Massachusetts Medical Society: A Discourse on Quackery

A Discourse on Quackery

Annual Oration 1834

By Zadok Howe, M.D., M.M.S.S.


Unaccustomed as I am to public speaking, and unskilled as I am in wielding the pen of the ready writer, I have found it difficult to bring myself to the belief that it would be in my power to discharge acceptably the duty, which this day devolves upon me; and I can truly say, that this diffidence is not a little increased from the circumstance, that it falls to my lot to follow the eloquent and learned Professor, who so ably performed a similar duty at our last Anniversary.

But relying upon that indulgence and friendly feeling which have ever been manifested by the Fellows of this Society, I shall now proceed to make some observations upon the subject of Quackery.

This topic has engaged the attention of philanthropists through a long succession of ages.

That Quackery prevailed in England, in the early part of the sixteenth century, to such a degree as to require the interference of Parliament, will appear by the Preamble to a Statute of Henry the 8th, which we find recorded in the following words:

“For as much as the science and cunning of Physic and Surgery is daily, within this Realm, exercised by a great number of ignorant persons of whom the greater part have no insight in the same, nor in any other kind of learning; some also ken no letters on the book; so far forth, that common artificers, as smiths, weavers and women, boldly and accustomably take upon them great cures, in which they partly use sorcery and witchcraft, and partly apply such remedies to the disease as being very noious and nothing meet; to the high displeasure of God, great infamy to the Faculty, and the grievous damage and destruction of divers of the King's people.”

The days of sorcery and witchcraft have long since passed away, but quackery still survives,—it not only prevails in England, but what is of more importance to us, the demon of Empiricism still hovers over the land of the Pilgrims.

The general diffusion of knowledge and the boasted march of intellect, of which so much has been said, seem not to have retarded the progress of quackery in the smallest degree; its course is onward; refinements in the science of imposition, if I may so speak, keep pace with other improvements of the day; and so long as a portion of mankind must and will be imposed upon, there will always be found a set of choice spirits to contrive and point out the ways and means.

The Quack Doctor considers any part of this country as his hunting ground; go where you will, through city, town or village, or through the wide expanse of thinly populated regions, his footsteps may be traced by marks of devastation. He levies his tax upon the credulity of all classes of people, from the judge upon the bench to the peasant who earns his bread by the sweat of his brow.

The weapons of his warfare are extorted from every part of the material world; from the animal, the vegetable and the mineral kingdoms, in multifarious combinations, from the all corroding caustic which destroys every thing before it, to the inert Vegetable Pulmonic Detergent, which is said to clarify and sweeten up the blood.

Volumes have been written and published to describe and point out the thousand tricks of the trade, and to guard the people against their injurious effects, but all to little purpose;—opposition to quackery from the regular practitioner is construed into persecution, which will never fail to raise up advocates for the weaker side.

It has been well said, by an acute observer, that “the less we know of the material word, the more extensive we suppose our acquaintance to be with the world of spirits; there can be no doubt, that from ignorance of the operations of nature, and of the laws of the animal economy, has originated that predilection for superstitious remedies, which in every age has constituted a prominent feature in the character of the people: a portion of the people at least, have neither leisure nor inclination to reason, credulity is of course more convenient for them than the researches necessary for the investigation of truth.”—Their opinion of medical skill corresponds exactly with Dogberry's views of writing and reading, that it comes by nature; hence an Indian doctor, a modern prophet, or a seventh son, is the man of their choice in difficult cases.

The popular clamor is almost always in favor of quack remedies, and for this obvious reason; when an individual finds that he has been caught in this kind of gull-trap, he is aware that it will not redound to his credit to proclaim it upon the house-tops, he therefore wisely holds his peace and permits others to go through with the same process;—but if, on the other hand, his health should happen to improve during the experiment, he is ready to certify that, under Providence, he has been restored by it to a comfortable measure of health and strength, after all other remedies had failed; and feels it to be his duty most conscientiously to publish his cure to the world for the benefit of the afflicted.

But this credulity is not confined to the humble walks of life; it is found in great abundance among men of science and literature. Mr. Madden says that “in general the knowledge of the world to be found in the minds of literary men is very limited in deed, because more of their time has been spent in the closet than in mixing in the business of life.”

Men of studious habits generally exercise their minds too much and their bodies too little, and hence not a few of them become dyspepticks, or in other words, they become hypochondriacs; then the gradual loss of mental energy is supplied by a morbid accumulation of that kind of faith which is satisfied with assertion instead of proof; this remark applies more particularly to whatever relates to their health; upon this subject they are insane, and, however brilliant may be their talents, they become like Samson shorn of his locks, weak, even as other men.

