quack is a pejorative term, disparagingly, albeit sometimes defensively,
applied by a member of the establishment, the orthodox, regular, professional,
credentialed and accepted class to describe the unorthodox, unlicensed, disapproved
member of a fringe or irregular group. . . . Above all, the term has
become associated with the sellers of medicines and the marketers of medical
systems, those with the 'true' method of curing specific ills or,
in an earlier day, all the ills of mankind."
William
Helfand, Quack,
Quack, Quack: The Sellers of Nostrums in Prints, Posters, Ephemera & Books, (New York: Grolier Books, 2002, p. 13).
From the pages of Puck and Judge, around the turn-of-the-century, it is certainly clear that consumers of the day had an astonishing array of medical choices -- and they weren't particularly keen on most of them--at least for long. As the medical minstrels of the nineteenth century (fig. 1) gave way to the advertising alleys of the twentieth (fig 2), skepticism was the cornerstone of the early twentieth century's medical culture. Homeopaths, allopaths (conventional doctors), and chiropractors vied with patent medicines and their promoters for their turn to be portrayed as "quacks," in the pages of the magazine. Poems such as Samantha Peterson's Faith-Cure testified to the "common sense" knowledge that the magazine promoted on issues of health. The underlying message: Samantha's marital misery had a cause and a cure, and it didn't take a doctor to diagnose and treat it.
When Mis' Samantha Peterson arose one night in meetin'
An' said her former trust in patent-medicines were fleetin'
An' she proposed to try, instead, the faith-cure for a spell,
A sort of solemn hush upon the congregation fell.
There were things about the faith-cure which we couldn't recommend,
An' we didn't know Samantha's plan nor how it all would end;
Still, when our first surprise wore off, a few of us confessed,
That, after all was said an done, it might be for the best.
Whatever else that we could say, we couldn't make denial
She'd given patent-medicines a fair an' thorough trial;
She kept them in a closet an' upon its spacious shelves
Stood bottles big an' boxes small which we had seen ourselves.
We had often read the labels: there was "Perkins's Purple Pills,"
An "Elder Jones's Elixir and Emollient for Ills;
There was "Fosdick's Hypo-Phosphate made to Fortify the Feeble,"
An' "Potterbury's Panacea for Pale and Ailing People."
Though Samantha threw them all away she didn't seek her bed;
She made a resolution she would go to work instead;
An' she hadn't tried her faith-cure long when folks' began to think
Samantha's face was actually growin' plump and pink.
We went an' told her husband, in a manner kind of sly,
She was growin' so good-lookin he might loser her by-an-by;
Samantha overheard us an' it pleased her, too, a lot,
An' she come to wear a look as though she'd rather laugh than not.
There isn't any doubt but what Samantha's really well,
An' about her wondrous faith-cure, now she often likes to tell;
Of the good of other faith-cures, we've our doubts, we must confess,
But we think Samantha's faith-cure was a glitterin' success.
(Puck Magazine, vol. 43, no. 1105, May 11, 1898)
Competition in the patent medicine industry was increasing and health "crazes" including health foods, began to divert the attention of potential patients.
"And you say these substitutes are injurious?" asked his friend.
"Very injurious, replied the patent-medicine man, emphatically;
"they raise Cain with my business."
(Puck Magazine, vol. 43, no. 1105, May 11, 1898)
Morphine (once an hour), quinine (4 times a day), Laudanum (teaspoon at times), Calomel (early and often), and arsenic (take often) are joined frontstage by the idiots, asses, fools, imbeciles, lunatics, noodles, and flatheads depicted on headstones as having taken them. Performing on stage are the major medical sects of the day: Allopathy, Hydropathy, Eclectic, Homeopathy, and Phlebotomy, and Spiritualists. Print courtesy of William Helfand.
Outdoor advertising was becoming quite an eyesore and this caricature satirizes some of the best known proprietary products including Bromo Seltzer, Braindeis' Pills, Fletcher's Castoria, Carter's Little Liver Pills, Hoods Sarsasparilla. Note Maltine at the top left. Print courtesy of William Helfand.
Note the label statement: "Accepted by the Council on Pharmacy and Chemistry of the American Medical Association." In an attempt to fight what they perceived as the "nostrum evils," the American Pharmaceutical Association and the American Medical Association had joined forces in 1905 to form a federal bureau to certify pharmaceuticals, funded by what we would now refer to as user fees. The Drug Division in the Bureau of Chemistry (forerunner of CDER) worked with the Council performing analyses until the council received a lab of its own, and there was ongoing Bureau representation on the Council. Print courtesy of FDA History Office.
A new doctor comes to town. Subscribing to the "new school" of "mind cures," he draws the reader's attention to his "no drugs" cemetery, while the "medicine man" (allopath) perched on the steps to the city next to the "chockfull" cemetery is quite defensive and protective of his "turf."
Dr. Quack "We must find a way," Again, drugs, whether patent or prescription, were being questioned by the public. This patent promoter makes the point that his patent medicine business was being threatened by an assortment of non-drug "health crazes" such as "the barefoot" treatment for rheumatism, the "all-fours" treatment for appendicitis, the "Hudson-river frappe cure for consumption" and the "metropolitan mud-cure" for "any old thing." Judge, vol 47, no. 1190, August 6, 1904
Tramp---"Could yer spare me a few doses of patent medicine, mum?
Mrs. Handout--"What kind?"
Tramp--"Oh, any kind will do. I only want ter git sick enough ter attract sympathy,
mum."
This tramp is seeking patent medicines to make folks feel sorry for him! (Judge, vol 46, no. 1181, June 4, 1904)
Silas--If I ain't better by Monday week I'll send for a doctor.
Samantha--What's the sense of waitin' till Monday week?
Silas--Well, on Monday week it'll be just forty years since I had a doctor.
I'd like to make it an even forty years Samantha.
This patient is proud of his past -- spent avoiding doctors. (Puck, vol 50, no. 1281, September 18, 19)