Until well into the 20th century the term ‘patent medicine’, throughout the English speaking world, didn’t necessarily mean that a medicine was either patented or – whatever the sellers may have claimed – that it had any genuine medicinal properties. Although both may sometimes have been true, often neither were.
The term originated with a relatively small number of British medicines that were patented during the first half of the 18th century, a time when being patented guaranteed neither effectiveness nor originality but did, at least in theory, give a monopoly on production to the patent holder.
Three 18th or early 19th century flint glass bottles (1) used for patented British 'patent medicines'. All are prominently embossed with the words 'By The King's Patent' to advertise the fact: Turlington's Balsam of Life (patented 1744), Spilsbury's Antiscorbutic Drops (patented 1792), and Juniper's Essence of Peppermint (patented 1762).
By the mid-18th century the term ‘patent medicine’ had come, by association, to mean any advertised medicine – and most of them were advertised, extensively and intensively, by any means possible – that was sold over-the-counter. The medicines needn't have been patented, and the counter needn’t have been in a druggist’s or apothecary’s shop. In fact it was more likely to have been that of a newspaper office, a bookshop, a toyshop, a pub, butcher, cobbler, or almost anywhere else. Newspapermen doing their delivery rounds sold them, ship’s captains were encouraged to take packages abroad to try out the markets in distant lands and, often, medicine proprietors gave ‘consultations’ and sold their medicines from their own homes: any and every way to reach new customers.
During the course of the 18th century posters, pamphlets, books, handbills, trade cards and, of course, newspapers and other products of the printing press largely (although not completely) displaced the in-person showmanship of travelling medicine men performing on street corners or in marketplaces.
It's probably no coincidence that the rise of patent medicines in Britain coincided with the rise, and rise, of newspapers. This relatively new medium of communication was then, as now, largely dependent on advertising income, and newspaper advertising offered patent medicine proprietors easy access to a growing market among the literate, and relatively prosperous, middle and professional classes in a way that had never before been possible.
This association of patent medicines and the printing press soon extended well beyond mere advertising, giving rise to a close and long-standing association whereby printers and newspaper offices were frequently agents for, and distributors of, patent medicines. From small provincial towns to the metropolises of London, Manchester and Edinburgh, printers and newspaper offices became an integral part of the patent medicines distribution network and economy.
This 1732 newspaper advertisement for Richard Rock's 'true, original, chymical Tincture for the Teeth' also includes mention of Rock's Grand Cordial Stomach Drops, the Chymical Liquor for the Itch and "the famous LIP SALVE", as well as a warning against imposters and the news that the 'Dr' himself is available three days a week to give advice on "all Venereal and other Distempers". From The Country Journal, or, The Craftsman. 7th October 1732.
One reason for the rise and success of patent medicines during the 18th and 19th centuries was the painfully obvious inability of the pre-scientific medical mainstream of the times to understand or explain most ailments, let alone successfully treat or cure them. At a time when the role of microorganisms in infectious diseases was unrecognised or rejected, when genes and genetics were unknown, when even the concept of allergies and autoimmune diseases was a hundred years or more in the future, and when surgery was torturously anaesthetic-free, it's understandable that people in search of alleviation or cure of their ailments would find the boasts and promises of advertised nostrums and cure-alls attractive.
The allure of those nostrums and cure-alls was only increased by the fact that, although expensive, they were still generally cheaper than the ministrations of a regular doctor. In many cases their ingredients, once tried, only increased faith in them: alcohol and opium, common ingredients of patent medicines, would promote a feeling of wellbeing unrelated to actual health, while other ingredients could suppress symptoms without addressing any underlying cause. Consumption 'cures', for example, might contain alcohol and opiates to make a person feel, temporarily, pretty good about life while chloroform, a cough suppressant, might give the impression that the disease itself had disappeared. Repeat sales, as well as glowing testimonials, wouldn't be particularly surprising in such circumstances.
