With a degree in biochemistry, Leah works for a small biotechnology company and enjoys writing about science.
Medicine Without Federal Regulation
A lack of federal regulations for truth in advertising and verification of safety and effectiveness created an environment ripe for businessmen to peddle drugs of dubious merit in the 19th century. Termed “Patent Medicine,” shows were staged around the country to entice people to buy concoctions compounded with various ingredients. Often, the active ingredient was alcohol. Some of the medication contained morphine, opium, and other addictive and dangerous drugs.
In 1906, the Food and Drug Act was passed by the legislature and required medicine companies to accurately represent ingredients used in their products. Unfortunately, the requirement did not require or enforce safety and effectiveness until 1938.
While most patent medications are no longer in use, a few (Carter’s Little Pills and Haarlem Oil) are still available for purchase as over-the-counter remedies. These medications have either been demonstrated as safe, as in the case of Carter’s Little Pills, which is the laxative bisacodyl, or are not regulated for claims. Haarlem Oil is now considered a “dietary supplement,” which is not regulated by the FDA.
Dr. Tutt’s Liver Pills
Advertised to cure constipation, the pills sold by Dr. Tutt’s Manufacturing Company (New York, USA) claimed “constipation is a crime against nature and no human being can be well for any length of time while constipated.” Advertisements in newspapers around the country extolled the length of time the pills had been in use and contained testimonials of faithful clients.
Analysis by the Henry Ford Museum indicates the pills contain a large amount of mercury, which is toxic and can cause memory problems, anxiety, hearing difficulties, and more. Mercury was a common treatment for syphilis and other medical problems in the 1800’s, as the metal was not recognized as dangerous in this era.
Mrs. Winslow’s Soothing Syrup
Mothers who were up all night with a crying, colicky baby were enticed by a medication that immediately calmed their infants. The syrup was effective due to the inclusion of morphine and alcohol. Each fluid ounce contained 65 mg of the opioid, and the dangerous effects included addiction, coma, and death. It is unknown how many infants died as a result of this medication.
Invented in the 1840s in New York, the Anglo-American Drug Co. aggressively marketed the syrup to desperate mothers. The bottles' labels never indicated the active ingredients, so parents did not realize they were giving their babies a mixture of morphine and alcohol.
The American Medical Association filed a suit against the company in 1915, subsequent to the passage of the 1906 Food and Drug Act. The company agreed it had behaved recklessly and fraudulently. The company was fined $100 for the promotion and sale of the drug. The Soothing Syrup was reformulated to contain laxatives and anti-flatulent medication in the early 1900s.
Bayer Heroin Hydrochloride
Bayer invented heroin in the late 1800s, initially intended as a cough suppressant and an alternative to codeine and morphine. Since conditions like tuberculosis and pneumonia were frequent problems in the late 1800s, thousands of doctors were sent free samples of the new medication to try. The advertisement for the new cough medication indicated:
“Bayer Pharmaceutical Products HEROIN-HYDROCHLORIDE is pre-eminently adapted for the manufacture of cough elixirs, cough balsams, cough drops, cough lozenges, and cough medicines of any kind.”
Bayer stopped manufacturing heroin in 1913, and the drug was banned in the United States in 1924.
Female medical problems were a big target of patent medicine companies in the 19th century. Targeting irregular menstruation, the Martin H. Smith Company in New York manufactured a drug composed of Ergot and Apiol.
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Ergot is a fungus that grows on rye and can induce hallucinations in large doses. The alkaloids produced by the fungus cause convulsions and tremors and the victims may appear manic and dazed. The fungal infection inhibits lactation, may induce abortion, and can prevent uterine hemorrhage.
Apiol was intended to induce menstruation but would also induce abortion in pregnant women. The compound is derived from parsley and is safe in small doses but can cause fever, kidney and liver damage, and death in large doses.
