Chapter 5

Thus as the present century opened, the old English patent medicines were still being sold. City druggists were dispensing them over their counters, and the peddler's wagon carried them to remote rural regions.[114] But the medical scene was changing rapidly. Improvements in medical science, stemming in part from the establishment of the germ theory of disease, were providing a better yardstick against which to measure the therapeutic efficiency of proprietary remedies. Medical ethics were likewise advancing, and the occasional critic among the ranks of physicians was being joined by scores of his fellow practitioners in lambasting the brazen effrontery of the hundreds of American cure-alls which advertised from newspaper and roadside sign. Journalists joined doctors in condemning nostrums. Samuel Hopkins Adams in particular, writing "The Great American Fraud" series for _Collier's Weekly_, frightened and aroused the American public with his exposure of cheap whiskey posing as consumption cures and soothing syrups filled with opium. Then came a revolution in public policy. After a long and frustrating legislative prelude, Congress in June of 1906 passed, and President Theodore Roosevelt signed, the first Pure Food and Drugs Act. The law contained clauses aimed at curtailing the worst features of the patent medicine evil.

[114] Robert B. Nixon, Jr., _Corner druggist_, New York, 1941, p. 68.

The Patent Medicines In The 20th Century

Although the old English patent medicines had not been the target at which disturbed physicians and "muck-raking" journalists had taken aim, these ancient remedies were governed by provisions of the new law. In November 1906 the Bureau of Chemistry of the Department of Agriculture, in charge of administering the new federal statute, received a letter from a wholesale druggist in Evansville, Indiana. One of his stocks in trade, the druggist wrote, was a remedy called Godfrey's Cordial. He realized that the Pure Food and Drugs Act had something to do with the labeling of medicines containing opium, as Godfrey's did, and he wanted to know from the Bureau just what was required of him.[115] Many manufacturing druggists and producers of medicine were equally anxious to learn how the law would affect them. The editors of a trade paper, the _American Druggist and Pharmaceutical Record_, issued warnings and gave advice. It was still the custom, they noted, to wrap bottles of ancient patent medicines, like Godfrey's Cordial and Turlington's Balsam, in facsimiles of the original circulars, on which were printed extravagant claims and fabulous certificates of cures that dated back some two hundred years. The new law was not going to permit the continuation of such 18th-century practices. Statements on the label "false or misleading in any particular" were banned.[116]

[115] Letter from Charles Leich & Co. to Harvey Washington Wiley, Bureau of Chemistry, Department of Agriculture, November 2, 1906. Manuscript original in Record Group 97, National Archives, Washington, D.C.

[116] _American Druggist and Pharmaceutical Record_, 1906, vol. 49, pp. 343-344.

A few manufacturers, as the years went by, fell afoul of this and other provisions of the law. In 1918 a Reading, Pennsylvania, firm entered a plea of guilty and received a fifty dollar fine for putting on the market an adulterated and misbranded version of Dr. Bateman's Pectoral Drops.[117] The law required that all medicines sold under a name recognized in the _United States pharmacopoeia_ or the _National formulary_, and Bateman's was included in the latter, must not differ from the standard of strength, quality, or purity as established by these volumes. Yet the Bateman Drops produced in Reading, the government charged, fell short. They contained only 27.8 percent of the alcohol and less than a tenth of the morphine that they should have had. While short on active ingredients, the Drops were long on claims. The wrapper boasted that the medicine was "effective as a remedy for all fluxes, spitting of blood, agues, measles, colds, coughs, and to put off the most violent fever; as a treatment, remedy, and cure for stone and gravel in the kidneys, bladder, and urethra, shortness of breath, straightness of the breast; and to rekindle the most natural heat in the bodies by which they restore the languishing to perfect health." Okell and Dicey had scarcely promised more. By 20th-century standards, the government asserted, these claims were false and fraudulent.

[117] Department of Agriculture, Bureau of Chemistry, Notices of Judgment under the Food and Drugs Act, Notice of Judgment 6222, United States vs. Pabst Pure Extract Co., 1919.

Other manufacturers sold Bateman's Drops without running afoul of the law. In 1925, ninety-nine years after the Philadelphia College of Pharmacy pamphlet was printed, one North Carolina firm was persuaded that it still was relevant to tell potential customers, in a handbill, that its Drops were being made in strict conformity with the College formula.[118] For Compound Tincture of Opium and Gambir Compound, however, most manufacturers chose to follow the _National formulary_ specifications, which remained official until 1936.

