Snake Oil Revisited: Household Medicine and the Condescension of Posterity

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The best-remembered snake oil salesman, Clark Stanley, handled live snakes in a turn-of-the-century medicine show. In front of the audience, he would kill one, extract its oil, and then blend, bottle, and label Clark Stanley’s Snake Oil Liniment, for sale after the show. Although “snake oil” has come to mean any quack medicine or indeed, any kind of panacea, there may have been more than hokum to its healing powers. Ninety years later, a respected teacher of botanical medicine and author of field guides to medicinal plants offered persuasive testimony to that effect on an international herbalists’ listserv.

There was more than hokum to many of the “patent” or proprietary medicines[1] sold before the 1906 Pure Food and Drug Act, most of them compounded not from snakes but from medicinal plants. These products and their marketing have been a favorite topic for historians of advertising, who describe how intense competition and the development of transcontinental and international markets motivated energetic entrepreneurs to develop new marketing techniques. Patent medicine did not require a large capital investment. Clark Stanley was not the only medicine show performer to do his bottling at or near the venue, and Philadelphia druggist Henry Helmbold, who got rich on his diuretic Extract of Buchu, claimed to have begun production with fifty cents. With low barriers to entry, huge potential markets, and many examples of successful firms, the industry was highly competitive. Proprietary medicine makers therefore had to argue for the unique merits of their remedies, and their innovative advertising associated their products with those claims by means of trade names, emblems, and symbols of reassurance or potency. Historians who have used nineteenth-century periodicals can testify both to the ubiquity of ads for the most popular patent medicines and to the extensive advertising for the many we have never heard of.

But advertising historians have not concerned themselves with the products themselves, relying primarily on James Harvey Young’s 1961 book Toadstool Millionaires, also a standard source for historians of medicine.[2] Scholars following Young have dismissed plant-based medicines and their ingredients as utterly harmless or incredibly harmful or sometimes both, charging manufacturers with fraud, and attributing any beneficial effects to alcohol, other addictive ingredients, or the placebo effect. The arguments are well known and often repeated, echoing both Young and such historical voices as Collier’s muckraker Samuel Hopkins Adams and Ladies’ Home Journal editor Edward Bok, whose writing informed the campaigns for the 1906 law.

There may be some truth to the placebo charge, and few of these medicines were as powerful or fast-acting as modern drugs, but patent medicines were not inert like the placebos in modern drug trials; their formulas incorporated plants and minerals long understood to affect people’s bodies.[3] And while many herbal medicines were indeed formulated with alcohol, there was a good reason. Alcohol is the best solvent for extracting a broad range of medicinal constituents from plants and for preserving the extraction, “indispensable and irreplaceable” in pharmacy, according to John Uri Lloyd, a president of the American Pharmaceutical Association whose manufacturing company supplied botanical physicians.[4] Besides, most of these remedies were consumed by the spoonful. Chugging them would have been unpleasant and expensive.

Lydia E. Pinkham’s Vegetable Compound, the enormously popular women’s medicine that Samuel Hopkins Adams called a “dangerous drug used largely by drinkers,” was formulated from plants traditionally used for menstrual cramps and menopausal symptoms. Although it was widely advertised for serious illnesses, this medicine addressed the much larger market of women suffering from more ordinary complaints. Lydia Pinkham, whose sons turned a remedy she developed into the highly successful patent medicine company that bore her name, started as a local healer in Lynn, Massachusetts. Her surviving notebook of case histories indicates that she tailored her recommendations to individual cases, prescribing dozens of plants besides those in the medicine her sons marketed with her trademarked image. When women bought the Compound, they were purchasing one formula, pitched to as many consumers as possible. The commodification of Lydia Pinkham’s image, her medicine, and the advice given in her name were hardly typical: this was an unusually successful company, with marketing devised by extraordinarily innovative entrepreneurs. But understanding the nature of the plants in this formula helps to take an interpretation of household medicines beyond accusations of fraud and quackery.[5]