Warner’s Safe Cure
Bright’s disease causes chronic inflammation of the kidneys, and Warner’s Safe Cure was marketed to cure the condition. Patented by H. H. Warner in Rochester, NY, the medicine was initially sold in 1849. The ingredient list included alcohol, glycerin, and potassium nitrate (saltpeter). Potassium nitrate is contraindicated in those with renal failure – Warner’s Safe Cure was not safe, and had the potential to seriously injure consumers.
Tonics and Elixirs: Documentary on 19th Century Medication
Dr. John Hooper’s Female Pills
This concoction was advertised for any ailment that could be conjured. The pills were to be used for giddiness, poor digestion, a “dejected countenance,” a dislike of exercise and conversation, and most certainly after childbirth. The pills would "purge off those gross humours [sic], which when retained, generate numerous diseases.”
The dosage of this drug ensured steady sales, as it was recommended that young women take “two or three boxes” to cure digestive issues. All women were encouraged to take the pills, from age seven years until menopause.
“They are the best medicine ever discovered for young women of a pale, sallow complexion or when billous, or afflicted with what is commonly called chlorosis, or green sickness, which two or three boxes seldom fail of curing.”
The pills contained dried sulphate of iron, powdered senna (a laxative), powdered canella (tree bark), powdered jalap (dried root of Ipomoea purga), aloes, oil of pennyroyal, and “excipient.” The effective ingredients were largely strong laxatives.
Doan’s Backache Kidney Pills
An active ingredient of potassium nitrate, or saltpeter, was included in Doan’s Kidney Pills. Testimonials were published in newspapers alleging the efficacy of the pills, which were supposed to almost instantly cure consumers with chronic backache. Intended to cure backaches caused by kidney problems, the saltpeter actually worsened kidney function and had the potential to kill those who had renal problems.
Kimballs’s White Pine and Tar Cough Syrup
With chloroform as an active ingredient, Kimball’s cough syrup was intended to relieve coughs, colds, and sore throats. Chloroform was a common ingredient in toothpaste, ointments, and cough syrups until late in the 20th century. The use of chloroform was dangerous due to potential inhalation, which could cause ataxia, coma, or death. Long-term ingestion of cough syrup containing chloroform could lead to permanent kidney and liver damage.
Chloroform for ingestion was banned by the FDA in 1976 after cancer was reported in laboratory animals. Chloroform is now listed as a category 2BG carcinogen, with possible carcinogenic activity in humans.
Popular Medicine Shows
Enticing large numbers of the public to learn about the medicines for sale, medicine shows traveled around the country to promote their goods with a promise of entertainment. The main salesman (and usually the company owner) would be referred to as “doctor” or “professor,” though most purveyors of medicine in this era were not medical doctors or scientists. Most of the time, the shows were held on city streets with troupes of performers demonstrating strength and health obtained from the “magic elixir.” Some members of the audience were paid by the company to act as if they had a physical ailment, and the “doctor” would then give the audience plant the medication. The actor would then demonstrate his or her miraculous cure.
The last traveling medicine show ended in 1951 for an elixir named Hadacol. The entrepreneur Dudley LeBlanc marketed the elixir as a panacea for epilepsy, cancer, and other ailments. The elixir’s name was Hadacol because LeBlanc “had to call” it something. Hadacol contained B vitamins, alcohol, and diluted hydrochloric acid. He toured the country with celebrities and was the second-biggest advertiser in the country. The Hadacol enterprise fell apart when the public found out LeBlanc was in trouble with the IRS and the company was in debt.
Kickapoo Indian Sagwa Renovator
Many patent medication firms relied on storytelling and shows to influence their audience. The Indian Kickapoo Company was founded in the late 1800’s with a fanciful tale of a chief from the Kickapoo tribe and his “Sagwa” medication. Charles Bigelow, one of the company’s founders, claimed he was dying in the wilderness when the chief found him and saved his life with the tribal medicine. Hosting shows all over the country, the company capitalized on a belief that native Americans had secret healing powers. Native Americans, none of which were from the Kickapoo tribe, were used in the shows to sell Indian Worm Killer, Indian Cough Cure, Buffalo Salve, and the Sagwa laxative.