[118] Original handbill, distributed by Standard Drug Co., Elizabeth City, North Carolina, 1925, preserved in the files of the Bureau of Investigation, American Medical Association, Chicago, Ill.

Another old English patent medicine against which the Department of Agriculture was forced to take action was Hooper's Female Pills. Between 1919 and 1923, government agents seized a great many shipments of this ancient remedy in versions put out by three Philadelphia concerns.[119] Some of the packages bore red seals, others green seals, and still others black, but the labeling of all claimed them to be "a safe and sovereign remedy in female complaints." This theme was expanded in considerable detail and there was an 18th-century ring to the promise that the pills would work a sure cure "in all hypochondriac, hysterick or vapourish disorders." No pill made essentially of aloes and ferrous sulphate, said the government experts, could do these things. Nor did the manufacturers, in court, seek to say otherwise. Whether the seals were green or red, whether the packages were seized in Washington or Worcester, the result was the same. No party appeared in court to claim the pills, and they were condemned and destroyed.

[119] Multiple seizures were made of products shipped by the Horace B. Taylor Co., Fore & Co., and the American Synthetic Co. The quotations are from Notice of Judgment 8868; see also 8881, 8914, 8936, 8956, 8974, 9134, 9147, 9203, 9510, 9586, 9785, 10203, 10204, 10629, 11519, 11669.

In one of the last actions under the 1906 law, a case concluded in 1940, after the first federal statute had been superseded by a more rigorous one enacted in 1938, two of the old English patent medicines encountered trouble.[120] They were British Oil and Dalby's Carminative, as prepared by the South Carolina branch of a large pharmaceutical manufacturing concern.

[120] Federal Security Agency, Food and Drug Administration, Notice of Judgment 31134, United States vs. McKesson and Robbins, Inc., Murray Division, 1942.

According to the label, the British Oil was made in conformity with the Philadelphia College of Pharmacy formula given in an outdated edition of the _United States dispensatory_. But instead of containing a proper amount of linseed oil, if indeed it contained any, the medicine was made with cottonseed oil, an ingredient not mentioned in the Dispensatory. Therefore, the government charged, the Oil was adulterated, under that provision of the law requiring a medicine to maintain the strength and purity of any standard it professed to follow. More than that, the labeling contravened the law since it represented the remedy as an effective treatment for various swellings, inflammations, fresh wounds, earaches, shortnesses of breath, and ulcers.

Dalby's Carminative was merely misbranded, but that was bad enough. Its label suggested that it be used especially "For Infants Afflicted With Wind, Watery Gripes, Fluxes and Other Disorders of the Stomach and Bowels," although it would aid adults as well. The impression that this remedy was capable of curing such afflictions, the government charged, was false and fraudulent. Moreover, since the Carminative contained opium, it was not a safe medicine when given according to the dosage directions in a circular accompanying the bottle. For these and several other violations of the law, the defending company, which did not contest the case, was fined a hundred dollars.

Throughout the 19th century, occasional criticism of the old English patent medicines had been made in the lay press. One novel[121] describes a physician who comments on the use of Dalby's Carminative for babies: "Don't, for pity's sake, vitiate and torment your poor little angel's stomach, so new to the atrocities of this world, with drugs. These mixers of baby medicines ought to be fed nothing but their own nostrums. That would put a stop to their inventions of the adversary."

[121] John William De Forest, _Miss Ravenel's conversion from secession to loyalty_, New York, 1867.

Opium had been lauded in the 17th and 18th centuries, when the old English proprietaries began, as a superior cordial which could moderate most illnesses and even cure some. "Medicine would be a one-armed man if it did not possess this remedy." So had stated the noted English physician, Thomas Sydenham.[122] But the 20th century had grown to fear this powerful narcotic, especially in remedies for children. This point of view, illustrated in the governmental action concerning Dalby's Carminative, was also reflected in medical comment about Godfrey's Cordial. During 1912, a Missouri physician described the death of a baby who had been given this medicine for a week.[123] The symptoms were those of opium poisoning. Deploring the naming of this "dangerous mixture" a "cordial," since the average person thought of a cordial as beneficial, the doctor hoped that the formula might be omitted from the next edition of the _National formulary_. This did not happen, for the recipe hung on until 1926. The Harrison Narcotic Act, enacted in 1914 as a Federal measure to restrict the distribution of narcotics,[124] failed to restrict the sale of many opium-bearing compounds like Godfrey's Cordial. In 1931, a Tennessee resident complained to the medical journal _Hygeia_ that this medication was "sold in general stores and drug stores here without prescription and is given to babies." To this, the journal replied that the situation was "little short of criminal."[125] The charge leveled against his competitors by one of the first producers of Godfrey's Cordial two centuries earlier (see page 158) may well have proved a prophecy broad enough to cover the whole history of this potent nostrum. "... Many Men, Women, and especially Infants," he said, "may fall as Victims, whose Slain may exceed Herod's Cruelty...."