Like purchasers of Nyquil and ibuprofen, and like people who buy herbal products today at Whole Foods or the health food store, many consumers who bought popular remedies were looking for relief from everyday ailments they did not consider consequential enough to merit a doctor’s attention. Others suffered from sexually transmitted infections they were embarrassed to reveal to physicians. People might seek expensive medical assistance when they broke bones or feared death, but bruises, burns, muscle strains, and digestive problems called for liniments, salves, and tonics. We need not construe people looking for relief as credulous dupes of advertising. Like people buying over-the-counter remedies today, they may have bought a first bottle because they bought the pitch, but if they came back for a second, they probably thought it had done some good.

Before the invention of aspirin in 1897, there was nothing to alleviate pain besides plant medicines; willow bark and meadowsweet offered mild relief, and even respectable people used drugs made from the stronger and more reliable opium poppy. Before sulfa drugs were developed during the 1930s, the most effective antimicrobial agents were derivatives of mercury and arsenic; numerous doctors and patients opted for less toxic plant medicines. Herbal treatment was not an alternative to seeing a doctor, nor did it suggest dissatisfaction with professional care. All kinds of physicians prescribed plant drugs, and commercial medicines were formulated with those same plants. Merck’s 1901 Manual of the Materia Medica, which lists “all those . . . drugs and chemicals . . . in current and well-established use in the medical practice of this country,” includes plant materials now considered cooking ingredients (such as cardamom seeds and ginger root), the materia medica of modern herbalists (including golden seal and valerian), herbs and chemical derivatives from plants now considered street drugs (like cannabis and heroin), and derivatives still employed by physicians (such as morphine and atropine, a derivative of belladonna).

These plants, and substances derived from them, had long histories of effective use in clinical practice, and they were the drugs that Merck sold, as did Parke-Davis, Eli Lilly, and other early pharmaceutical companies. Along with the wholesale drug firms located in every port city, these companies obtained plant materials from all over the world. Beginning in 1871, Parke-Davis sent expeditions to Central and South America, the West Indies, the Pacific Northwest, and Fiji to prospect for promising new drug plants.[6] Domestically, too, plants collected from forests or grown on farms entered commerce, traded for cash or manufactured goods at country general stores, which sold them to wholesalers.[7] These practices endured into the twentieth century in the cash-scarce Appalachians, where many important plant medicines grew wild.[8] Consumers could purchase plant medicines at retail druggists (which also sold herbal tonics at their soda fountains) and from the up-and-coming department stores and mail order houses.

Central to the early development of the domestic trade were businesses operated by the Shakers, whose communities grew and sold medicinal plants and herbal preparations, creating a Shaker brand image that communicated high quality decades before they marketed their famous furniture.[9] They sold herbs in bulk to urban drug wholesalers and even internationally; by the 1840s Shaker communities were shipping thousands of pounds of dried plant material and thousands of bottles of prepared medicines. They soon built new production facilities with state-of-the-art equipment and expanded distribution with a Shaker Depot in New York City’s herb district. Already innovators in the commercial production and distribution of individual medicinal plants, Shakers became leaders in patent medicine after the Civil War, selling compounds with secret formulas: Norwood’s Tincture, Mother Siegel’s Curative Syrup, and various medicines branded with the Shaker name.

Medicinally potent plants were processed and sold both by proprietary medicine makers, who used secret formulas and sold to the general public, and by companies that labeled themselves “ethical” and marketed exclusively to physicians and druggists. Merck, Lilly, and Parke-Davis sold a wide range of products—herbal and non-herbal, single plants and chemicals as well as compounds. In the 1880s, for example, Parke-Davis offered cannabis in three forms: packages of pressed, dry herb; a liquid preparation; and pills, coated with sugar and gelatin, in three dosages.[10] By the turn of the century, the company offered several more preparations of the drug, including chocolate-coated tablets of cannabis extract. “Cannabis is used in medicine to relieve pain, to encourage sleep, and to soothe restlessness,” explained the 1926 edition of the United States Dispensatory, a 1,792-page reference work for pharmacists and physicians. But the Dispensatory complained about variability among samples of this drug and questioned the claims Parke-Davis and other companies made that their products had been tested and standardized.[11] By that time cannabis was illegal for nonmedical purposes in many states; it was first classed with narcotics in federal legislation in 1929.