The medication was advertised as a medication to cure headache, upset stomach, all disorders of the liver and blood, and “female disorders.” The elixir contained alcohol, rhubarb, mandrake, capsicum, guaiacum, and sal soda as active ingredients.
Hamlin’s Wizard Oil
A liniment rather than an ingestible medication, Wizard Oil was advertised as a way to soothe muscle ache, sunburn, sprains, and insect bites. Sold through a series of medical shows that traveled the nation, the entertainment was a way to entice customers. Along with the medication, a Wizard Oil songbook could be purchased with “Old Familiar Songs and Words.”
Despite the passage of the 1906 Food and Drug Act, regulation of new medications was poor. The label must not contain fraudulent information about ingredients, but safety and efficacy were not addressed by the legislation. “Wonder drugs” were often sold without clinical trials for safety and effectiveness. The patent drug era was over, but public safety was still at risk. The most striking example was of a cough syrup dubbed Elixir Sulfanilamide in 1937. This drug was formulated with a newly discovered antibiotic had an extremely pleasant taste. The liquid form was easy to dispense to children. Unfortunately, the drug was compounded in diethylene glycol – a compound more readily identified as antifreeze. By the fall of 1937, more than 250 gallons of the medication had been distributed around the country. Oklahoma reported the first casualties when six patients developed renal failure and died. Nearly all of the FDA’s inspectors were called to investigate the matter, and the use of the diethylene glycol solvent in the medication was quickly identified as the deadly component. The FDA raced to recall the medication to prevent more deaths, but more than 100 people died as a result of the drug.
Massengill, the company which manufactured and distributed the elixir, had not broken any laws at the time. The labeling was accurate for the contents of the medication and it made no fraudulent claim as to the purpose of the drug. The shocked public rallied together to demand a better regulatory system for drug producers. The 1938 Food, Drug, and Cosmetic Act was passed shortly after the incident, requiring drug manufacturers to prove safety and efficacy prior to the sale of a drug on the commercial market.
How Elixir Sulfanilamide Changed Drug Regulation
Patent Medicines Still in Use
Carter’s Little Liver Pills
Marketed as a cure for headache, constipation, and indigestion, the Little Liver Pills were invented in Erie, Pennsylvania by Samuel J. Carter in 1868. The active ingredient is the stimulant laxative known as bisacodyl, and this patent medication is still available for purchase today. The FDA did require the name “Liver” be removed from the label, as the claim the product has any influence on the liver is fraudulent. The name of this patent medication is now simply called “Carter’s Little Pills.”
Haarlem Oil (Dutch Drops)
Haarlem oil is a patent medication that has been available for over 400 years. The product was discovered in Holland in 1696 and is now manufactured by Laboratoire Lefevre in France. The oil contains sulfuretted oils of turpentine and linseed. Current advertisements indicate it is the most “bioavailable form of sulphur” and is able to treat conditions ranging from jaundice and kidney stones to gout and intestinal parasites. The medication is also marketed for use in horses.
Other patent medicines still available include:
- Bromo-Seltzer and Alka-Seltzer
- Vick’s VapoRub (Vick’s Magic Croup Salve)
- Phillips Milk of Magnesia
- Coca-Cola, which originally had extracts from the coca plant
- 7Up, which was originally called Bib-Label Lithiated Lemon-Lime Soda. The original formulation contained lithium
- Bayer aspirin
Questions & Answers
Question: What was used for upset stomach in the 1850-1860s in the Midwest?
