Public Health

Thousands of Remedies
by Food and Drug Administration (FDA)

(Page 2 of 6)

The trouble was not just in food; it may have been worse in the medicine trade. There were very few medicines known to work effectively - one doctor said all could be counted on the fingers of one hand. But there were thousands of remedies on the market, divided roughly into two kinds - the inadequate but seriously intended treatments prescribed by doctors, and the commercial medicines sold by some for no other reason than for profit.

Medicine was one of the first fully national markets that used nationwide advertising, and so quack medicines, of which there had always been a trickle, suddenly became a flood as tradesmen, not doctors, saw the possibilities for profit. A new category of drugs and health supplements, shaped in England but exploited on the American side of the Atlantic, was created specifically to suit the new methods of business. Though called patent medicines, they were not actually patented. Rather, the words "patent" and "proprietary" referred to the secrecy in which their formulas were held. Ingredients were not disclosed to either the doctors who administered the "drugs" or the patients who took them.

This secrecy was a break from the past. In every developed nation, doctors and lawmakers had worked to construct a known, stable list of medicines and their ingredients. These were the pharmacopoeias and national formularies. They were put together in an effort to assure citizens that the medicines they were taking were standard mixtures of known ingredients, whether or not they could be said to be effective. The efforts to regularize medicine, to set universal formulas for each known remedy, had advanced from the 17th century until the 19th century.

The patent medicines often were created from the standard remedies doctors used, made from the same herbs and minerals. Their effects were very similar, though confounded by the multiple ingredients they contained, from a half dozen to 40. They were sold solely on the basis that someone, somewhere, was said to have been cured by them. The difference between them was one of marketing. It was the packages and the advertising sheets that were the key to the rise of the era of quack medicines.

This was a first for any product. Manufacturers, as America's leading historian of food and drugs, James Harvey Young, writes, patented neither the key medicine in these offerings nor the composition of the entire formula. Instead, the makers patented, trademarked, or copyrighted the distinctive shape of the bottle, the box the medicines came in, the type styles and pictures on the labels, and the advertising associated with it all.

They worked with more than 15,000 names, including - the "Grand Restorative," the "Universal Vegetable Pill," and "Wheeler's Nerve Vitalizer." The claims for what they did were relatively modest and narrow in the 17th and 18th centuries, but became florid and aggressive by the 19th century. Swaim's remedy, for example, was sold with claims to cure "cancer, scrofula, rheumatism, gout, hepatitis, and syphilis," and the list expanded gradually over the decades it was on the market.

The makers of these remedies were the first to exploit the new communications boom and accounted for a large percentage of the income of many newspapers, often half of a newspaper's entire advertising income. The drugs "flourished in direct ratio to the availability of cheap newspa-pers and magazines," writes historian of medicine John Duffy.

The Troubled American Food and Drug Trades

Standards for known drugs were also low. At one point, concern about the medical drugs coming into the port of New York from Europe prompted a yearlong investigation by M.J. Bailey, an inspector appointed by the secretary of agriculture. At the end of the study, he told Congress: "More than one half of the most important chemical and medicinal preparations ... come to us so much adulterated, or otherwise deteriorated, as to render them not only worthless as a medicine, but often dangerous." Rhubarb root was a common ingredient in medicines, and in one three-month period, Bailey recalled, he had reviewed 7,000 pounds of the root and found "not one pound of it fit, or safe." Opium was a vital painkiller, and when medical shipments arrived in New York, they had been cut to one-third natural strength and laced with Spanish anise and other bitter powders to disguise the dilution. Further, a substantial part of all opium shipments was infested with live worms. Massachusetts reported that of all medical drug samples taken there between 1882 and 1900, 37 percent were adulterated. In New York, of the 343 samples of one drug purchased, phenacetin, 315 were diluted with acetanilide, a very hazardous painkiller.

The market in medicines, without any regulation, was essentially the same as the illicit trade today in heroin, cocaine, and other drugs. The supply was unreliable, the purity suspect, the price high and variable.

"The magic power of profits," said Edward R. Squibb, M.D., the founder of the drug giant of the same name, was apparently able to corrupt "a large majority" of the pharmacists, and many doctors. He felt sympathy for those who wanted to maintain high standards, and believed they deserved a fair chance to earn a good living, which they could not do in such an environment. Adulteration of drugs was enough to get the U.S. Navy's Bureau of Medicine and Surgery to stop buying drugs from pharmaceutical companies altogether. The bureau set up its own laboratory for making drugs to be sure they would be both potent and uncontaminated.

European nations increasingly came to fear American goods and started embargoes against food. Rampant contamination of American products gave European nations an opportunity to create trade barriers that would do wonders for their own farmers and food manufacturers. After a round of trichinosis infections in the United States caused by infected pork, the acting British consul in Philadelphia wrote to his foreign office, with an apparent combination of horror and glee, of the symptoms of one man in Kansas, ill with trichinosis: "Worms were in his flesh by the million, being scraped and squeezed from the pores of his skin. They are felt creeping through his flesh and are literally eating up his substance." Even in countries without boycotts, the sale of American products dropped drastically.

About the Author

www.fda.gov
FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.