The Medical Messiahs:
A Social History of Health Quackery
in Twentieth-Century America

Chapter 2: The Lawless Centuries

James Harvey Young, PhD


"For many years, a vast system of medical empiricism, sustained by popular credulity and the sanction of government, has prevailed in this country, to the serious detriment of the public health and morals.... The increase of empiricism and of patent medicines within the 19th century, is an evil over which the friends of science and humanity can never cease to mourn."

—House Report No. 52, 30th Congress, 2nd Session, 1849


In 1908 Robert Harper of Washington paid a fine for misbranding Cuforhedake Brane-Fude. In 1708 Nicholas Boone of Boston paid a fee for placing the first patent medicine advertisement in an American newspaper. At the Sign of the Bible near the corner of Scbool-House Lane, noted apothecary Boone in the News-Letter, he would sell "DAFFYS Elixir Salutis, very good, at four shillings and sixpence per half pint bottle." [1] In the two centuries between the Elixir and the BraneFude, patent medicines in America had flourished mightily.

Daffy's Elixir was the first of a score or more of packaged remedies shipped over from the mother country which dominated the American nostrum market during the late colonial years. From Boston to Charleston, from New York to Savannah, merchants advertised Bateman's Pectoral Drops, Turlington's Balsam of Life, Dr. Benjamin Godfreys Cordial, and other therapeutic wonders. This American advertising was drab, a mere listing of the patent medicine brands just arrived on the latest ships from London and now for sale by apothecary, Postmaster, grocer, printer, or physician. More vivid was the English prose crowded on the paper wrapper, sealed with wax over the vial of distinctive shape which contained each brand of medicine. Here the proprietor let himself go, boasting of the curative merits of his product, both in his own glowing adjectives and in testimonials from customers who had used his remedy with success.

Some of the English medicines—like Turlington's Balsam—had actually been patented. This proud fact was heralded on the wrapper, indeed, was even molded into the glass. The distinction, however, between patented brands and unpatented ones, like Daffy's Elixir, grew fuzzy in the trade. All brands, patented or not, sat side by side on the same shelf, were listed indiscriminately in the same ads, were spoken of in common parlance as "patent medicines." In time, this lack of distinction was to lead to some confusion. Patenting a nostrum, in England and later in America, required revealing its ingredients, so all might know its composition. But unpatented "patent medicines" made a virtue of their very secrecy. Since most nostrums in the American future were to be unpatented and secret, the term "patent medicine" became increasingly inappropriate. Misnomer though it was, the term stuck tenaciously, despite much criticism.

The American Revolution, disrupting trade as well as other ties between mother country and colony, ended the dominance in America of the old English patent medicine brands. Even before the war, American apothecaries had begun to imitate a flourishing English custom, that of imitating the noted proprietary packages. Importing empty vials (or refilling used ones), importing printed wrappers (or having facsimile versions printed), venturesome Americans marketed their own counterfeit versions of Daffy's Elixir and other British brands. A recent diving operation at old Fort St. Marks bas retrieved a lead seal used to affix the wax on wrappers around bottles of Godfreys Cordial during those days between the French and Indian War and the Revolution when the British owned the Florida peninsula [2]. Neither there nor fartber northward was the problem difficult as to what to put in the various vials. Formulas for some of the patent medicines had become official in the London and Edinburgh pharmacopeias, and versions had been included in many popular medical handbooks for laymen, like Primitive Physic compiled by the founder of Methodism, John Wesley. Patent medicine formulas were blood brothers of preparations prescribed in the orthodox medicine of the day. The 18th-century physician knew little about the precise action of drugs in relation to given ailments. Polypharmacy was in vogue, and Robert Turlington, in the patent specifications for his Balsam, reflected prevailing orthodox standards in naming 26 botanicals, some from the Orient and some from the English countryside.

In America much deviation occurred from the original formulas, as the practice of filling empty bottles went on apace, booming during the war. But the customer was seldom aware, since bottle shape and wrapper looked familiar, that his English healing draught was being brewed on American shores. After the war British proprietors again dumped their therapeutic wares on the American market, but it was too late for them to regain their pre-Revolutionary ascendancy. American imitations were too widespread and too cheap. The old English medicines came to play a different, a sort of generic, role. Their proprietary status gone, they now were formulas in books, ready for concocting by any wholesale or retail druggist. As such they were much used during the 19th century, nor are they yet completely gone.

Why did not some shrewd colonial, observing the steady sales of British proprietaries, and sensing the gold that might lie at the end of such a rainbow, launch a competitive homegrown remedy? The answer is that there were indeed fumbling efforts heralding the day of native American nostrums. Yet, prior to the Revolution, no American entrepreneur managed to offer a real challenge to Bateman's Pectoral Drops or Hooper's Female Pills. Many mountebanks wandered about the colonies, persuading the gullible to purchase their panaceas, one Francis Torres showed up in Philadelphia selling something called Chinese Stones to cure toothache, cancer, and the bites of mad dogs and rattlesnakes. Moreover, humble men and women, most of them no doubt sincere, went into the marketplace with remedies borrowed from folk medicine, and occasionally advertised them. So Benjamin Franklin's mother-in-law, the Widow Read, promoted "her well-known Ointment for the ITCH." [3] But such commercial efforts were local, sporadic, and limited.

Not until the cultural nationalism accompanying and following the Revolution did the British proprietary example take firm root in American therapeutic soil. Imbued with the pride of victory, the United States gloried in new American textbooks, American maps, American inventions, and American drugs. Reputable medicine as well as pseudo-medicine was quickened by the upsurge of patriotism. American physicians sought diligently to discover American herbs which could relieve the American sick of unrepublican dependence on European remedies. Benjamin Rush, a signer of the Declaration of Independence and the new nation's most distinguished physician, proclaimed that there were twenty times more intellect and a hundred times more knowledge in America than there had been before the Revolution [4] . In such a spread-eagle mood, made-in-America patent medicines really began.

Colonial reticence gave way. Some of that shrewdness and boldness that had characterized the English medicine wrappers began to appear in American advertising. The localism of prewar pitches also was abandoned, as several proprietors anxious to sell their products far and wide began to insert column-long advertisernents in scores of the ever more numerous newspapers. Few colonial products had borne distinctive names. New Sovereign Ointments, Grand Restoratives, and Damask Lip-Salves came on the market. Congress enacted a patent law under the new federal Constitution, and a few medicine makers looked to government to protect their inventive genius represented in such wonders of medical science as Bilious Pills.