Prescriptions were not legally required for any drug before 1914, and the current distinction between prescription and over-the-counter medications was not enacted until 1951. The line between nineteenth-century proprietaries and physician-prescribed medicines was by no means clear. They were all formulated with the same plants, minerals, and solvents. Many physicians prescribed proprietaries. Although the American Medical Association adopted numerous resolutions against secret formulas, medical journals not only carried ads for patent medicines, but used public relations material from the proprietaries as editorial matter.[12]

Both Lydia E. Pinkham’s Vegetable Compound and Parke-Davis’s herbal products were eclipsed by chemical drugs, biological agents, and other powerful modern pharmaceutical products. The attack on self-dosing with commercial medicines, which began in the states long before the 1906 law, was taken up again by consumer advocates in the 1930s. The racialized and xenophobic campaign against cannabis led by Harry Anslinger, for 32 years the Commissioner of the Federal Bureau of Narcotics, and the subsequent tax laws made medical use of that plant anathema for many decades, but so did the decline of all kinds of plant medicines.[13] Isolated and synthesized chemical drugs were better suited to uniform manufacture and distribution; they were stronger, faster-acting, and more therapeutically predictable than plant-based medicines.

For much of the twentieth century, medical authorities and the media disparaged botanical medicines. To some extent, the lore of herbal healing was kept alive by folklorists, ethnobotanists, and gardeners. Beginning in the 1960s, practices that had nearly vanished were revived by women’s health activists and hippies, who challenged chemical drugs along with other products of the military-industrial complex. Now herbal products are again for sale at every drugstore, the objects of fads and the subjects of marketing gimmicks. Accurate and useful information on growing, processing, and using medicinal herbs is widely available from a well-developed international community of listservs, blogs, and podcasts with no commercial interest in particular products as well as from purveyors.

Plant medicines are so popular that doctors’ offices display posters warning of potential interactions between herbs and prescription medications. Big Pharma firms produce some of those posters, but, like Parke-Davis in the nineteenth century, they also send bioprospectors to tropical rainforests in search of new drugs. The resurgence of medicinal plant use suggests consumer resistance to many of the trends of modern medicine.[14] Contemporary bioprospecting, echinacea cough drops, and medical marijuana all demonstrate that plant-based drugs are taken seriously by pharmaceutical firms, voters, and state legislatures. Historians should rescue them from what E.P. Thompson called the “enormous condescension of posterity.”[15]

Susan Strasser has been praised by the New Yorker for “retrieving what history discards: the taken-for-granted minutiae of everyday life.” Her books include Never Done: A History of American Housework (1982), Satisfaction Guaranteed: The Making of the American Mass Market (1989), and Waste and Want: A Social History of Trash (1999). She is the Richards Professor Emerita of American History at the University of Delaware and has taught at the Evergreen State College, George Washington University, Princeton University, and the Bard Graduate Center for Studies in the Decorative Arts, Design History, and Material Culture. She is also an OAH Distinguished Lecturer. For her current work, including her research on medicinal herbs and her lecture series “A White Historian Reads Black History,” see her website, www.susanstrasser.net.

[1] “Patent medicine” was almost always a misnomer, since patent applications required revealing the formula. Most manufacturers sought other protections: trademarks, patents on containers, and copyrights on labels and promotional materials. See Joseph M. Gabriel, Medical Monopoly: Intellectual Property Rights and the Origins of the Modern Pharmaceutical Industry (University of Chicago Press, 2014).

[2] James Harvey Young, The Toadstool Millionaires: A Social History of Patent Medicines in America before Federal Regulation (Princeton, 1961).