When a great man is left to do a weak thing he will excel even in that, it will be great of its kind;—these weak traits produce a striking contrast in the general character, like the deep shades in a picture, which serve to bring forward the principal figures in bold relief.

Among the circumstances which have had a direct tendency to increase the pernicious effects of quackery, is the willingness with which men of respectability permit their names to be attached to certificates of the efficacy of quack remedies;—upon this list may be found the names of magistrates, doctors of divinity, doctors of laws, and, strange is it may seem, even doctors of medicine, men from whom the community have a right to expect better things;—thus a celebrated Panacea is carried to the uttermost parts of the earth, with the names of distinguished medical professors to recommend it; while the name of an ex-professor of one of our most respectable medical schools, is going down to posterity in glaring capitals, on the wrapper of a bottle of aromatic snuff.

Let a man of any distinction, through inadvertency or from any other cause, lend his name in this manner, he enlists during the war; there is no retreat for him, his certificate is stereotyped, and copies of it scattered by thousands to the four winds of heaven: having done this, although he may repent in sack cloth and ashes, the evil remains the same, his opinion has gone forth and can never be recalled.

The man whose talents or station may give him a commanding influence over public opinion, should ever remember that he is in duty bound to exert that influence for the public good.

It is to be regretted that even in these days of medical light and knowledge, the line of demarkation between the scientific practitioner and the professed quack, is not always so clearly defined as it should be.

The following case, which occurred a few weeks since, will afford an illustration in point.

I was called upon to examine a tumor upon the neck of a gentleman from a neighboring State. Upon removing his cravat, which partially concealed the tumor, I discovered a ten cent piece attached to a cord, which passed around his neck, together with a string of gold beads hanging in festoons over the tumor. I first made inquiries touching those “deposites of the precious metals,” and was informed by the patient that he had consulted a seventh son, who presented him with the ten cent piece, to be constantly worn about his neck;—but that the gold beads had been subsequently directed by a regular practitioner, who informed him that the silver was a very good application, but that in real scrofulous humors, the gold was more powerful.

There is a custom which sometimes prevails among practitioners of respectable standing, which is nevertheless a species of quackery; they prescribe for a sinking faintness at the stomach, strengthening bitters to be steeped in old Holland gin, while the scientific apothecary advertises Huxham’s Tincture of the bark, prepared in Coniac brandy; these articles produce their exhilirating effects and seem to afford temporary relief,—but bitters, like all other sublunary things, pass away, they are gone before the patient is aware of it, he then concludes to try for a few days the effect of the gin alone, and is agreeably surprised to find that the gin answers his purpose very well without the bitters. And he who takes the bark, in the same easy way, comes to the conclusion that old Coniac brandy, if it be really nice, is a pretty good substitute for Huxham’s Tincture; he takes it, and says he always feels the better for it.

These individuals are generally found in the higher walks of life; the articles of potatoe whiskey or New England rum are never found within their precincts: still they are carried away captive by that same old serpent called alcohol, who, in the end, is sure of his victim. In this manner many an excellent man has been hurried out of the world by the use of the very means which were intended to keep him in it.

The physician whose prescriptions may be productive of such results, must upon deliberate reflection feel a weight of responsibility which nothing but habit can render tolerable;—he actually puts into the hands of his patient a license to become intemperate, for which he is justly accountable.

Doctor Fothergill, in the latter part of his life, regretted having used spirtuous tinctures so frequently in his practice, as he feared that in many instances he had insensibly paved the way to spirit drinking.

But to return to our subject.

It is not very common for people in these regions, while laboring under acute diseases, to trust themselves in the hands of a professed quack. These cases are generally committed to the charge of the regular practitioner, who having perhaps safely conducted his patient through the acute stage of a dangerous disease to a state of convalescence, may have the mortification to see that patient on his first appearance abroad, collecting sums of money from his neighbors, in order to employ a quack doctor, to purify his blood and complete the cure; while he who has borne the burthen and heat of the day receives nothing for his services but the ingratitude of his patient.

That a large proportion of chronic complaints are at length subdued by the powers of the system, is a fact well known to the Empiric. He also knows that weakness of body and imbecility of mind generally go hand in hand; he therefore turns his attention almost exclusively to individuals laboring under chronic diseases;—these are diligently sought out and made to suffer the consequences of their credulity. He commences his work of deception with soothing promises, even in the most desperate cases, and like the serpent in the garden of Eden, whispers in the ear of his deluded patient, “thou shalt not surely die.”