[122] Charles H. LaWall, _The curious lore of drugs and medicines (Four thousand years of pharmacy)_, Garden City, New York, 1927, p. 281.

[123] W. B. Sissons, "Poisoning from Godfrey's Cordial," _Journal of the American Medical Association_, March 2, 1912, vol. 58, p. 650.

[124] Edward Kremers and George Urdang, _History of pharmacy_, Philadelphia, 1951, pp. 170, 278.

[125] "Godfrey's Cordial," _Hygeia_, October 1931, vol. 9, p. 1050.

For those who persist in using the formulas of the early English patent medicines, recipes are still available. Turlington's Balsam remains as an unofficial synonym of U.S.P. Compound Tincture of Benzoin. Concerning its efficacy, the _United States dispensatory_[126] states: "The tincture is occasionally employed internally as a stimulating expectorant in chronic bronchitis. More frequently it is used as an inhalent ... It has also been recommended in chronic dysentery ... but is of doubtful utility."

[126] _The dispensatory of the United States of America_, 25th ed., Philadelphia, 1955, p. 158.

A formula for Godfrey's Cordial, under the title of Mixture of Opium and Sassafras, is still carried in the _Pharmaceutical recipe book_.[127] _Remington's practice of pharmacy_[128] retains a formula for Dalby's Carminative under the former _National formulary_ title of Carminative Mixture.

[127] _The Pharmaceutical recipe book_, 2nd ed., American Pharmaceutical Association, 1936, p. 121.

[128] Eric W. Martin and E. Fullerton Cook, editors, _Remington's practice of pharmacy_, 11th ed., Easton, Pennsylvania, 1956, p. 286.

In the nation of their origin, the continuing interest in the ancient proprietaries seems somewhat more lively than in America. The 1953 edition of _Pharmaceutical formulas_, published by the London journal _The Chemist and Druggist_, includes formulas for eight of the ten old patent medicines described in this study. This compendium, indeed, lists not one, but three different recipes for British Oil, and the formulas by which Dalby's Carminative may be compounded run on to a total of eight. Two lineal descendents of 18th-century firms which took the lead in exporting to America still manufacture remedies made so long ago by their predecessors. May, Roberts & Co., Ltd., of London, successors to the Newbery interests, continues to market Hooper's Female Pills, whereas W. Sutton & Co. (Druggists' Sundries), London, Ltd., of Enfield, in Middlesex, successors to Dicey & Co. at Bow Churchyard, currently sells Bateman's Pectoral Drops.[129]

[129] Letter from Owen H. Waller, editor of _The Chemist and Druggist_, to George Griffenhagen, January 15, 1957.

In America, however, the impact of the old English patent medicines has been largely absorbed and forgotten. During the past twenty years a revolution in medical therapy has taken place. Most of the drugs in use today were unknown a quarter of a century ago. Some of the newer drugs can really perform certain of the healing miracles claimed by their pretentious proprietors for the old English patent medicines.

A more recent import from Britain, penicillin, may prove to have an even longer life on these shores than did Turlington's Balsam or Bateman's Drops. Still, two hundred years is a long time. Despite the fact that these early English patent medicines are nearly forgotten by the public today, their American career is none the less worth tracing. It reflects aspects not only of medical and pharmaceutical history, but of colonial dependence, cultural nationalism, industrial development, and popular psychology. It reveals how desperate man has been when faced with the terrors of disease, how he has purchased the packaged promises offered by the sincere but deluded as well as by the charlatan. It shows how science and law have combined to offer man some safeguards against deception in his pursuit of health.

The time seems ripe to write the epitaph of the old English patent medicines in America. That they are now a chapter of history is a token of medical progress for mankind.