A common feature of 'patent' medicines (apart from the relatively small proportion that actually were patented (2), and so had by definition placed the recipe - or at least a recipe - into the public domain) was that recipes would be maintained as closely guarded secrets for as long as possible. In fact, and in spite of claims to the contrary (3), ingredients were generally mundane, usually cheap and, if they had any medicinal properties at all, were often culled from standard, easily available, medical texts and pharmacopoeias:
“there is, for the average man or woman a certain fascination in secrecy. The quack takes advantage of this common foible of human nature to impress his customers. But secrecy has other uses in his trade ; it enables him to make use of cheap new or old fashioned drugs
[while claiming] that his product possesses virtues beyond the ken of the mere doctor ;
his herbs have been culled from some remote prairie in America or among the mountains of Central Africa, the secret of their virtues having been confided to him by some venerable chief ; or again he would have us believe that his drug has been discovered by chemical research of alchemical profundity, and is produced by processes so costly and elaborate
that it can only be sold at a very high price.” (4)
In fact the 'secret' recipes for many of the more successful patent medicines were eventually widely published. Some became so well known that the medicines could be, and were, made by any apothecary or druggist with an inclination to do so. In effect they became the patent medicine equivalent of today's generic drugs, such as aspirin or paracetamol.
This website is primarily about British patent and quack medicines of the 18th and 19th, centuries, but Georgian and Victorian Britain was the centre of an Empire that extended from Australia and India to the Americas, a fact that British patent medicine proprietors took full advantage of. In many cases those colonies subsequently developed their own home-grown patent medicine industries, and nowhere did this happen more convincingly than in the post-independence United States where, in 1905, the investigative journalist Samuel Hopkins Adams wrote:
“Gullible America will spend this year some seventy-five millions of dollars in the purchase of patent medicines. In consideration of this sum it will swallow huge quantities of alcohol, an appalling amount of opiates and narcotics, a wide assortment of varied drugs ranging from powerful and dangerous heart depressants to insidious liver stimulants; and, far in excess of all other ingredients, undiluted fraud.” (5, 6).
It isn’t too great a stretch to say that something similar was true of Britain and the British at that time, and for at least a century or two beforehand.
Two bottles that once contained 'patent medicines' that weren't patented. On the left, a circa 1830s Daffy’s Elixir bottle used by Sutton & Co (formerly Dicey & Co) of Bow Church Yard in London. Dicey’s Daffy’s Elixir was sold in bottles similar to this for around 150 years, up until the late 1920s. On the right, a distinctively cone-shaped Dalby’s Carminative bottle, this one dating to any time between the late 18th century and the 1840s (there will be more on dating bottles in future posts). One of the principal active ingredients of Dalby's Carminative was laudanum, otherwise known as tincture of opium.
Legislation introduced in the United States in 1906 (7), in part because of the writing of Adams, didn't bring the patent medicines industry there screeching to a halt, but it did start to bring its most egregious excesses under control. In Britain, in contrast, a Parliamentary inquiry on 4th August 1914 (8) reported that:
'For all practical purposes British law is powerless to prevent any person from procuring any drug, or making any mixture, [ ... ] advertising it in any decent terms as a cure for any disease or ailment, recommending it by bogus testimonials and the invented opinions and facsimile signatures of fictitious physicians, and selling it under any name he chooses [ ... ] for any price he can persuade a credulous public to pay' (9, 10, 11).
Great events then unfolding in Europe and across the globe understandably overshadowed the report's publication and conclusions for years to come.
It wasn't until the late 1930s and early 1940s that the old-fashioned patent medicine industry in Britain, descended from that of the early and mid-18th century, was subjected to the kind of legislation that the 1906 Food and Drugs Act had introduced in America. Instead, the British industry was incrementally subjected to legislation that was often enacted for reasons, such as taxation, that were entirely unrelated to medicine or health (12), or that addressed wider issues, such as the 1868 Pharmacy Act which was introduced, in part, to address the 19th century epidemic of accidental poisonings (13).