He is constantly harping upon the injurious effects of mercury, and bloodletting, while he extols the virtues of vegetable productions; let his compounds therefore be what they may, they are always called vegetable, and consequently, safe.

The trade of compounding and vending quack medicines, has increased in this country to an alarming degree; the business has become systematized, and affords constant employment for thousands of individuals, who had rather subsist by their wits than by their labor. Here foreign impudence and Yankee ingenuity have produced results which are truly astonishing. Many of these medicines are distributed from house to house by tin-pedlers,—who are not only ready to accommodate their customers with tin graters and coffee pots, but also with jaundice bitters, cough drops and Hygeian pills, all warranted genuine, and highly recommended. The tax which is in this manner levied upon the people, great as it is, is of little moment, when compared with the positive evil which attends the use of these articles. A single patentee, who is constantly at home compounding his medicines and sending them through the country, is doing more injury to the community than a host of itinerant quacks.

The principal object of this discourse is to point out a remedy for this species of quackery. If I should fail in my undertaking, it will subject me to little mortification, because abler men have labored in vain and spent their strength for nought in the same cause.

There is a mistaken impression abroad in the world, that quack doctors and patent medicines, by preventing and curing diseases, diminish the business, of the regular practitioner; and that his opposition to quackery arises from selfish motives. Now this mistake should be corrected. We have proofs without number, which tire by their sameness, that spirit-drinking leads to poverty, litigation and crime, and consequently affords employment for the lawyer;—no one doubts the truth of this; but it is equally true, that the use of quack medicines, by multiplying and aggravating chronic diseases, is constantly affording employment for the scientific physician; this fact, having attracted very little attention, is not generally known by the people at large.

Now the lawyer, and physician, whose sole object is the accumulation of dollars and cents, will be perfectly willing to leave these matters to regulate themselves; but as christians, and philanthropists, they are in duty bound to cooperate with others in abolishing the use of these pernicious articles.

Some idea of the extent to which quack medicines are circulated may be formed by the country practitioner. He is compelled by circumstances to carry his medicines with him, and to deal them out with his own hands. In his excursions abroad, he frequently has occasion to inquire for phials at the house of his patient; this inquiry brings forth the family medicine chest, where he is almost sure to find a goodly number of empty phials and pill boxes, which had once been filled with patent medicines, while printed certificates of marvellous cures supply him with wrapping paper for his Dover's powders. Here he finds anti-bilious pills, Gordak's physical drops, anti-scorbutics, and worm-destroying lozenges. In this same chest he may also find the wreck of the once popular Conway medicines, bearing upon their envelope, between an index and a mark of admiration, a caution more salutary than the medicines themselves, “as you value your health, be particular.” A due regard to this caution might have saved many lives.

But the trials of the country practitioner end not here; his patients will, now and then, take a dose of some of their infallible compounds, during his regular attendance; this, by the way, is carefully concealed from the doctor, lest he should be offended. Thus he is liable to find his patient under the influence of some powerful quack medicine, with which he may be totally unacquainted. If, under such circumstances, he should happen to hesitate, he is told by the patient, or nurse, that the medicine which has been taken never does harm in any case; and in proof of this assertion, he is presented with the printed certificate of the “sole agent and proprietor” of the article, who declares upon his honor that the medicine may be taken with perfect safety, by persons of all ages, both sexes, and under any circumstances. There is the proof in black and white; and with this explanation, the doctor must seem at least to be satisfied;—arguments are useless; if he have “reasons as plenty as blackberries,” he may reserve them for other occasions; he may as well attempt to convince a patient in delirium tremens, that there are no rats about his bed, or sheriffs about his house. And here let me exhort the physician to keep himself cool, for in matters of faith, counter-irritation is at best but a doubtful remedy.

If we may judge of the future from the past, little can be expected, in the present state of things, from legislative enactments for the suppression of quackery. The importance of the subject has not been sufficiently impressed upon the minds of the people. Instead, therefore, of petitioning for legislative interference, let the people first be enlightened upon the point; let them be made to realize the extent of the evil and its ruinous consequences, and in due time wholesome laws will be enacted, which will be duly enforced, and produce the desired effect.

The laws which have heretofore been passed in these States for the suppression of quackery, so far as my knowledge extends, have generally failed of accomplishing the benevolent intentions of the different legislatures. But this is not all; they have, in many instances, not only failed of their object, but have actually operated as a bounty upon quackery. For example, the statute of this Commonwealth deprives the quack doctor of the privilege of collecting his accounts by law; this, instead of depriving him of his fee, affords him a fair excuse for demanding it in advance, a rule which the whole fraternity have always endeavored to enforce upon their patients.