[3] On placebo, see Susan Strasser, “Sponsorship and Snake Oil: Medicine Shows and Public Culture,” in Marguerite S. Shaffer, ed., Public Culture: Diversity, Democracy, and Community in the United States (Penn Press, 2008), 101.

[4] John Uri Lloyd, Wolfgang Ostwald and Walter Haller, “A Study in Pharmacy,” Journal of the American Pharmaceutical Association XIX (October 1930), 1081. See also John Uri Lloyd, “Eclectic Fads, No. 2–Alcohol Not ‘An Eclectic Fad,’” Eclectic Medical Journal LXXX (March 1920), 1-8.

[5] Samuel Hopkins Adams, “II-Peruna and the ‘Bracers’—The Great American Fraud,” Collier’s, October 28, 1905, 17. On the herbs in Lydia E. Pinkham’s Vegetable Compound, see Susan Strasser, “Commodifying Lydia Pinkham: A Woman, A Medicine, and a Company in a Developing Consumer Culture,” Working Paper #32, ESRC/AHRB Cultures of Consumption Programme, 11-14, www.consume.bbk.ac.uk/working_papers/Strasserlydia1704.doc.  Lydia Pinkham’s notebook is in the Lydia E. Pinkham Medicine Company Collection, Arthur and Elizabeth Schlesinger Library on the History of Women in America, Radcliffe Institute for Advanced Study, Harvard University.

[6] Milton O. Hoefle, “The Early History of Parke-Davis,” Bulletin for the History of Chemistry, 25 (No. 1, 2000), 28–34.

[7] See the papers of Calvin Cowles, who marketed drugs from western North Carolina during the 1850s, in the Southern Historical Collection, University of North Carolina library, and at the North Carolina State Archives.

[8] See C.O. Ewing and E.E. Stanford, “Botanicals of the Blue Ridge,” Journal of the American Pharmaceutical Association, 8 (1919), 16-26; Edward T. Price, “Root Digging in the Appalachians:  The Geography of Botanical Drugs,” Geographical Review 50, No. 1 (Jan., 1960), 1-20; Gary R. Freeze, “Roots, Barks, Berries, and Jews: The Herb Trade in Gilded-Age North Carolina,” Essays in Economic and Business History, 13 (1995), 107-27.

[9] See Amy Bess Miller, Shaker Herbs : A History And A Compendium (C. N. Potter, 1976); Theodore R. Schatzki, The Site Of The Social : A Philosophical Account Of The Constitution Of Social Life And Change (Pennsylvania State University Press, 2002), pp. 25-38 and passim;  Stephen J. Stein, The Shaker Experience In America: A History Of The United Society Of Believers (Yale University Press, 1992), pp. 133-48.

[10] Notice no. 159, from James Van Deusen, Foreman of the Pressed Herb Dept., Parke, Davis & Co., in Kremers files C38(a)I/Parke, Davis, 1886, American Institute for the History of Pharmacy.  “Improved Forms of Administering Standard Medicine,” p. 8, in Parke, Davis & Co. Brochures, Lloyd Library 101/67/24.

[11] Horatio Wood, et. al., The Dispensatory of the United States of America, 21st edition (J.B. Lippincott Company, 1926), p. 280. We Test Them Physiologically,” Parke, Davis advertisement, The Pharmaceutical Era, June 29, 1899, p. 7.

[12] David L. Dykstra, “The Medical Profession and Patent and Proprietary Medicines during the Nineteenth Century,” Bulletin of the History of Medicine, 29 (1955), 408-409.

[13] See Richard J. Bonnie and Charles H. Whitebread II, The Marijuana Conviction:  A History of Marijuana Prohibition in the United States (The Lindesmith Center, 1999).

[14] See the work of Nancy Tomes, especially Remaking the American Patient: How Madison Avenue and Modern Medicine Turned Patients into Consumers (North Carolina, 2016).

[15] E.P. Thompson, The Making of the English Working Class (Vintage, rev. ed.,1980), p. 12.

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