It was during the First World War and its immediate aftermath that British legislation first started to make serious inroads into some of the more dangerous and fraudulent aspects of patent medicines (14). In 1917 claims to cure venereal diseases (a staple of patent medicine advertising since its earliest days [15]) were prohibited, and in 1920 the use of dangerous drugs, such as opiates, in medicines was largely brought under control (16).
The Cancer Act of 1939 added cancer to the list of diseases for which it was illegal to advertise cures. At around the same time the two Acts that probably did more than any others to finally bring the age of 'old patent medicines' to an end in Britain were introduced: The Food and Drugs Act of 1938, which regulated the contents and labelling of drugs and medicines, and the Pharmacy and Medicines Act of 1941, which abolished the medicine tax, forced manufacturers for the first time to list ingredients on packaging (and so brought over two centuries of 'secret remedies' to an end), and extended the prohibition on the advertising of cures for the incurable.
120 years of Roche's Embrocation, a patent medicine patented in 1803 for "the cure of hooping cough, chin cough, fixed coughs, and all other complaints, disorders, affections, or diseases of a similar nature". From left to right: 1) circa 1803-1830s; 2) 1850s-60s; 3) 1870s-1900s; 4) 1920s-30s; 5) circa 1940s. The bottle far left shows a surface patina from burial (it was dug in Bermuda in the 1960s). Numbers 1 - 3 are hand blown, bottles 4 and 5 are machine made. The external screw top of bottle 5 is a type of closure that didn't start to become common in Britain until the 1930s, and could be understood as representing the end of the line for the packaging of the old Georgian and early Victorian patent medicines in Britain.
"BY THE KING'S PATENT". Seal for Jesuits Drops from a 1763 newspaper advertisement. Walker's Jesuit's Drops were patented in 1755, and continued to be manufactured and sold for over 100 years (17).
Notes and References.
1. Glass tax (1745 - 1845). It's not possible to really understand British glass bottles of the 18th and early 19th centuries without understanding something of the history and impacts of the glass tax (1745 - 1845, i.e. most of the period of interest to this website). Just one example of how the tax system affected bottles is that smaller bottles tended to be made from colourless 'flint' glass while larger bottles, even for the same product, were generally blown in shades of green or 'black' glass - an artefact of different tax rates for different types of glass, and the consequent need for the more heavily taxed glass makers ('flint and phial glass' makers) to be protected from unfair competition by the less heavily taxed part of the industry ('bottle glass'). This protection was achieved by prohibiting the bottle glass industry from making small bottles, which were reserved for the 'flint and phial glass' industry. A future post, or posts, will be dedicated to this subject.
2. The patent specifications of some medicines were vague or misleading to the point that they couldn't be used by others to recreate the medicine even after patent protection had expired. The best known example of this was probably Robert James's patent for his Fever Powders (a medicine itself best known for its involvement in the early death of Oliver Goldsmith). Patented in 1751, the medicine quickly became commercially successful, and remained so even after the publicity surrounding Goldsmith's death, but attempts by many others to recreate it by following the directions given in the patent were consistently unsuccessful. the suspicion is that the directions were deliberately inaccurate to preserve the secrecy of James's recipe. See Crellin, J.K. (1974) A Note on Dr James's Fever Powder. Transactions of the British Society for the History of Pharmacology. Vol. 1, No 3, pp136 - 143.
3. For example Samuel Solomon claimed that his Cordial Balm of Gilead, a medicine that made him a wealthy man, was "a most noble Medicine, and composed of the real pure Essence of Virgin Gold! together with some of the choicest natural Balsams and Strengtheners in the whole Materia Medica, and is considered to be the greatest Discovery that has been made in the Memory of Man." (for example, The Northampton Mercury, 25th May 1799). In fact it is believed to have been nothing more than brandy flavoured with herbs.
4. British Medical Association (1909). Secret Remedies: What They Cost and What They Contain. British Medical Association, London. 195pp.
5. In 1905 $75 million was equivalent to around £15.5 million (figures from historicalstatistics.org/, 4th August 2020) which, depending on which measures are used, is itself is equivalent to anywhere from £1.7 billion to £17.6 billion now (measuringworth.com, 4th August 2020).