Samuel Lee, jun., of Windham, Connecticut, got the first patent, in 1796. The specifications for his "Bilious Pills" were burned in a Patent Office fire, but a later dispensatory gave the ingredients as gamboge, aloes, soap, and nitrate of potassa. Guarded by an American eagle, Lee's remedy went forth to battle bilious and yellow fevers, jaundice, dysentery, dropsy, worms, and female complaints [5].

This pioneering nostrum maker is a shadowy figure, but some of Lee's character may be deduced. He had ingenuity, as the priority of his patent attests. He possessed vigor, for he made a success of his patent by marketing techniques scarcely yet exploited by American entrepreneurs. He was equipped with imagination, as the cleverness of his advertising attests. One more trait is evident from the scanty record. Samuel Lee had an abundant capacity for indignation, and he had occasion to use it, for three years after he had begun selling his Bilious Pills another Samuel Lee began to trespass on his preserve.

Samuel H. P. Lee was a physician who also lived in Connecticut. In 1799 this New London doctor secured a patent, and the name of his medical invention was also "Bilious Pills." The coincidence seemed too great. The original Samuel, obviously angry, addressed the public on the subject of his upstart rival. After the launching of his own pills, he wrote, "the demand soon became so great and benefits , . . so amply demonstrated" that the New London scoundrel, thinking to "take advantage of the similarity of names and of the credit of my Pills," obtained a patent. The public needed a warning. "If people incautiously purchase his pills for mine," Samuel, jun., cautioned, "I shall not be answerable for their effects." [6]

The national appetite for Bilious Pills was obviously enormous. Drug catalogues listed both varieties, and the Connecticut rivals fought each other from nearby newspaper columns with an acerbity worthy of their English ancestors. The vigor of the competition may have boosted the sale of both brands. When 14 years had expired, each patent was renewed, and on the contest raged. Nor was it limited to Connecticut and surrounding states. Early in the 19th century Bilious Pills were being sold in Georgia to the south and in the newly acquired territory west of the Mississippi River. And numerous other aspiring promoters throughout the nation had entered the battle against biliousness.

A critic of nostrums observed sadly as early as 1800, "The venders of patent medicines in almost every capital town in the United States are fattening on the weakness and folly of a deluded public." [7] This was just the first fruits of cultural nationalism applied to the nostrum field.

Patent medicine promoters also profited from the state of regular medicine. During the early 19th century, from the patient's point of view, the arduous impact of disease was aggravated by the arduous impact of therapy. Both as to science and as to ethics, medicine yet rested on unsure foundations. The prevailing American vogue in therapy, owing much to the influence of the patriotic Dr. Rush, stressed extreme bleeding and purging. It was medicine's "heroic" age. Not every sick man felt like being a hero, and irregular practitioners appealed to the cowards with promises of mild medication. Many nostrum makers—like Samuel Lee, jun.—boasted that there was no harsh mercury in their formulas. They pictured regular doctors, armed with scalpels and mercurial purges, as heartless brutes. Physicians, wrote Samuel Thomson, a self-taught botanical irregular, learned nothing about the true nature of the medicines they prescribed except "how much poison [could) be given without causing death." [8]

Suspicion of the regular doctor because of his heroic therapy deepened with the rise of Jacksonian democracy. The upsurge of democratic sentiment in the West and in the poorer sections of cities had its anti-intellectual aspects, and to many citizens the plain man of common sense seemed superior to the trained expert. "The priest, the doctor, and the lawyer," charged Thomson, were all guilty of "deceiving the people." A committee of the New-Hampshire Medical Society reported "so strong an antagonistic feeling" between physicians and the public that the people considered "their reliance upon nostrums and quack administrations of medicine more valuable than any dependence upon a learned profession." This sentiment was bolstered by the emotional power of popular religion, which opposed the use of male physicians in obstetrical cases and condemned the dissection of cadavers for anatomical study. The judicious might grieve, but the people had their way. In a pioneering report on the public health in Massachusetts, Lemuel Shattuck wrote, "Any one, male or female, learned or ignorant, an honest man or a knave, can assume the name of physician, and 'practice' upon any one, to cure or to kill, as either may happen, without accountability. It's a free country!" [9]

In such an atmosphere of self-reliance, nostrum brands on the market doubled and doubled again. A New York drug catalogue in 1804 listed some 80 or 90 names; by 1857 a Boston catalogue included 500 to 600. Regional and local brands swelled the number. A list compiled in 1858 from newspaper advertising totaled over 1,500 patent medicine names. It took no real medical knowledge to launch a new nostrum. "Any idle mechanic," as an Ohio editor pointed out, could do it. He "by chance gets a dispensatory, or some old receipt book, and poring over it, or having it read to him . . . he finds that mercury is good for the itch, and old ulsers; that opium will give ease; and that a glass of antimony will vomit. Down goes the hammer, or saw, razor, awl, or shuttle-and away to make electuaries, tinctures, elixirs, pills, plasters, and poultices." [10]

The expanding market for patent medicines owed much to the expansion of American newspapers, since a popular press proved a good medium for promoting the sale of popular remedies. At the beginning of the century, there had been 200 papers, some 20 of them issued daily. By 1860 there were nearly 4,000 papers, almost 400 of them dailies. Among the dailies were many examples of the penny press. First begun in the 1830's, these were newspapers for the urban masses, flamboyant in both news and advertising. Almost every village had its weekly gazette. Whether in city or village, these papers secured their greatest revenue from advertising, and patent medicine advertisers were the first and most extensive national advertisers. "Nothing can be done without the press," wrote the physician-author of Quackery Unmasked. "Enterprise must stop here, and the skill of the wizard be hushed in darkness, unless the Press will publish it to the world." [11] At least one pill man, according to a Congressional committee in 1849, was spending $100,000 a year in advertising his purgative." [12]

Promoters were assisted in other ways by the workings of Jacksonian democracy. The expansion of public elementary education in the North and West better equipped the common man to read the gory symptoms, the glorious cures, the glowing testimonials, of nostrum advertising. Provision for free delivery of newspapers, if published in the county of the subscriber's post office, gave the manufacturer readier access to potential customers. Internal improvements, effected in part through popular pressures, helped the nostrum proprietor convey his wares by wagon, steamboat, and eventually rail to the ailing throughout the nation.

Urbanization, during these same years, brought changes in the disease pattern which offered new opportunities to quackery. After 1815 mortality began to rise, largely as a result of the increase of tuberculosis and the dread typhoid, typhus, and yellow fever. In 1831 cholera appeared. Pulmonic syrups and pectoral lozenges abounded on the nostrum shelf, and remedy makers brazenly promised cures for the worst scourges.

