Popular Science Monthly/Volume 68/June 1906/Facts About Nostrums
By HORATIO C. WOOD, Jr., M.D.
UNIVERSITY OF PENNSYLVANIA
THE quantity of secret and semi-secret drug mixtures consumed by the American people is enormous. While it is impossible to determine accurately the extent of the custom of self-medication a recent writer has estimated that over $100,000,000 is expended annually for so-called 'patent medicines.' The investigation of the causes which have led to the growth of this business affords an interesting study of human nature and also throws a light upon the subject of the effect on the health of the community. Since time was mankind has desired when sick the advice of some one who has devoted especial attention to the subject of relieving human suffering, and while here and there are scattered over the land adherents to various faddists, who, on account of religious beliefs or credence in some peculiar theory of health, have ceased to consult doctors, yet the overwhelming majority of the people still believe in the usefulness of the medical profession as well as of drugs.
The two motives which most commonly lead to experimentation with advertised nostrums are the desire to avoid calling in a physician and to save thereby the doctor's fee, and the hope that better results may be achieved than are offered by the regular medical profession. Occasionally, as in unsettled districts, the impossibility of obtaining medical advice forces 'home treatment,' but this condition is so infrequent that it may be practically disregarded.
In the majority of instances it is the indisposition to send for the doctor which explains the self-dosing, not always from the desire to save money, but at times from a sense of shame in annoying a busy man with some trivial complaint which the patient believes he can treat himself with equal benefit. This feeling covers the use of a large number of the less objectionable proprietary remedies such as the laxatives, but is also the predominant factor in the employment of the most diabolical of them all, the 'soothing syrups,' with which hundreds of non-thinking mothers are poisoning their children. One of the dangers, which attend all self-medication but apply with especial force to the habit of relieving seemingly trivial complaints, is that some serious trouble, still in its formative stage when proper treatment is most efficacious, is neglected until the damage wrought becomes irreparable. For example, a man is taken with what he believes to be an ordinary 'stomach-ache,' due to indigestion, and buys some 'painkiller' or 'dyspepsia tablet' with which he experiments on himself for two or three days; the physician called too late finds appendicitis gone on to a stage perhaps where a fatal issue is unavoidable. Again, in the spring of the year a feeling of languor is diagnosed by the doctor-patient as 'spring fever,' for which he doses himself religiously with some stimulating 'blood purifier,' while the real nature of the case may be a beginning typhoid fever. The list of such conditions which may and do occur might be drawn out ad infinitum, but enough has been said to show the great fundamental objection to all nostrums.
This danger, it must be confessed, however, is after all a comparatively remote one. The great imminent peril which threatens the life and health of the nation lies in the fact that a large number of these remedies contain poisonous and habit-forming ingredients. The most horrible instance of this is the 'soothing syrups.' These are universally loaded down with morphine. The immediate deaths which have followed an overdose of some opium-containing 'soothing syrup' are numerous enough, but the thought of the hundreds of children condemned from the cradle to a life of invalidism, to which the grave is preferable, by the formation of a morphine habit from which the delicate nervous system is never able to recuperate, is horrible. The poor ignorant mother is usually not to blame, but the devilishness of the nostrum vender who deliberately sets out to poison helpless infants puts him below the murderer in criminal immorality, and the supineness of a government which permits such crime to go unpunished must bring a blush of shame to the face of every thinking citizen.
Another frequent offender of this class is the 'cough syrup' or 'pectoral.' These nearly all contain either opium or some closely allied drug. Those of the headache powders and other remedies for the relief of pain which do not contain opium almost without exception are preparations of acetanilid, a substance derived from coal tar, which, although perhaps not so dangerous as morphine, produces an insidious weakening of the heart when used repeatedly, and whose victims number into the thousands.
Those who employ patent medicines from the second motive mentioned, that is, with the hope of obtaining better results than are promised by the regular medical profession, are naturally found chiefly among the less educated classes of society. To an intelligent mind it is evidently improbable that an untrained observer whose interests are purely commercial should know of some remedy of great value which generations of devoted physicians and scientists had failed to discover. The claims made by this group of nostrum mongers are so palpably impossible as to be ridiculous to all thinking men. Yet it is surprising to find how many persons of presumable intelligence, driven by the desperation of an incurable disease grasp at this frail straw in the hope of being rescued from untimely death. Such are found especially among cases of consumption, cancer, spinal disease or other similar chronic complaints whose outlook is unfavorable. Many of the nostrums belonging to this class are quite inert, while others contain opiates or stimulants which give temporary relief from symptoms but only hasten the end.