Answer: There were many patent drugs sold to address digestive complaints. One of the most common drugs sold was Stuart's Dyspepsia Tablets, which were advertised to "rest tired stomachs." These tablets were manufactured by the F.A. Stuart Company in Marshall, Michigan. These particular tablets actually listed their ingredients, which was rare for patent medicines. The ingredients listed were: goldenseal, bismuth, "hydrastis" (another name for goldenseal), and "nux." Nux is derived from the seeds of nux vomica, and contain strychnine. Continued use can cause poisonous levels of strychnine to build up in the body over time
Question: If I wanted to write a book of poetry regarding patent medicines and not infringe on any trademark or copyright (understanding that patent medicines were not trademarked), would I have to go about contacting any source?
Answer: The patent medicines were not trademarked, but some written material is protected by copyright. You will need to obtain permission from the author or verify the material is now in the public domain. If the material is in the public domain, you may use it with a proper citation.
Leah Lefler (author) from Western New York on May 18, 2018:
I completely agree, Glenn. The philosophical difference between the regulatory agencies in the USA and in Europe is striking. In Europe, a food additive must be proven to be safe before it is allowed for use. In the USA, a food additive must be proven dangerous to be prohibited for use in food. There are chemicals in the USA which would never be allowed in Europe, or at least are given an "E" number to demonstrate there is a questionable preservative or other artificial material in food. The good news is that all foods are required to list their ingredients, so we do have the ability to read the ingredients list and choose food that does not contain these ingredients, but not everyone among the general population is careful with reading labels.
Glenn Stok from Long Island, NY on May 17, 2018:
You’re right Leah. It’s still happening today. But even the FDA approves things that are questionable in my opinion. Almond Breeze milk, for example, has Carrageenan in it as a preservative. It’s on the label. That’s a chemical used as an airplane deicer. The FDA approves small quantities for human consumption.
Leah Lefler (author) from Western New York on May 17, 2018:
The lack of regulation really did lead to harm for many people, Glenn. While regulations can sometimes cause medication to take a long time to get to the market, ensuring safety and efficacy is paramount. The progenitor of the FDA formed a "poison squad" to test various food additives, including boric acid and other preservatives which were routinely added to food back prior to the addition of regulations. Lead salts were added to cheese to make the color more orange (all in the name of profit)!
This legacy still lives on in the "supplement" business, which is not regulated by the FDA in any way. There have been some calls to increase the FDA's role in the marketing of supplements (some of which are old patent drugs). There have been people who have suffered liver damage and even death from supplements, so it is likely a matter of time before laws are made regarding the sale of "natural medicines," too.
I am grateful to live in an era where medication is far safer, though with the current opioid epidemic, one wonders if the regulation of pharmaceutical companies (who encouraged physicians to dispense highly addictive medications like Oxycontin) goes far enough in ensuring a new medication does more good than harm for society.
Glenn Stok from Long Island, NY on May 17, 2018:
This is a very compete review of the history of patent medicine Leah. I didn’t even know the term until I read your article.
I found it interesting that there are still a few on the market that get around the regulations. It’s amazing that in the old days it was worse, since drug manufacturers didn’t have to report the ingredients. I wonder how many people developed dementia or Alzheimer’s because of the mercury in the medications.
It’s amazing how so many tonics and elixirs existed in those days that people used without having any idea what’s in them.
It’s sad that even after the patent medicine era (although some still exist today), there were still companies that mislabeled their medications and only got caught after people had died from it, as you talked about with Elixir Sulfanilamide in the 1930s.
I leaned a lot of fascinating facts from your article, and the images you included made it interesting too.
Leah Lefler (author) from Western New York on April 19, 2018:
I agree, Nichole! The FDA was necessary to curb abuses in the food industry (along with the patent drug industry). We used to have formaldehyde in milk and lead salts in cheese in addition to the opiates and toxic chemicals in patent medicine. I appreciate a free market, but there must be controls in place to protect the consumer from fraudulent practices.
Nichole Segrue from Lakewood on April 19, 2018:
Fascinating! Makes me thankful for the FDA!