City eating habits aggravated the widespread biliousness renamed dyspepsia—which had prompted the Lees to market their patented pills. For the dietary dark ages still prevailed and developed a deeper gloom among the urban poor. The belief was widespread that all foods contained one "universal element" which kept life going, so quantity and not quality was stressed. Over-eating was a national habit, an evil com pounded by a diet stressing starchy dishes, salt-cured meats, and fat-fried foods. Especially lacking in urban diets were fresh fruits and vegetables and milk.

Purges of various potencies were a popular prescription by regular physicians. The quacks, too, as a New York doctor pointed out, fastened on the "almost universal prevalence of indigestion." But no one who read the advertisements needed to be told. There were scores of remedies on the market "whose chief mission," as a pharmacist put it, "appear[ed] to be to open men's purses by opening their bowels ." [13]

The unabated suffering from countless ailments, rapid growth in the population of the expanding nation, the spirit of therapeutic laissez-faire in a democratic age, the constant growth in media for advertising, legislation that could be turned to good account-all these were factors broadening the market for vendors of packaged remedies. And the big-scale patent medicine maker, during the first half of the 19th century, blazed a merchandising trail. He was the first American manufacturer to seek out a national market. He was the first producer to help merchants who retailed his wares by going directly to consumers with a message about the product. He was the first promoter to test out a multitude of psychological lures by which people might be enticed to buy his wares. While other advertising in the press was drab, his was vivid; while other appeals were straightforward, his were devilishly clever. The patent medicine promoter was a pioneer, marching at the head of a long procession of other men with ships and shoes and sealing wax to sell.

During the great boom of American industrialism after the Civil War, the nostrum promoter continued in some ways to pace the field. In total money spent for national advertising, the proprietary medicine industry held on to top place throughout the 19th century. Advertising media expanded mightily. The craving for news from the fighting fronts during the Civil War had enlarged the size of daily papers and inflated their circulations. The Sunday edition had been born. Pressure for newsprint hastened the discovery of wood pulp paper, introduced in the seventies. This cheaper paper and technical improvements in the printing process permitted newspaper size and advertising volume to grow. The war years also saw the real beginning of magazine advertising. During the year 1860, for every person in the United States, there had been issued 29.5 copies of daily, weekly, or monthly periodicals. As a result of the revolution launched by the war, the figure had grown to 107.5 by 1900 [14]. In almost every case each separate issue was larger in size. There was no limit to the advertising space the venturesome nostrum maker might fill.

In prewar days a purgative proprietor had awed his rivals by achieving a total annual advertising outlay of $100,000. In the closing years of the century, many major nostrum vendors spent two, four, or six times this sum. To carry the messages of Scott's Emulsion and Lydia E. Pinkham's Vegetable Compound to the American people required the expenditure in behalf of each remedy of about $1,000,000 a year [15].

With the boom in advertising, in the war years and after, the advertising agency, an antebellum infant, passed through a stormy adolescence. Nostrums, as one executive put it, provided the "backbone" of the typical agency's business. Medical advertising "offered the ad-writer his greatest opportunity," wrote Claude Hopkins, who had himself been through that mill, and "the greatest advertising men of my day were schooled in the medicine field." [16] Thus nostrums were deeply involved in the growing sophistication of business life.

They shared too in another major economic trend of the late 19th century, that toward the concentration of business ownership. Not all of the patent medicine fortunes amassed during these years were a pot of gold at the end of a rainbow that began with a poor man and his recipe. Many of the mightiest entrepreneurs had never mixed a formula, but were men who bought and sold medicines as other men might buy and sell mills or railroads. Charles Crittenton of New York was a merchant-manufacturer of this type, keeping 12,000 proprietary articles in stock, constantly acquiring and launching his own new brands. The same trend toward concentration, on a smaller scale, went on regionally. In 1904 an Atlanta druggist, Joseph Jacobs, was able to turn over to his pharmacy 82 proprietaries which he had been assembling for nearly 20 years, among them Jacobs' Antikink, Aunt Fanny's Worm Candy, and Palmer's Hole in the Wall Capsules [17]. The trademark for a medicine was a highly marketable commodity, a fixed star in a universe of flux. The formula might change from time to time; the diseases for which medicines were advertised might vary; but the trademark, protected first by common law and then by federal statute, endured forever. Skillful merchandisers like Crittenton amassed whole galaxies of proprietary trademarks.

In this new day of ever-bigger business, the small-time operator found the going hard. Yet the would-be maker of medicines was better off than the beginner in petroleum or steel. Costs of raw products were scarcely higher than before the war, even if promotion was both more expensive and more complex. Certainly formulas were as cheap as ever. Hundreds of hopeful men and women kept coming to the market with their wares. The number of nostrums, it seemed, was almost as "formidable . . . as were the frogs of Egypt." In 1905 a leading drug journal listed the names of over 28,000, and the next year a witness before a Congressional committee estimated that there were 50,000 patent medicines made and sold in the United States [18]. Thus, while there was a trend toward concentration in the proprietary field, it by no means came even within shouting distance of absolute monopoly.

Another form of economic consolidation, characteristic of the times, brought the major medicine manufacturers together in a trade association. Early in the Civil War a group of New York proprietors, hearing that a patent medicine tax was being considered as an emergency revenue measure, sent a delegation to Washington to protest this action. Their journey was in vain. Thaddeus Stevens, chairman of the House Ways and Means Committee, told them, "Gentlemen, you must respond. The country is in peril. We must have money. When this exigency is past, your showing will be considered." [19]

Twenty years later the exigency was long since past, but the 4 per cent tax on the retail price of all proprietary medicines still hung on. Individual protests had been made by medicine manufacturers who believed it unjust to tax the people's right of self-dosage, at least in times of peace. But these had come to naught. To a group of proprietors who had begun meeting informally from time to time in New York, organized pressure seemed to offer greater hope of success. During November 1881, in the office of Charles Crittenton, there was established The Proprietary Medicine Manufacturers and Dealers Association. Immediately they sent off a memorial to Congress urging repeal of the tax. In March 1883 the deed was done.

Right from the start, the growing Proprietary Association found other duties to perform. It represented the manufacturers in protracted and vain attempts with trade associations of drug wholesalers and retailers to stabilize nostrum prices. It vented its wrath on certain drug journals that printed formulas purporting to be those of remedies made by Association members. It sought to restrict the infringement of trademarks and the counterfeiting of labels. It lobbied against a tax on grain alcohol used in manufacturing and the arts. It sought to keep another emergency tax, when the Spanish-American War came, at as low a rate as possible. It took quick and decisive action whenever any measure restricting patent medicines was even hinted at in the corridors of state legislatures or the national Congress. In short, the Proprietary Association did those things in the interest of the trade which other trade associations were doing in the turbulent business economy of the late 19th century.