The question must present itself most forcibly, if the statements outlined above are true, how does it come that such a large body of the people continue to use these irrational remedies? This question is usually answered by attributing the results to 'shrewd advertising.' If shrewdness is synonymous with falsehood and blackmail the answer is correct. While it is true that an enormous amount of money is spent in advertising, yet back of all these advertisements is a mass of deceit which in any other business would prove ruinous.
It is necessary to digress for a moment to obtain a comprehension of the factors which have made successful commercial methods which under ordinary circumstances would mean certain failure. All patent medicines, with a few exceptions, as the laxatives, may be divided into two classes, the inert and the dangerous. The harmful remedies which are employed are usually either opium, cocaine, alcohol or acetanilid. All of these are drugs whose use is liable to lead to a craving for more. It is evident that if Peruna once starts an alcohol habit, or if Bull's 'Cough syrup' makes an opium fiend, or Birney's 'Catarrh Cure,' a cocaine habitué, the future sale of that remedy is assured. After once being persuaded to consume the first bottle of the deadly nostrum the financial and moral wreck of the victim is an easy matter. It is asserted that so widespread has become the use of some of these remedies that cures are now being advertised for the relief of the Peruna habit. With the inert nostrum the conditions are somewhat different. These depend for their prosperity upon the large number of credulous persons from among whom new customers may be obtained when some old customer awakes to the fact that, in the language of the college youth, 'he has been stung.'
It is clear that the task of the purveyors of inert frauds is a more difficult one than that of the vender of habit-forming poisons. But the methods of procuring new customers is essentially the same in each instance. To obtain fresh victims there is no depth of immorality to which the manufacturer of the nostrum will not stoop. The lies are of manifold variety, but of a few classic types.
The first of these, which may be denominated as the lie simple, is the extravagant claim to cure all sorts of conditions, based simply on the statement of the owner of the drug. Sometimes these are fortified by offer of 'money back if not satisfied' or one hundred dollars, or a thousand, or a million—it makes no difference, since it is never paid—'for a case which can not be cured,' etc. As an example of the sincerity of these offers an illuminating correspondence is quoted from the Journal of the American Medical Association, as follows:
April 21st, 1906.
Drs. Brown and Lenox, Rogers, Ark., send us an account of a case of catarrh which was not cured by Hall's Catarrh Cure. The patient, Mr. Robert Parks, consulted these physicians for catarrh and stated that he had just finished his twenty-sixth bottle of Hall's Catarrh Cure, but that instead of being benefited he was worse. Mr. Parks wrote to the Cheney Medicine Company, the maker of Hall's Catarrh Cure, giving his experience, and asking the firm to pay $100.00 in accordance with the advertisements: "$100.00 for any case of catarrh which it will not cure" or to refund the money he had paid.
The following is a copy of a letter which he received in reply:
Toledo, Ohio, March 30th, 1906.
Robert Park, Rogers, Ark.
Dear Sir: Yours of recent date received and in reply will say, as we have already said, that many cases require much more than you have taken for a cure, and as this is the case and Hall's Catarrh Cure is not placed on the market on the 'No cure, no pay' plan, we would not feel at all justified in refunding the money paid for this trial of the medicine. Will further say that you have failed to state much regarding your disease, symptoms of same, of how long standing, symptoms of the action of the medicine, etc. Had we more information concerning your case, we might have been able to make some helpful suggestions regarding the treatment."
Yours very truly,
F. J. Cheney & Co.
A. G. A.
The second type of falsehood which is used by these manufacturers is the testimonial lie. Some obscure citizen who has been rescued from some imaginary complaint spills his gratitude to the nostrum manufacturer in a lurid if ungrammatical epistle. Sometimes, however, it is not an obscure citizen, but a prominent one, a senator, or an admiral of the United States Navy or some one equally before the public eye. Some of these testimonials are absolute fabrications. The boldness with which nostrum venders manufacture evidence is astonishing, and only comprehensible in view of the fact that there is usually no legal punishment. Some years ago, Duffy's Malt Whiskey Company stated in their advertisements that it was recommended in consumption by Dr. ———, one of the most prominent physicians of Philadelphia, when as a matter of fact he had never tasted it nor prescribed it; but the courts offered no redress and the only means of cleansing his reputation was an advertisement in the daily papers. Some of the testimonials are bought. (There is a firm in this country which is engaged in the sale of testimonials to nostrum manufacturers.) The following circular speaks for itself.
