Good for Man or Beast: American Patent Medicines from 1865 to 1938

TUSCALOOSA, Ala. — In these days of revolutionary advances in both our medicine and in our understanding of the nature of disease, it is easy to forget that less than 100 years ago, the germ theory was in its infancy, the Food and Drug Administration was merely a glint in FDR’s eye, and trips to the doctor were likely to make patients sicker.

On the other hand, we are also in an age when more and more people are turning to alternative medicines, as herbal remedies enjoy resurgence and anecdotal accounts of their efficacy flood the market. Perhaps the world of patent medicines, and the motivations behind their use generations ago, is not all that difficult for us to fathom.

In the winter 2001 issue of Alabama Heritage, Michael A. Flannery revisits the phenomenon of patent medicines at the turn of the 20th century. In doing so, he charts their rise and fall, as well as the myths and facts surrounding them.

Patent medicines, often prepared from secret formulas and sold directly to the public without prescription and without independent verification of their safety and efficacy, were not always fraudulent, writes Flannery. Often their purveyors actually believed they worked. In some cases, such as with Lydia Pinkham’s Vegetable Compound, extolled as an aid to ease menstrual cramps, these elixirs can be proven today to have contained active ingredients that probably did address the complaints they were meant to address.

It is the comic and, sadly, sometimes tragic, cases that are the most memorable, however. Many products with outlandish names and garish packaging, such as Dr. Kilmer’s Swamp Root or Pink Pills for Pale People, were little more than placebos or sweet-tasting intoxicants. Others of these drugs proved dangerous, even fatal. The most egregious of these were children’s remedies containing stupefying doses of morphine, opium, and other narcotics known even then to be hazardous.

The final straw came in 1937, when the S.E. Massengill Company of Bristol, Tenn., began experimenting with a drug called sulfanilamide. Touted in the days before penicillin as “the only known chemical capable of curing serious systemic bacterial infections in man in doses allowing a satisfactory margin of safety,” it seemed a much-needed panacea. The problem was there were few solutions in which it readily would dissolve. Massengill chemists eventually discovered that it would dissolve in diethlyene glycol, the basis for modern antifreeze.

The subsequent disaster (over 70 deaths were reported) spurred the federal government to become a more active regulatory watchdog of the pharmaceutical industry. In June 1938, FDR signed the Federal Food, Drug and Cosmetic Act into law. After minor tweaking, the FFDCA served consumers well by replacing the laissez-fare attitude of the drug industry and ushering in a safer, more judicious way of treating the nation’s infirm.

Michael A. Flannery is associate director for historical collections, Lister Hill Library of the Health Sciences, University of Alabama at Birmingham. He received his M.L.S. from the University of Kentucky and his M.A. in history from California State University, Dominguez Hills. Flannery has written extensively on the history of pharmacy and pharmaco-therapeutics. His books include John Uri Lloyd: The Great American Eclectic (1998), co-authored with Alex Berman, and America’s Botanico-Medical Movements: Vox Populi (forthcoming, 2001). He is presently working on a history of pharmacy and drug provision during the Civil War.

Alabama Heritage is a nonprofit quarterly magazine published by The University of Alabama and UAB. To order the magazine, write Alabama Heritage, Box 870342, Tuscaloosa, Alabama 35487-0342, or call 205/348-7467.