On the eve of the Civil War, in 1859, the proprietary medicine industry had an output valued in census figures at $3,500,000. By 1904 the sum had multiplied by more than 20 times. An observer reckoned that the value of cocoa and chocolate, blacking and bluing, flavoring extracts and axle grease, beet sugar and glue, castor oil and lard, kindling wood and cosmetics could all be added together, and still the total sum would not bulk so large as the $74,500,000 which was the manufactured value of American patent medicines [20]. At retail prices, the nostrum-taking public paid many millions more.

This great growth in products for self-dosage had taken place during the same decades that saw a revolution in the science of medicine. The "heroic" age of massive interference by the physician with nature's effort to heal the patient had been succeeded, at least on the part of America's most advanced doctors, by therapeutic nihilism, a theory that gave nature the primary role and urged upon the physician extreme caution. Then, in the 187Us, came word from Europe that some interference with nature might be resumed, and for the first time in history on genuinely scientific grounds. For the researches of Louis Pasteur and Robert Koch and their fellow scientists had not only demonstrated that bacilli could cause disease, but that weakened bacilli introduced by inoculation could promote immunity. American physicians had played only a very small part in establishing the germ theory, nor did all of them accept it as valid before the new century. It took time for the separate details of the new medical knowledge to be comprehended, evaluated, coordinated, and applied. The old killers were still the big killers in 1900: influenza and pneumonia, tuberculosis, and gastrointestinal complaints. And the level of education among practicing physicians: was discouragingly low. With respect to drugs t6y received less training than had once been the case, since therapeutic nihilism had weakened the emphasis in the medical curriculum upon pharmacology and the materia medica.

Being the chameleon-like creature that it is, quackery continued growing during the late 19th century by taking advantage of orthodox medicine's promising prospects as well as its persisting weaknesses. For one thing nostrum makers began to simulate the methods by which medical and pharmaceutical science kept the profession informed of new developments, turning the doctors themselves into unwitting allies in the campaign to reach the public. Articles were planted in medical periodicals reporting exciting therapeutic advances. The names of the new remedies had a scientific lilt, and complex (if nonsensical) formulas were revealed. Reprints were mailed to doctors, who soon were visited by detailmen, talking as knowingly as did the agents of reputable pharmaceutical manufacturers. The truth was, however, that the first prescription which a doctor wrote for products like Fellows' Syrup of Hypophosphites was apt to be the last. When the sufferer looked at the printing on the carton and the pamphlets packed within it, he found enough medical advice in vigorous, down-to-earth, and frightening prose to let him dispense with a doctor. As late as 1915 Fellows' proprietary syrup was still being promoted exclusively to physicians, with not a cent spent on direct advertising to the consumer, but 90 per cent of its sales were over the counter without a prescription." [21]

As to the germ theory itself, many Americans got their first inkling of this signal scientific advance through the distortions of patent medicine advertising. Long before most American physicians had been persuaded of the theory's soundness, a rash of germ-eradicating nostrums had assailed the mass market. One of the boldest was the Microbe Killer invented by a Texas gardener named William Radam. He was willing to credit Pasteur and other titans of natural science with discovering, slowly and laboriously, that a few diseases were caused by bacteria. But these inquirers had been halting and shortsighted, Radam. said, and it had been left for him to discover the whole truth, that all diseases were caused by microbes.

Killing microbes was like killing bugs on plants, and Raclam's pale pink liquid, he asserted, killed all microbes and hence cured all disease. The Microbe Killer contained, according to governmental analysis, 99.381 per cent water [22]. The rest—what rest there was—was hydrochloric and sulphuric acids and red wine. The liquid was nonetheless potent enough to float Radam from his Texas acres to a New York mansion overlooking Central Park.

Quacks were just as quick to exploit advances in the physical sciences as they were to pervert biological achievements. The discovery of radium by the Curies gave a cue to Dr. Rupert Wells, though even his name was a fake. He called his medicine Radol, labeled it as "radium impregnated," and advertised that it would cure all cancer. The liquid was really an acid solution of quinine sulphate with alcohol added, and such a product could be expected to exhibit the bluish fluorescent glow which Wells attributed to radium. But Radol, as a critic said, contained "exactly as much radium as dishwater" did and had the same therapeutic powers when treating cancer [23].

Thus the glamor of new science was twisted to benefit the unscrupulous promoter and to injure poor, suffering humanity, ill equipped to differentiate between the valid and the specious in the realm of health. Nonetheless, even with respect to quackery, the public was gaining by the advance of scientific discovery. For never before in history had there been so firm a foundation of medical and pharmaceutical knowledge on which to build a sound critique of quackery.

On commonsense grounds, medical quackery had long been assailable. Judicious men had, of course, always known that many advertising boasts could not be true. During the heroic age critics had often pointed out that nostrums promoted as cures for mercurial poisoning were themselves loaded with mercury. As part of the humanitarian wave accompanying Jacksonian democracy, there had occurred the nation's first major campaign against medical quackery. Perceptive physicians, like Oliver Wendell Holmes, had written and spoken out against dishonest therapeutic claims, faked statistics, fabricated testimonials, hazardous ingredients, and other disreputable features of the nostrum game. But so long as the causes of disease were a mystery even to physicians, and their own curative attempts were mistakenly bold—as with heroic treatment—or circumspectly hesitant, their critique of quackery could not be completely persuasive.

In 1889 a physician-pharmacist named R, G. Eccles exposed the watery formula of William Radam's Microbe Killer and termed the ex-gardener a "misguided crank" intent on "outquacking the worst quacks of this or any other age" while earning profits of 6,000 per cent. "A universal microbe killer," the doctor asserted, "would necessarily be a universal life destroyer." [24] Dr. Eccles represents a new and sounder type of attack on quackery: the Microbe Killer and other specious nostrums could be measured against the yardstick of the new bacteriology and the new chemistry. The yardstick was not yet as precise a tool as it would become, but it was already capable of measuring many of quackery's weaknesses with considerable precision.