The following case, which occurred a few years since, will exhibit a promptness in collecting, which has rarely been surpassed by practitioners who have the law on their side.

A German doctor, on his journey from Vermont to Boston, made a short stop in a village within a few miles of my residence,—he called upon all the invalids, examined their cases, told them exactly how they felt, and that he had cured thousands like them in the “old countries.” But having had a great deal of business to do on his journey, he had completely exhausted his whole stock of medicines: and happening to be a little short of funds just at that time, he concluded, after much deliberation, to take their phials, and a little ready money to purchase the necessary medicines, and call on his return and cure them up. It was said, moreover, that he was a pious man,—kind-hearted and good to the poor; where they were unable to advance two dollars, he condescended to take one, and when they had no money, he generously received their empty bottles, to be filled with medicines without fee or reward. This little artifice was contrived and executed with so much address, that in the short space of two days he not only collected their empty phials, but actually received forty dollars in cash, and straightway took his journey for Boston.

But disappointment is the common lot of man; for some unaccountable reason, which has never been clearly explained, the doctor did not happen to return that way, and has never been heard of since. But this has become an old affair; these people never mention it now.

In a government like ours, where the people make and administer their own laws, a statute which does not harmonize with public sentiment, will be repealed, modified or nullified; in a word, it will never be enforced. A law which would deprive a citizen of the privilege of tampering with the lives of his fellow citizens, might be deemed an infringement upon the rights of the people, and incompatible with the spirit of our free institutions.

In some of the governments of Europe, quackery is restrained by statutes which subject the offender to severe penalties. In Russia, for example, no one is allowed to visit the sick, who has not been previously examined by the College of physicians, under the following penalties, to wit,—if he be a native, he is liable to be sent to Siberia, and to have his property confiscated; if a foreigner, to be sent out of the empire.

In Germany, no empiric is allowed to exhibit a single nostrum. This circumstance will account for the multitude of German quacks with which this country is infested. These are generally birds of passage, and as their works will follow them, they seldom stay long in a place. Too indolent to labor, they embark with their goods and chattels for this land of freedom, which they expect to find flowing with milk and honey; they arrive among us without much silver or gold, but this deficiency is abundantly supplied to them by a double portion of brass, which too often passes here as true coin; this, together with what is commonly called a “knowledge of men and things,” constitutes their whole stock in trade. Our people are hospitable to strangers, and take them in,—then in return are taken in themselves. Dr. Moor observes, these are generally men of superficial knowledge, and a considerable degree of natural shrewdness, and such a portion of impudence as sets them above embarrassment, even when their ignorance and fraud are made manifest.

The people of these States are intelligent, industrious, and enterprising. Through the medium of the public press, a mass of useful information is constantly furnished to every class of our citizens. The thousands of newspapers and periodicals which are circulated among us every day, abundantly prove that we are a reading people; we rejoice that it is so,—for we rely principally upon the information of the people for the permanency of our present form of government; but it unfortunately happens that the newspapers are the channels through which the greater part of quack medicines are puffed into notice; some of these papers derive their principal support from advertisements of this description.

It is curious enough to notice the ingenuity with which some of these things are got up. I will, with your indulgence, exhibit a single specimen of this kind of advertising,—we will take, for instance, “Dr. Relfe's Aromatic Pills,” for females. Here we find a medicine offered for sale, with which the purchaser would expect to procure abortion. The advertisement is couched in artful phraseology, still the language is too plain to be misunderstood, even by that class of individuals for whom it is intended. These pills are said to be innocent in their operation, but powerful in removing female obstructions; married ladies will find them equally useful, except in cases of pregnancy, when they must not be taken. Price five dollars a box. There is the article; there is the price; and who can mistake the object?

Now please to mark this prohibition; these pills are not to be taken by married ladies during pregnancy. I will illustrate this prohibition by an anecdote of the Revolutionary war. A portion of the American army was stationed, at a certain time, near the residence of wealthy farmers, where pilfering from the inhabitants was strictly prohibited by a general order: a number of the officers, while walking together at sunset, discovered above their heads a flock of turkeys perched upon a tree. One of these officers turned to his waiter, and observed to him, with a significant nod, John, you perceive here are turkeys, but remember, they are not to be disturbed. This prohibition was perfectly understood,—and it is hardly necessary for me to add, that these officers supped upon turkeys that night.

This is one of the many cases where an inert medicine may be productive of fatal results; the promise of a safe and certain remedy will diminish the fear of multiplying risks. A trial of this medicine would of course end in disappointment. Then comes the danger; the disappointment would be directly calculated to drive the deluded wretch, as a last resort, to the commission of suicide; then the solemn farce of the Coroner's inquest closes the scene.