6. Samuel Hopkins Adams (1905). The Great American Fraud, Part I. – The Nostrum Evil. Colliers Weekly, October 7th 1905. All eleven parts of both series were reprinted as The Great American Fraud in book form in 1906.
8. Report from the Select Committee on Patent Medicines, together with the Proceedings of the Committee, Minutes of Evidence, and Appendices. Reports from Committees. 1914. Vol. 3, p22. HMSO, London. 4th August 1914. The publication date provides a clue as to why the conclusions of this Inquiry were not acted upon: Other considerations were, at that time and for the next several years, more pressing.
9. An exception was the 1868 Pharmacy Act: Accidental poisoning was a common cause of death in the mid-19th century, and eventually led to the Pharmacy Act of 1868 (although arsenic had been the subject of an earlier Act, in 1851). The 1868 Act prohibited most poisons (those named, or 'scheduled', in the Act, and in later amendments), from being sold in most circumstances. The 1868 Act did however include an opt-out for patent medicines which wasn't effectively addressed for another two decades (discussed in Leeson et. al. 2020 [4]).
10. There was, again, an exception: From 1889 onwards advertising was not to be 'obscene' according to the Indecent Advertisements Act of that year, which prohibited the use of obscene words or phrases. In practice this was easy to get around: Long before the 1889 Act medical advertising had already mastered the art of the coded phrase, whereby seemingly innocuous terms would be understood by most readers to be references to socially unacceptable maladies, illegal practices, and so on.
11. Although this seemingly wasn't the case with the Kellys at Jedburgh in 1876: they appear, there, to have fallen foul of general laws against fraud rather than any law related specifically to medicine. This does however beg the question of how they avoided similar problems south of the border, apparently for many years. Perhaps there were differences between Scottish and English law in play? I don't know, but would be interested to hear from anyone who does. On the other hand perhaps the explanation is as simple as 'in Scotland they made the mistake of going back'.
12. Patent and proprietary medicines were first taxed in Britain in the late 18th century. The system was overhauled at the beginning of the 19th century and then remained in force, with relatively minor changes, until 1941.
13. A famous example is the Bradford Sweets Poisoning, but far more common was accidental poisoning in the home, either through accidentally drinking from unlabelled or poorly labelled bottles (or from properly labelled bottles in the dark), in the belief that they contined something else such as a medicine, or by unwittingly overdosing on medicines that contined dangerous ingredients, which ranged from mercury and antimony to laudanum and cocaine.
14. It may seem obvious*, from our standpoint here in the 21st century, that regulation of the ingredients of medicines and of the claims made for them is inherently a good thing, especially when the history of fraud associated with medicines is considered (about which more, later). That is however only part of the story. Broadly there are two competing, but by no means mutually exclusive, schools of thought about motivations for regulation. On the one hand the public-interest motive, which holds that 'stopping people from being defrauded and / or poisoning themselves is self-evidently a good thing', and on the other hand the 'rent-seeking' theory which maintains that regulation was primarily a self-interested move by the medical establishment to squash competition from medical irregulars. The former assumption has been implicit or explicit in much of the discussion of patent medicines regulation until quite recently. For a discussion of the latter see Leeson, P.T., M.S. King, & T. J. Fegley (2020). Regulating quack medicine. In: Public Choice, March 2020. Available at www.researchgate.net. Accessed 9th January 2021.
15. The Veneral Disease Act, 1917, which prohibited advertising medicines to cure venereal diseases.
16. The Dangerous Drugs Act, 1920, which restricted the sale of various dangerous and / or addictive drugs, some of which had been common components of some types of patent medicines for centuries.
17. From the Manchester Mercury, 28th September 1762. From www.britishnewspaperarchive.co.uk, Accessed 3rd July 2018. Redrawn from the original by Jeremy Kemp.
*At least, to most of us.
© Jeremy Kemp, 2021.
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