The Eccles critique had appeared in a trade paper, the Druggists' Circular. Similar exposures were printed in medical journals, although reforming doctors were so concerned with the Fellows' Syrup of Hypophosphites type of racket within their own ranks that their attacks on old-fashioned patent medicines promoted directly to consumers were only sporadic. The lay public, of course, did not read either the Druggists' Circular or the Journal of the American Medical Association. Nor did they see in any great number the occasional anti-nostrum bulletins coming from the pens of a new type of scientist, the agricultural chemist. The Civil War had launched a boom in canned and packaged foods. Greater remoteness of producer from consumer, with complicated processing in be tween, coupled with new chemical techniques, led many manufacturers to sophisticate the foods they packaged. Farmers were aroused at the use of chemistry to revive rancid butter and recolor aged peas. What chemists had learned to disguise, the farmers began to realize, chemists could learn to detect. On state payrolls there began to appear agricultural chemists, men interested not only in exposing fraud in food, but intrigued by any crookedness involving chemistry. From Connecticut to North Dakota, these chemists began to issue official pamphlets reporting the real ingredients in nostrums and denouncing the falsity of label claims. Valuable as these bulletins were, their circulation was slim.

Nor was there much else that the layman might read, in the waning years of the 19th century, wherein he might find patent medicines questioned. An occasional farm journal assumed a skeptical stance; Popular Science Monthly was steadily hostile; the Ladies Home Journal took a stern view of nostrums that were liquor in disguise. Most magazines and newspapers, however, were a haven for the patent medicine advertiser, not for his critic. Indeed, the remedy proprietor developed a technique to try to make sure that this continued to be so. He invented a "red clause" to insert in advertising contracts. "It is mutually agreed," the red type read, "that this Contract is void, if any law is enacted by your State restricting or prohibiting the manufacture or sale of proprietary medicines." This clause, boasted the maker of Hall's Catarrh Cure to his fellow members of the Proprietary Association, was "pretty near a sure thing." It could be pointed to explicitly, from time to time, when danger threatened from some legislative proposal [25]. During the 1890's, therefore, the newspaper reader saw columns of patent medicine advertising, but almost no questioning of patent medicine efficacy.

With the dawn of the new century came the Progressive period, and with the Progressive period came a vigorous crusade against patent medicines that reached fruition in the anti-nostrum provisions of the 1906 Pure Food and Drugs Act. Voices of reform, hitherto muted and isolated, gained strength and cohesion during the Progressive years and reached the ears of most Americans, who now, alarmed at the evils threatening the nation's institutions, were anxious to control them. Malefactors of wealth—and the patent medicine proprietor could be made to fit this category—were placing in jeopardy ancient virtues like freedom, honesty, cleanliness, the integrity of the political process.

The "muckraking" of nostrums was a collaborative effort, now possible because of the Progressive climate of opinion, dependent for its raw data on the new knowledge in medicine and chemistry. The American Medical Association at long last purged its journal of questionable advertising, and the Council on Pharmacy and Chemistry, created to supervise this effort, made its investigations known to other foes of nostrums. Drug journal editors did likewise, and state chemists pooled their knowledge of nostrum analyses. Most important, all of these scientists were eager to furnish specific information on proprietary articles to lay reporters.

For an increasing number of newspaper editors, the "red clause" lost its deterrent force during the Progressive years. William Allen White's Emporia Gazette led a procession of papers willing to point out to readers the hazards of selfdosage with patent medicines. But the main medium through which the broad public learned of nostrum evils was the popular magazine. The Ladies Home Journal broadened its attack to other types of quackery besides high-alcoholic bitters, especially after losing a libel suit. In an editorial, Edward Bok had listed the ingredients of various nostrums, citing a document some quarter of a century old that had been issued by the Massachusetts State Board of Health. One of the medicines did not contain the ingredients Bok had mentioned, and the careless mistake proved costly. But it spurred Bok to greater relentlessness in his anti-nostrum efforts, using fresh and accurate information gathered for him by a young, Harvardtrained journalist and lawyer named Mark Sullivan [26]

The most provocative and exciting muckraking effort aimed at patent medicines was the Samuel Hopkins Adams series that began in late 1905 in the pages of Colliers, then under the enlightened editorship of Norman Hapgood. Adams was a free-lance journalist, who rendered his judgment of nostrums in his series title, "The Great Arnerican Fraud." He had done sleuthing as a crime reporter and had written articles on medical developments. This background helped him in his investigations, and he also relied on counsel from agricultural chemists and editors of pharmaceutical journals. The result was a series crammed with facts and imbued with moral passion."

"Gullible America," Adams began, "will spend this year some seventy-five million 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 other ingredients, undiluted fraud. For fraud, exploited by the skilfulest of advertising bunco men, is the basis of the trade."

After this sweeping introduction, Adams got down to cases. He rebuked Pond's Extract for "trading on the public alarm" by running an advertisement baldly headed "MENINGITIS" while New York was suffering an epidemic. Next to his criticism was a reproduction of the offending ad. Adams reported on the institution of the "red clause" and demonstrated his words with a picture of the contract offered by a proprietary company to the Emporia Gazette.

The whole series was equally explicit and vivid. Adams exposed the boozers and bracers that did a brisk business in prohibition territory. He examined the fake antiseptics, like Radam's Microbe Killer. His bitterest venom Adams reserved for catarrh powders that contained cocaine and soothing syrups that contained opium. It was a "shameful trade," he asserted, "that stupefies helpless babies and makes criminals of our young men and harlots of our young women." He attacked the pain-killers overloaded with acetanilid—like Cuforhedake Brane-Fude—and condemned all nostrums, whether they contained active ingredients or were inert, which preyed on the incurables, offering false hope to men and women suffering from consumption, epilepsy, and heart disease.

The only effective method of curtailing patent medicine abuses, Adams believed, was the enactment of a national law. Efforts to secure such a law from Congress were at high tide when "The Great American Fraud" series went to press. For a quarter of a century, from time to time, food and drug bills had been before Congress, seldom reaching a vote in either House. Proprietary manufacturers had been wary but not worried through most of these years, since the proposed national bills specifically excluded their medicines from control. State formula disclosure bills had been the grave threat. By 1903, however, the Proprietary Association was much concerned. In the atmosphere of Progressivism, successful passage of a national law seemed close at hand. Could patent medicines preserve the favored exempt status they had in earlier bills? The prospect did not look promising. Many critics demanded that legislation extend to proprietary remedies. The voice of one man in particular worried the proprietors. He was the generalissimo of the pure food crusaders, Harvey Washington Wiley.