As you are aware, we have your testimonial to our remedy. It has been some time since we have heard from you, and so we thought best to make inquiry as to your present state of health, and whether you still occasionally make use of Peruna. We also want to make quite sure that we have your present street address correctly, and that you are making favorable answers to such letters of inquiry which your testimonial may occasion. Remember that we allow twenty-five cents for each letter of inquiry. You have only to send the letter you receive, together with a copy of your reply to same, and we will forward you twenty-five cents for each pair of letters. We hope you are still a friend of Peruna, and that our continued use of your testimonial will be agreeable to you. We are inclosing stamped envelope for reply.
Very sincerely yours,
The Peruna Drug Manufacturing Co.,
It would seem time for the law to intervene to stop this noxious traffic. Owing to recent agitation in certain magazines some effort has been made to restrict it, but it has met with vigorous opposition from a venal lobby. Those interested in the business argue that this is a free country and that each one must be allowed to use his own judgment as to what is harmful or beneficial. Such sophistry would be laughable if it were not used with such deplorable results. In almost every state of the union the practise of medicine is rigidly controlled. The applicant must show not only proof of medical education, but must pass an examination given by the state, before he is licensed to practise. As sensible an argument would it be to say that every one has a right to practise medicine and that each one must use his common sense in choosing a doctor who is educated. In many states of the union there are laws regulating the adulteration of foods. In but one or two states are there laws preventing the sale of deadly poisons in the form of patent medicines.
Government is for the purpose of protecting society from the depredation of persons whose moral intuitions are below the average of the people in general. We hang murderers in order that they may find no further victims; we lock up thieves that our property may remain safe; we allow patent-medicine monsters to murder and to steal without restraint. The proprietors of these nostrums are to be classed as moral perverts, for while they may deceive the public with various statements concerning the value of their remedies, they themselves are in no wise deceived. Being so, it becomes the duty of our legislative bodies to protect the community. The general public does not and can not be expected to separate the truth from the falsehood about the value of unknown drugs. When the poor, uneducated, epileptic whose mind has been enfeebled by disease, reads in a respectable paper an advertisement backed with some testimonial, he can not know that the testimonial is false and that the claims are absolutely impossible, but readily becomes the dupe of the charlatan, throwing away both money and life in search of the 'Will-o'-the-wisp.'
There is now pending before the United States legislature a bill which the nostrum dealers cry out is a terrible crime against personal liberty and a ruination of a great business. And what is the terrible proviso which so frightens those engaged in patent medicine business? Simply that all proprietary remedies containing opium, cocaine or other poisonous ingredient shall state upon the label the exact amount of the poisonous ingredient present; as feeble and conservative a measure for this great evil as one could well imagine.
With any other measure of similar importance before congress the newspapers, which are the great voice of the people, would cry in such a tremendous chorus for relief that no legislator would dare to hesitate to pass the bill. But the silence of the newspapers and magazines, with a few notable exceptions, has been bought through the advertising columns. In this morning's paper I find an advertisement for Hood's Sarsaparilla which occupies space value, according to the published rates of the paper, of seventy-five dollars; Doctor Pierce occupies sixty-five dollars' worth; Cuticura is satisfied with thirty dollars' worth, and other advertisements in similar quantities bring up the day's total to $240. This does not include the smaller notices of drugs among the personal columns and small classifications. In the evening paper Duffy's Malt Whiskey has a prominent place with the picture of a 'grand old patriarch' who was enabled to reach the age of one hundred and four years through the constant use of this liquor, while one tenth of the entire issue is advertisements of secret remedies. Receiving as they do $900,000 a year apiece from this business, is it any wonder that the newspapers are disposed to keep silent concerning the evil of it? The mouthpiece of the nation is stopped with gold; let the people, therefore, speak directly and bid their legislators save the ignorant and the innocent from the voracity of the conscienceless degenerates who are robbing them of health and money at the same time.