Another circumstance, connected with the trade, seems to require a passing remark; the profits accruing to the retailer from the sale of quack medicines, hold forth a powerful inducement for him to circulate them as extensively as possible. These articles are deposited with the retailers of other goods in all parts of the country, to sell or return. The patentee will frequently allow his retailing agents fifty per cent, profits on their sales. Handbills proclaiming their wonderful efficacy are therefore displayed in conspicuous parts of their stores, to attract the attention of their customers; this is done, too, by men who have conscientiously abandoned the sale of ardent spirits. When reminded of their inconsistency, they excuse themselves by saying, “people must see and judge for themselves.” Still the charge, of leading the weak and credulous into temptation, must rest upon them. It is not only hoped, but confidently believed, that the time is not far distant, when no man of respectability will be found willing to become an agent in this work of imposition and fraud. And unless we are greatly deceived, the signs of the times will justify the prediction. We are led to this conclusion, from the well known fact that great moral evils carry with them the rudiments of their own destruction.

This, verily, is an age of inventions; innovation is the order of the day; we have changes for the better, and changes for the worse. For instance, our ships, our land carriages, and our printing presses are propelled by steam; then, by the application of the same power, with the assistance of poisonous vegetables, our credulous invalids are hastened on to “that undiscovered country, from whose bourne no traveller returns.”

This is moreover a day of discussion: every thing is discussed; we have orations, addresses, lectures, and long speeches upon all subjects, and, I had almost said, upon all occasions. In former times, these duties devolved almost exclusively upon clergymen; but it is now ascertained, that not only clergymen, but laymen, also, can give lectures upon subjects which have engaged their particular attention. In fact, almost any man of common intelligence is capable of lecturing upon something.

This is as it should be; many advantages have resulted from multiplying this class of public teachers. The individual, during his preparation for a public discourse, will be almost sure to gain for himself more or less information upon his subject, which will ultimately be added to the common stock. Then curiosity to hear the maiden speech of an obscure individual will sometimes fill a house to overflowing. With a knowledge of this fact, the manager of the Theatre announces “a gentleman, for his first appearance on any stage.”

If the speaker be well qualified for his undertaking he will always impart light and instruction to his hearers, which will turn to account. And if he should happen to be a little deficient, or even poorly qualified, he may excite a laudable emulation among his audience, which should always be cherished; they would naturally turn their attention to what might have been said upon the topic under discussion; many a modest man, while listening to a dull discourse, has experienced the heartfelt conviction, that he could have treated the subject better himself. The puny production of him who possesses but one talent, may rouse the attention of clearer heads, and assist in developing the mental resources of a whole community.

Mankind are gregarious, they form societies and associations, for the purpose of directing the united efforts of the multitude to objects which could never be accomplished by individual exertion: and although, within a few years past, this system may have sometimes been applied to frivolous objects, and in some instances carried to ridiculous extremes, still it must be admitted that much good has resulted from it.

For the truth of this assertion, no better proof can be required than the brilliant success which is crowning the exertions of the great association for the suppression of intemperance. This grand work is going on, conquering and to conquer, with a steady aim to the accomplishment of the ultimate object. The fruits which have already been realized from the well-directed efforts of this association, have compelled even skeptics to admit, that this in reality is one of the wonders of the age. This great change has been brought about by an entire change in public opinion; the change in public opinion has been effected by a general diffusion of knowledge among the people upon this particular subject.

I will give one other instance of the overpowering influence of public opinion. Some few years ago, the attention of the people was directed, by some newspaper essays and discussions, to the subject of Lotteries, as a nuisance which required investigation; then, the timely discovery of the embezzlement of a few hundred dollars, together with a suicide which grew out of it, produced an excitement which has banished this species of gaming from our commonwealth. Public sentiment has proclaimed to the venders of lottery tickets, in a tone of energy which cannot be resisted, “thus far shalt thou go, and no farther.”

From these, and other instances which might be adduced, we arc led to infer, that the people will ever be disposed to do right, when they are brought to realize that they are doing wrong.

That the suppression of quack medicines is an object of importance second to none, save that of intemperance, is a truth which will be admitted by everyone, who may give the subject a thorough investigation. The remedy in both cases must be the same; namely, a change in public opinion. The people are now disposed to investigate for themselves; they seem unwilling to take any thing on trust. The antiquity of a system will no longer guarantee its continuance. This therefore seems to be a favorable time to commence this great work of reformation. But in order to insure success, the subject must engage the attention of individuals of influence and character out of the Medical profession; in a word, it must become a common cause, or effort will be useless.

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