Wiley was a state chemist who had gone to Washington [28] Born in southern Indiana, he had been trained as a doctor, though he never practiced. It was the nutritional side of health that interested him. In 1874, after study at Harvard, Wiley became professor of chemistry at the newly opened Purdue and, simultaneously, state chemist of Indiana. One of his tasks was to reveal the extent to which cane sugars and syrups sold in the state were adulterated with glucose. In 1883 Wiley became chief chemist of the Department of Agriculture. With him to Washington went his antipathy to adulteration. Enlarging upon the modest beginnings of his predecessor, Wiley launched a continuing analysis of America's food and drink, revealing in 1,400 pages published over 16 years how nearly every item on the family dinner table was being modified by "creative" chemistry. When the first Congressional hearings were held on a pure food bill, in 1899, Wiley was scientific adviser to the Senate committee, first witness, and chief draftsman of the bill presented in the Senate.

Wiley also undertook to arouse public opinion to the need for a law. Raised in an evangelical home, the chief chemist applied his moral fervor to the pure food crusade. The science of his bulletins was buttressed by the passion of his oratory. Like an itinerant preacher, he stumped up and down the country, and every women's club rostrum was a pulpit. Like most Progressives, his sense of righteousness was offended by fraud, and he inveighed against adulterators as economic cheats.

"Dr. Wiley is built on large lines," a joumalist wrote of him. "He is tall and massive of stature, with a big head firmly poised above a pair of titanic shoulders. His hair never stays in order, but masses itself forward on both sides of the forehead, giving him at times a somewhat uncouth appearance. The penetrating glance of his rather small eyes, the large and roughly modeled nose, and the severe lines of his mouth add to this impression." [29] Wiley had a light touch and a warm heart. His wit was the talk of the banquet circuit, and he had a flair for clever doggerel. A bachelor, he was free to move about, and he was an ardent clubman, an eager dinner guest. Wiley had the knack of eliciting tremendous loyalty, and his personal associations, tending toward the conspiratorial, were as important as his public speaking in creating organized pressure for a food and drug bill. Endowed with tremendous energy, he could operate without tiring on several fronts at once.

Wiley's main interest was fraudulent food; this had monopolized his research time and oratory. Of course, he abominated medical quackery, but it had held a low priority among his concerns. As chief chemist he had collected "bales of advertising of fraudulent remedies," and his bureau had tested "lost manhood" treatments for the Post Office Department. In 1903 he got around to expressing himself forthrightly in public on the nostrum issue. The new law that soon would come, he said, should contain "stringent" controls over patent medicines .especially." [30]

Since Wiley had hitherto gone along with draft bills that exempted proprietary medicines, his call now for tight controls sounded especially ominous to the remedy makers. It came at a time of increasing tempo of anti-nostrum publicity, and it was shortly followed by a Senate bill that defined drugs in a sweeping way and stated that any drug was adulterated which fell below the professed standard under which it was sold. For the first time in a Congressional hearing, proprietary remedies were extensively debated. This particular bill did not pass. But the pressure on proprietors was great enough to jar their intransigence. They forsook their adamant opposition to a national bill that controlled proprietary remedies in any way and centered on versions sponsored by the Wiley-led reformers. At a special secret meeting in December 1905, the Proprietary Association called for an end to nostrums containing narcotics and remedies overloaded with alcohol. They urged their committee on legislation to work for a law that would exercise restraint in these respects. It was close to the midnight hour. Samuel Hopkins Adams' "Fraud" series was in full swing, and President Theodore Roosevelt, somewhat tardily, had just spoken out in behalf of a national law.

A Senate bill was passed in February 1906, with a moderate set of nostrum controls, weakened from the stronger initial version after considerable floor debate. The House bill, containing more rigorous provisions, seemed for a time destined to suffer the fate of earlier bills, death by inaction. Then the shocking impact of Upton Sinclair's novel, The Jungle, with its incidental description of the horribly unhygienic way in which American meat was processed, made a pure food law inevitable.

The House debate in June made clear how much wider was the awareness of the nostrum menace than it had been five years, even a year, before. To be sure, no attention need be given meat, for a separate inspection bill had already been swept through the House. There was discussion of the food, whiskey, and administrative provisions of the bill, themes which had dominated debate in earlier Congresses. But the main theme was the patent medicine evil. "Of all the great civilized nations of the earth," stated a Texan, "the United States is about the only one that has not a strict law on the subject." Even Russia did, he added. For every illness caused by unclean meat, insisted another member, there were a hundred cases of poisoning and death from nostrums. More than that, tainted meat was not habit-forming. Congressmen were chided for giving testimonials to proprietary concerns. "Indeed," jibed a member, "Peruna seems to be the favorite Congressional drink." The anti-nostrum provisions, asserted the Congressman from Adams' home district, were "the most important subjects of the bill." Others expressed the same sentiment, and the name of Adams came frequently into the debate. Congressman James R. Mann acknowledged with appreciation that the list of dangerous drugs which must be named on medicine labels had been drawn up with the journalist's help. Wiley, too, had been at Mann's elbow throughout the final stages of House consideration, supplying clippings, nostrum analyses, and advice on strategy. Women's organizations and the American Medical Association exerted significant pressure for a rigorous bill [31]

The House bill passed on June 23, and from the House and Senate conference to reconcile their different versions, nostrum provisions emerged somewhat stronger than they had been in either bill. On June 30 Theodore Roosevelt put his signature to the Pure Food and Drugs Act, a measure often spoken of at the time and since as Dr. Wiley's law.

Almost all segments of opinion greeted the new law with approval. The most ardent champions of the pure food and drug cause were too optimistic in their appraisal. As a result of the act, editorialized the New York Times, "the purity and honesty of the food and medicines of the people are guaranteed." The patent medicine provisions, predicted the Nation, would deal a "death-blow" to harmful nostrums. The law was "far better in every respect," asserted the Journal of the American Medical Association, than its most ardent supporters could have hoped. "Certainly the powerful Proprietary Association of America has not proved to be so powerful after all." [32]

Yet the Proprietary Association was not unhappy. Frank J. Cheney, its president, thought it was "silly' to require him to put a new label on Hall's Catarrh Cure just because it contained "a trifling amount of alcohol." But the general effect of the law, he said, would be good. "People generally will reason, and reason correctly, that preparations which come up to the requirements of a congressional enactment must be all right, or, certainly, that they are not harmful or dangerous." Even the National Druggist, most acrimonious foe of legislation, termed the final result "not such a terrible thing after all." "But let it not be supposed," the editor added, "that the law would have been enacted in its present rather innocuous form but for bard, intelligent and most tactful work on the part of the representatives of the interests it is intended to regulate." [33]

As to proprietary remedies, the new Wiley law required that the labels which manufacturers put upon their medicines must tell the truth-not the whole truth, but the truth in certain significant respects. The presence and amount of certain dangerous drugs-alcohol, the opiates, chloral hydrate, acetanilid, and several others-must always be stated on the package. Other ingredients need not be named unless the proprietor wished to, but if he chose to indicate that certain substances were present, they must indeed be there, and in the quantity claimed. If he asserted that certain ingredients were not present-denying that a nostrum contained opium was a favorite promotional device-then they must in fact be missing. As the law put it, a remedy was adulterated "if its strength or purity fall below the professed standard under which it is sold." If a proprietor could not beguile consumers with respect to ingredients, neither could he deceive in other respects or be guilty of misbranding. He could not misinform about the state, territory, or country in which his product was made. Nor, indeed, could he put upon his label "any statement, design, or device" regarding the medicine or its ingredients which was "false or misleading in any particular ." [34]

Keep quiet on the label or do not lie, the law said. Respecting the listed dangerous ingredients, silence was forbidden. Thus the law did not strike a blow against self-medication, but sought to make it safer. It was based on a favorite Progressive assumption, an assumption as old as American independence, that the average man was intelligent enough to plot his own course and would avoid risks if he was aware of them.

The Pure Food and Drugs Act represents a new Progressive assumption as well, that the national government can and must deal directly with aspects of natural science imbued with great public concern. Science and democracy were not, to the progressive, incompatible. The objectivity and dedication to truth which science represented were needed for the securing of economic and political justice. And the fruits of science must be used by government for the general welfare. The National Bureau of Standards was established in 1901, and the Bureau of the Census, giving permanence to what had been a makeshift decennial venture, was created in 1902 [35].

In the realm of public health, the urgency was especially great. It was more than a matter of humanitarian concern: the national interest was vitally involved. Health was a valuable American asset subject to extravagant waste. "If we appraise each life lost," wrote Irving Fisher, chairman of the Committee of One Hundred on National Health, in 1909, "at only $1,700 and each year's average earnings for adults at only $700, the economic gain to be obtained from preventing preventable disease, measured in dollars, exceeds one and a half billions. Governmental as well as private action was mandatory to preserve this indispensable natural resource. Thus did Progressivism link its passion for conservation to the public health [36].

With respect to health, the national government took many concrete steps during the Progressive years. It set up the Yellow Fever Board in Cuba (1900), transformed the Hygienic Laboratory of the Marine Hospital Service into the Public Health Service (1902 to 1912), established tests and licensing for manufacturers of serums and vaccines (1902), and participated in the first effort aimed at international control of narcotics (1909), as well as seeking to regulate narcotics within the nation's borders (1914). Thus the food and drug law was part of a much broader pattern [37]

Both despair and hope, a characteristic Progressive mood, marked the atmosphere in which these federal actions took place. Irving Fisher and other commentators could, with much justice, bemoan the needlessly high death rate, the tardiness in applying hygienic knowledge already learned, the inadequate training of many physicians. The very fact of the lamentations, however, was an optimistic sign, indicating that America had ceased to take for granted its second-rate status in medical science. The future was bright. "The world is gradually awakening to the fact of its own improvability," wrote Fisher. "Hygiene, the youngest of the biological studies, has repudiated the outworn doctrine that mortality is fatality, and must exact a regular and inevitable sacrifice at the present rate year after year. Instead of this fatalistic creed we now have the assurance of Pasteur that 'It is within the power of man to rid himself of every parasitic disease.'" [38]

If expectations of a millennium of health soared too high, Pasteur and his successors were indeed providing health reformers with legitimate grounds for hope. Besides new biological vaccines and antitoxins, the new century brought to the united States from Germany the first results of modern chemotherapy, especially Paul Ehrlich's salvarsan for treating syphilis. During the same years, sanitation techniques that could virtually eliminate insect-transmitted yellow fever and malaria and curtail epidemics of typhoid fever spread by water and milk were being proved and improved. A better understanding of nutrition arrived with the new century; the first years of the food and drug law's operation coincided with animal experiments demonstrating the need for minerals and vitamins in the diet. In 1911 the word "vitamine" was coined." [39]

Cities and states, as well as the national government, accelerated their application of health research to the welfare of the citizenry. So likewise did private philanthropy, as represented by the Rockefeller Foundation and the Carnegie Institution, and so did national voluntary societies, pioneered in 1904 by the National Tuberculosis Association, each aiming its activities against a major disease. The American Medical Association employed the yardstick of the new science not only to exclude nostrum advertising from its journal, but also to elevate the standards of medical practice, education, and hospitals [40].

Much might be done for the American by governments and private organizations, but the citizen in a democracy possessed great personal responsibility for his own health. Progressivism conjoined corporate and personal endeavor for desirable ends. Popular magazine articles, large traveling exhibits, courses in the school curriculum, all were used to alert Americans to a properly hygienic mode of life [41]. Skepticism with respect to patent medicines was one part of this mode, but only one. Children also marched about singing, to the tune of the Battle Hymn of the Republic, this didactic ditty:

The filthy fly is flying in a flight that's strong and fleet;
He carries germs and microbes in his mouth and on his feet;
Let us swat the dirty insect with a blow that's swift and neat,
While he is flying on." [42]

The effort, therefore, to punish a prominent citizen of the nation's capital for mislabeling his Cuforbedake Brane-Fude was not an isolated incident. It was one event in a great campaign to improve the public health. If, during the Progressive years, the great campaign, and, within it, the anti-nostrum crusade, were pursued with too great expectations, they nonetheless both were worthy and both made significant gains in behalf of American health.

References

  1. Boston News-Letter, Oct. 4, 1708.
  2. Correspondence during May and June 1962 with S. J. Olsen of the Florida Geological Survey, Charles H. Fairbanks of Florida State University's Department of Anthropology and Archeology, and George B. Griffenhagen of the American Pharmaceutical Association.
  3. Pa. Gazette, Aug. 19, 1731.
  4. Rush cited in Oliver Wendell Holmes, Medical Essays, 1842-1882 (Boston, 1892), 192.
  5. Lyman F. Kebler, "United States Patents Granted for Medicines during the Pioneer Years of the Patent Office," Jnl. Amer, Pharmaceutical Assoc., 24 (1935), 486-87; Dispensatory of the U.S. (10th ed., Pbila., 1854), 75n.
  6. Columbian Museum & Savannah [Ga.] Advertiser, Sep. 29, 1802.
  7. N.Y. Daily Advertiser, Sep. 18, 1800, citing Gazette of the U.S.
  8. Cited in Wilson G. Smillie, "An Early Prepayment Plan for Medical Care," Jnl. Hist. Med. and Allied Sciences, 6 (1951), 253.
  9. Samuel Thomson, New Guide to Health ... to Which Is Prefixed a Narrative of the Life and Medical Discoveries of the Author (Boston, 1835), 201; Now-Hampshire Medical Society, Transactions, 1856 (Concord), 36; Shattuck, Report of the Sanitary Commission of Massachusetts, 1850 (Cambridge, 1948), 58.
  10. Portsmouth [Ohio] Journal, cited in Madge E. Pickard and R. Carlyle Buley, The Midwest Pioneer. His Ills, Cures, and Doctors (N.Y., 1946),286.
  11. Dan King, Quackery Unmasked (Boston, 1858), 249.
  12. 12.Patent Medicines, 30 Cong., 2 ses., House Rep. 52 (1849), 31.
  13. David M. Reese, Humbugs of New-York (N.Y., 1838), 121; George D. Coggeshall, "Address . . .," Amer. Jnl. Pharm., 26 (1854), 205.
  14. George B. Waldron, "What America Spends in Advertising," Chautauquan, 38 (Oct. 1903), 156.
  15. Scientific American, 73 (Oct. 5, 1895), 214; Jean Burton, Lydia Pinkham Is Her Name (N.Y., 1949), 230.
  16. Claude C. Hopkins, My Life in Advertising (N.Y., 1927), 73.
  17. Pharm. Era, 16 (1896), 968-70; the Jacobs' contract, Aug. 9, 1904, was given to the author by Jerome A. Conner.
  18. William Brewer, "Reminiscences of an Old Pharmacist," Pharm. Record, 4 (1884), 326; Philip L. Allen, "Dosing the Public as a Business," Leslie's Monthly Mag., cited in Druggists' Circular, 49 (1905), 124; Hearings before the Committee on Interstate and Foreign Commerce ... on H.R. 13086 (Wash., 1906), 7.
  19. Herbert D. Harding, "The History of the Organization among Manufacturers and Wholesale Dealers in Proprietary Articles," Amer. Druggist, 36 (1900), 190-93; Frederick Humphreys, "Origin and History of the Association," Pharm. Era, 16 (1896), 900-905; Frank A. Blair, "The Proprietary Association, Its History Since the Founding in 1881," Standard Remedies, 19 (June 1932), 4-7, 24-26; Frederick J. Cullen, "The First Twenty-Five Years," mimeographed copy of address delivered in May 1956.
  20. Bureau of the Census, 13th Census of the United States . viii, Manufactures, 1909 (Wash., 1913), 452; Allen, 123.
  21. Solomon Solis Cohen, "Shall Physicians Become Sales-Agents for Patent Medicines?" Phila. County Med. Sec., Proceedings, 13 (1892), 213-16; George H. Simmons, "Work of the Council on Pharmacy and Chemistry," Southern Med. Jnl., 8 (1915), 259-65.
  22. The American Medical Association issued three volumes on Nostrums and Quackery, all published in Chicago. The first volume appeared in 1911 with a 2nd ed. in 1912; the second volume, edited by Arthur J. Cramp, was published in 1921; the third volume, also edited by Cramp, was published in 1936 and bore the longer title, Nostrums and Quackery and Pseudo-Medicine. In references below, the titles of all three volumes are abbreviated as N&Q, and the 2nd ed. of the first volume is used. The Microbe Killer analysis is at 1, 447.
  23. Ibid., 68-75; Samuel Hopkins Adams, The Great American Fraud (Chicago, 1906), 91.
  24. Druggist' Circular, 33 (1889), 195-96.
  25. Mark Sullivan, The Education of an American (N.Y., 1938), 188-91; Collier's, 36 (Nov. 4, 1905), 13-16, 25.
  26. Ladies' Home Jnl., 21 (May 1904), 18, and (July 1904), 18; Bok, The Americanization of Edward Bok (N.Y., 1923), 342-43.
  27. The series ran in Collier's between Oct. 7, 1905, and Feb. 17, 1906; a second series ran between July 14 and Sep. 22, 1906.
  28. An excellent biography of Wiley is Oscar E. Anderson, Jr., The Health of a Nation: Harvey W. Wiley and the Fight for Pure Food (Chicago, 1958).
  29. Edwin Björkman, "Our Debt to Dr. Wiley," Worlds Work, 19 (1910), 12,443.
  30. Wiley, "Drugs and Their Adulterations and the Laws Relating Thereto," Washington Medical Annals, 2 (1903), 205-28.
  31. Cong. Record, 59 Cong., 1 ses., 8,889-9,801; Wiley, "The Value Of the Food and Drug Act to the Consumer," Chautauquan Daily, July 29, 1908, clipping in box 191, Wiley Papers, Library of Congress; James G. Burrow, AMA, Voice of American Medicine (Baltimore, 1963), 74-83.
  32. N.Y. Times, July 1, 1906; Nation, 82 (1906), 523; JAMA, 47 (1906), 42, 116.
  33. Ntl. Druggist, 36 (1906), 210, 372.
  34. Ch. 3,915, 34 Stat. 768.
  35. A. Hunter Dupree, Science in the Federal Government: A History of Policies and Activities to 1940 (Cambridge, Mass., 1957), 279, 291-92, 300-301, 385. Dupree, 296-97, suggests that, during the Progressive years, government science was marked by practicality, utility; basic research was not deemed a proper function of government, but of the universities.
  36. Fisher, Report on National Vitality: Its Wastes and Conservation (Bull. 30, Committee of One Hundred on National Health: Wash., 1909), 1; Richard H. Shryock, The Development of Modern Medicine (N.Y., 1947), 403-405.
  37. Dupree, 264-69; H. J. Anslinger and William F. Tompkins, The Traffic in Narcotics (N.Y., 1953), 29-30.
  38. Dupree, 299; Fisher, 14.
  39. Dupree, 269; Shryock, Development of Modern Medicine, 438-49; Julius Stieglitz, ed., Chemistry in Medicine (N.Y., 1928), 123-40, 33335, 397, 464-66, 485; Glenn Sonnedecker, "The Concept of Chemotherapy," Amer. Jnl. Pharmaceutical Education, 26 (1962), 1-3; David L. Cowen, "Ehrlich the Man, the Scientist," ibid., 4-11.
  40. Stieglitz, 333-35, 653-54; Dupree, 297-99; Shryock, National Tuberculosis Association, 1904-1954 (N.Y., 1957), Preface; Burrow, 27-53.
  41. Shryock, Development of Modern Medicine, 317, 330; Shryock, National Tuberculosis Association, 100-103.
  42. Gary Webster [Webb B. Garrison], Codfish Cats and Civilization (Garden City, N.Y., 1959), 135.
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